UNIVERSITY OF CALIFORNIA Los Angeles Modernization, Revolution, and Midwifery Reforms in Twentieth-century China A dissertation submitted in partial satisfaction of the requirements for the degree Doctor of Philosophy in History by Byungil Ann 2011 UMI Number: 3452026 All rights reserved INFORMATION TO ALL USERS The quality of this reproduction is dependent upon the quality of the copy submitted. In the unlikely event that the author did not send a complete manuscript and there are missing pages, these will be noted. Also, if material had to be removed, a note will indicate the deletion. UMI Dissertation Publishing UMI 3452026 Copyright 2011 by ProQuest LLC. All rights reserved. This edition of the work is protected against unauthorized copying under Title 17, United States Code. uest ProQuest LLC 789 East Eisenhower Parkway P.O. Box 1346 Ann Arbor, Ml 48106-1346 Copyright © by Byungil Ann 2011 The dissertation of Byungil Ahn is approved. lgYan £U*\ Dora Weiner '{MLUM^, Kathryn Bernhardt, Committee Co-chair 5 hilip C.C. Huang, Committee Conchchaia r University of California, Los Angeles 2011 ii TABLE OF CONTENTS 1. CHAPTER ONE Introduction 1 2. CHAPTER TWO Historical Background: Knowledge and Practices of Childbirth in the Pre- Guomindang period 26 3. CHAPTER THREE Who Should Assist Chinese Birthing Women? - The Ideology and Practices of the GMD Midwifery Reform 67 4. CHAPTER FOUR Living with Reform: How Did the GMD Midwifery Reform Shape Old-Style and Western-Style Midwives' Daily Lives? 116 5. CHAPTER FIVE The Limitations of State Medicine and the Failure of the GMD Rural Midwifery Reform (1928-1949) 161 6. CHAPTER SIX Ideology, Medical Discourses, and Practices of the CCP Midwifery Reform in the Early Revolutionary Period (1935-1952) 211 7. CHAPTER SEVEN Rural Midwifery Reform during Socialist Construction and the Great Leap Forward (1953-1960) 257 8. CHAPTER EIGHT A Socialist and Revolutionary Form of State Medicine-The CCP Midwifery Reform in Urban Areas 309 9. CHAPTER NINE Conclusion 380 CHARACTER LIST 401 Ml REFERENCES 407 iv LIST OF TABLES 1-1. Composition of the Women's Federation Files from 1949 to 1963 in Hebei Provincial Archives 23 3-1. Conditions for Each Obstetric Professional in Beijing, 1928-1932 99 6-1. Daily Timetable of Old-Style Midwives Retraining Program in 1952 Ding County 244 6-2. Daily Curriculum of Old-Style Midwives Retraining Program in 1952 Ding County 245 7-1. Distribution of Government Budget Expenditures, 1950-1957 262 7-2. Share of Agriculture in Capital Construction Investment 262 7-3. Budget for the Ministry of Public Health 263 7-4. Number of Hospitals and Hospital Beds in China 264 7-5. Budget Distribution in the Bureau of Public Health in Shanxi Province 265 7-6. Budget Distribution in the Bureau of Public Health in Hebei Province 265 8-1: Comparison between GMD and CCP Standard Curricula for Zhuchanshi Education 333 8-2. Curriculum for JieshengpolLaolao (Old-Style Midwife) Retraining Program in Beijing 345 8-3. Curriculum for Chanpo (Old-Style Midwife) Retraining Program in Shanghai 345 8-4. Assessment Chart Measuring the Success of Wutong fenmian 372 8-5. The Number of Articles in People's Daily on Wutong fenmian Per Year 373 v LIST OF FIGURES 1. Figure 3-1. The First Page of Obstetrics and a Selection of Illustrations 85 2. Figure 3-2. The First Pages of Taichan xuzhi and Accompanying Illustrations 86 3. Figure 3 -3. Illustrations of Complications and Methods of Handling Them 89 4. Figure 3-4. Pages from Jieshengpo xuzhi 104 5. Figure 4-1. Self-image of Zhuchanshi in the Dade Midwifery School Yearbook ... 145 6. Figure 4-2. The Contrast between Old and New Style Midwives 149 7. Figure 7-1. Infant Mortality Rates by Sex, 1949 to 1982 301 VI VITA November 5, 1973 Born, Yeasu, Korea 1998 B.A. History Sogang University, Seoul, Korea 2001 M.A. Oriental History Sogang University, Seoul, Korea 2004 M.A. Chinese History University of California, Los Angeles 2003-2006 Teaching Assistant Department of History University of California, Los Angeles 2005-2007 Field Work, China under Chiang Ching-kuo Foundation, Pacific Rim Research Program and Franklin Murphy Endowment, UCLA History of Medicine 2008 Teaching Fellow Department of History University of California, Los Angeles 2008 Laura Kinsey Teaching Assistant Prize Department of History University of California, Los Angeles 2008- Assistant Professor Department of History Saginaw Valley State University, Michigan PUBLICATIONS AND PRESENTAIONS Ahn, Byungil. "Ch'onghugi Sangin Chojik ui Chibang Haengjong Chamyo" (A Case Study on the Merchant Organizations' Participation in the Local Administration in Late VII Qing China). Myong-ch'ongsa yun'gu (Journal of Late Imperial Chinese History) 14 (April 2001): 99-145. Ahn, Byungil. "Ambiguous Boundary between State and Society in Late Imperial China." Paper presented at California Chinese History Graduate Conference, University of California, San Diego, April 26-27, 2003. Ahn, Byungil. "Modernization, Revolution, and Midwifery Reforms in Twentieth Century China." Paper presented at California Chinese History Graduate Conference, University of California, Davis, April 30-May 1, 2005. Ahn, Byungil. "Modernization, Revolution, and Midwifery Reforms in the Chinese Revolution." Paper presented at 16th Annual "Thinking Gender" Conference, UCLA Center for the Study of Women, March 3, 2006. Ahn, Byungil. "Ideology, Medical Knowledge, and Practices of Wutong Fenmian in 1950s China." Paper presented at Annual Meeting of Association of Asian Studies, March 25-28, 2010. VIII ABSTRACT OF THE DISSERTATION Modernization, Revolution, and Midwifery Reforms in Twentieth-century China by Byungil Ahn Doctor of Philosophy in History University of California, Los Angeles, 2011 Professor Philip C.C. Huang, Co-chair Professor Kathryn Bernhardt, Co-chair The Guomindang and the Chinese Communist Party, the two ruling parties in twentieth-century China, made improving infant and maternity health a crucial aspect of their projects to modernize Chinese society. Both parties promulgated regulations and laws governing the registration of midwives and the quality of their education and services. They also founded professional schools to train midwives in scientific and modern techniques, and supported retraining programs for old-style midwives while banning unqualified women without "proper" medical education from practicing. ix However, despite these similarities, the two parties had different understandings and visions of their reform programs and employed different strategies to actualize their reform ideals. The main concerns of this dissertation are how ordinary Chinese people, especially women, experienced the state programs that introduced modern medical programs and the power of the state into their daily lives and how their responses, in fact, reshaped those reform programs and determined their success. Empirical evidence for this dissertation comes from medical textbooks, handbooks for midwives, personal writings and letters of midwives, newspapers, novels, and other archival materials such as police documents and the CCP work reports regarding midwifery reform. In addition, I use interviews with rural midwives, ex-barefoot doctors, local CCP cadres, and villagers from my field research conducted in major cities, including Beijing and Shanghai, and in rural villages in northern China. Those formal interviews with local people and the archival materials powerfully illustrate how the two parties' different visions of modernizing and reshaping Chinese society interacted with medical reformers, midwives, and local communities and ordinary Chinese women in different ways with respect to midwifery reform. x CHAPTER ONE Introduction This dissertation focuses on the midwifery reform carried out by the Guomindang (hereafter GMD 1928-1949) and the Chinese Communist Party (hereafter CCP 1949- present) between 1928 and 1961, the year that the Great Leap Forward ended.1 This period saw historic events such as the GMD's projects to transform China into a modern nation-state, the War of Resistance to Japan, Land Reform, and Collectivization, showing the two parties' efforts to fundamentally change Chinese society in order to deal with external threats and internal economic crisis. Two main themes running through these historical events during this turbulent period were modernization and revolution. Although the GMD and the CCP significantly differed in their political ideas, they both claimed to be revolutionary and modernizing parties, and vigorously carried out various programs to reshape Chinese society based on their own vision of modernization and revolution. Therefore, in order to accurately understand twentieth-century Chinese history and the two parties' legacies today, it is essential to answer the following questions: How did the GMD and the CCP define modernization and revolution in different ways? How did the two parties' implementation of these two concepts interact and intertwine with the daily practices, economic conditions, and popular customs of the people who were the target of the policies? Finally, in what ways did the ' This does not imply that I view the Cultural Revolution that began in 1966 as a break in the history of the People's Republic of China. As far as midwifery reform is concerned, there was continuity rather than a radical break. Yet, it is also true that the discourse of rural midwifery reform by the CCP changed during this period. 1 modernizationist and revolutionary efforts of each party change or not change the daily lives of ordinary people? The reasons this study has chosen to focus on the midwifery reforms in order to address the research interests stated above are: 1) Childbirth is ahistorical and universal in that it takes place all the time in all human societies, yet at the same time midwifery reform is historical in that the intervention and guidance of the state with respect to childbirth is a very modern phenomenon. Hence, midwifery reform is a prism through which we can see how the state defines old and modern methods of medicine, and understand the state's logic behind its attempts to regulate the daily practices of ordinary people in order to reshape society as whole.