The blind Chinese activist Chen Guangcheng was prepared to spend years in the US embassy in Beijing if necessary as he weighed his next move after escaping house arrest, the US ambassador has said.

But the future of the "barefoot lawyer" and his family is now uncertain, after he agreed to a deal allowing him to stay in China and study, with assurances from the government, only to then change his mind and ask to go to the US.

Chen, who is now in a Beijing hospital, said in a phone interview with the Guardian that he was worried about his health, the safety of relatives still in his home town and his lack of communication with the outside world. "I can't go out. No friends visit me. For a time, my cellphone did not work last night so I worry so much about my relatives back home.

"There are many people around my home with sticks and they have installed closed circuit cameras. I heard they are putting an electric fence around my home."

His health is another worry. "My condition is not very good. The blood in my stool is still very serious, and my leg is broken and in plaster," he said, before the phone was cut off.

His dramatic escape from 19 months of illegal house arrest in his home village in eastern Shandong province led to five days of difficult negotiations involving Chen, the US and Chinese officials.

"He knew the stark choices in front of him," the US ambassador, Gary Locke, told reporters.

"He knew and was very aware that he might have to spend many, many years in the embassy. But he was prepared to do that …

"And he was fully aware of and talked about what might happen to his family if he stayed in the embassy and they stayed in the village in Shandong province."

Lock added: "He made it very, very clear from the very, very beginning that he wanted to stay in China, that he wanted to be part of the struggle to improve the human rights within China."

But after he was reunited with his wife and children at a hospital in Beijing, his wife's account of threats from officials and his conversations with friends about the risks the family faced appear to have changed his mind.

"My fervent hope is that it would be possible for me and my family to leave for the US on Hillary Clinton's plane," the 40-year-old told the Daily Beast in an interview from his hospital room.

US state department spokeswoman Victoria Nuland confirmed that Chen and his wife had spoken to US officials and "they as a family have had a change of heart about whether they want to stay in China". She said US officials needed to talk further with Chen to decide on options.

It appears that as of lunchtime on Thursday officials had been unable to see him in person, but his friend Teng Biao, a well-known lawyer, said via Twitter that Chen's communications with diplomats were now going smoothly.

Asked about Chen's case at a regular press briefing, Chinese foreign ministry spokesman Liu Weimin said: "After Chen Guangcheng's release from prison he was a free person, as far as I know. He has been living in his home town."

Clinton, who is in Beijing for annual bilateral talks now overshadowed by Chen's case, urged China to protect human rights in remarks at the opening of the meeting, but did not mention the activist specifically.

"Of course, as part of our dialogue, the United States raises the importance of human rights and fundamental freedoms," the secretary of state said.

"We believe all governments have to answer our citizens' aspirations for dignity and the rule of law and that no nation can or should deny those rights."

© Guardian News and Media 2012

[Photo of Chen Guangcheng via AFP]