Reproductive Subjects: The Global Politics of Health in China, 1927-1964 by Joshua Hubbard A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy (History and Women’s Studies) in the University of Michigan 2017 Associate Professor Pär Cassel, Co-Chair Professor Wang Zheng, Co-Chair Professor Susan Greenhalgh, Harvard University Professor Mrinalini Sinha Professor Elizabeth Wingrove Joshua Hubbard [email protected] ORCID iD: 0000-0001-5850-4314 © Joshua Hubbard 2017 Acknowledgements I am indebted to friends and colleagues who have provided support—in a myriad of ways—along my long and winding path toward completing this dissertation. First and foremost, I want to thank my husband, Joseph Tychonievich, who now knows more about Chinese history than he ever cared to know. He has cooked meals, provided encouragement, helped me think through arguments and questions, and offered feedback on early drafts. Many wonderful people have come into my life since I began my graduate education, but he is chief among them. I am also especially thankful to my sister, Heather Burke, who has been an enduring source of friendship and support for decades. Faculty at Marshall University guided me as I began developing the skills necessary for historical research. I am especially grateful to Fan Shuhua, David Mills, Greta Rensenbrink, Robert Sawrey, Anara Tabyshalieva, Chris White, and Kat Williams. As an East Asian studies master’s student at The Ohio State University, I received excellent mentorship from Joseph Ponce, Christopher Reed, Patricia Sieber, and Ying Zhang. The strong cohort of Chinese studies graduate students there, many of whom have since gone on to become faculty, also pushed me to think deeply and across disciplines. For this, I am particularly grateful to Austin Dean, Greg Freitag, He Man, John Knight, and Li Mengjun. While at OSU, I studied Chinese in Columbus and in Taipei with the support of Foreign Language and Area Studies fellowships administered by the East Asian Studies Center. This would not have been possible without the assistance of Center staff, including Amy Carey. ii At the University of Michigan, I have benefited from the mentorship and guidance of many renowned and generous scholars across history, women’s studies, and Chinese studies, including Elizabeth Cole, Leela Fernandes, Mary Gallagher, Will Glover, Dena Goodman, Dean Hubbs, Brandi Hughes, Peggy McCracken, Anthony Mora, Ellen Muehlberger, Christian de Pee, Leslie Pincus, Helmut Puff, Tang Xiaobing, Hitomi Tonomura, and Valerie Traub. I am especially thankful to my advisors, Pär Cassel and Wang Zheng, as well as my dissertation committee, Susan Greenhalgh, Mrinalini Sinha, and Elizabeth Wingrove, for taking the time to provide mentoring throughout the years of work that this dissertation has required. I am also thankful for the feedback and comradery of many fellow graduate students across departments at Michigan, including Angie Baecker, Nan Z. Da, Chelsea Del Rio, Katie Dimmery, Adrienne Lagman, Veronica Rabelo, Rita Seabrook, Marie Stango, Mike Thompson, Ignacio Villagran, and Linda Zhang. This dissertation also rests on the unfailing support of university staff at Michigan, including Donna Ainsworth, Diana Denney, Aimee Germain, Kate Sechler, Carol Stepanchuk, and Jen Zhu. During my time at Michigan, my research has received generous support from the American Council of Learned Societies, the Department of History, the Department of Women’s Studies, the Eisenberg Institute for Historical Studies, the Institute for Research on Women and Gender, the Lieberthal-Rogel Center for Chinese Studies, the Mellon Foundation, the Rackham Graduate School, the Rockefeller Archive Center, and the Woodrow Wilson National Fellowship Foundation. I am also indebted to librarians and archivists scattered throughout Asia, Europe, and North America, including Reynald Erard, Margaret Hogan, Jacques Oberson, and Tom Rosenbaum. In particular, I am thankful to Fu Liangyu of the University of Michigan Asia Library, who worked miracles to transfer books and documents across borders. I am also iii especially grateful to Professor Chen Yan of Fudan University, who helped me obtain the affiliation and documentation necessary to access archives in China. In the final months of my research, Al Hermalin of the University of Michigan Population Studies Center shared information on the Center’s programs in Taiwan and connected me to a wealth of resources and contacts. For this, I am truly grateful. My path to a doctoral degree has depended further on public education, free lunches, children’s health insurance programs, Pell grants, subsidized student loans, and provisions won through strong labor unions. No amount of hard work could have compensated for the absence of these resources. iv Table of Contents Acknowledgements………………………………………………………………………………..ii List of Figures…………………………………………………………………………………….vi Note on Transliteration…………………………………………………………………………..vii Abstract……………………………………………………………………………..………...…viii Chapter 1: Introduction……………………………………………………………………………1 Chapter 2: Converging Investments: Chinese Maternal and Infant Health (MIH) in the Interwar World……………….…44 Chapter 3: Local Adaptations: The Geography of MIH and Pre-revolutionary Yunnan……..………………..…….99 Chapter 4: “Developing the Northwest:” MIH in Pre-revolutionary Gansu…………………………………………………...147 Chapter 5: Maternalism, Medicine, and Feminist Praxis……………………………………….199 Chapter 6: Differences that Confound: Maternalist Solidarities, Gendered Citizenship, and the Welfare State…………….236 Chapter 7: Diverging Legacies: Chinese Maternal and Child Health in the Cold War World……………………….276 Chapter 8: Conclusion………..…………………………………………………………………329 Bibliography………………………………………………………………………………...….335 v List of Figures Figure 3.1 Number of Professional Midwives Registered with the NHA……………………...104 Figure 3.2 Provincial Distribution of Licensed Midwives……………………………………...106 Figure 3.3 Distribution of Graduates of the First National Midwifery School…………………107 Figure 4.1 Existing Public Health Offices of Gansu Province—Village Distribution Map……169 Figure 4.2 MIH Examinations in Gansu, 1934-41……………………………………………...183 Figure 4.3 Deliveries by Licensed Midwives in Gansu, 1934-43………………………………184 Figure 4.4 Home Inspections in Gansu, 1939-41………………………………………………184 Figure 4.5 Work of Gansu Provincial Midwifery School in Lanzhou, 1942-46……………….185 vi Note on Transliteration The geographic reach and temporal scope of this dissertation have made it difficult to maintain both historicity and consistency with regard to transliteration. Many of the actors that fill these pages lived under both Nationalist and Communist regimes, with extended stays in Europe, North America, or elsewhere in the world. Throughout their lives they used different English transliterations of their Chinese names, often simultaneously using English and variably transliterated Chinese names depending on particular audiences. Many actors indicate no transliteration preference in the archival sources, but appear in foreign accounts with inconsistent transliteration. When an actor used a consistent English name or non-pinyin transliteration (eg: Kuomintang, T.V. Soong), I refer to them as such, often providing their Chinese name as well in characters at the first mention. This is the case for many Nationalist-era actors and institutions that later moved to Taiwan. For all others (including those who never used pinyin but also never established a consistent preference for transliteration), I default to pinyin, which has become standard for transliterating Chinese names in the historiography. vii Abstract In the middle third of the twentieth century, the distinct aims of international health organizations, new imperialisms, transnational feminisms, and Chinese state-building converged on the reproductive functions of Chinese women. Reproductive Subjects probes the reciprocal relations among these diverse actors to ask how and why childbirth and mothering in China proved integral not only to Chinese state-building, but also to early ventures in international health and a realignment of global political power in the decades surrounding the Second World War. Reproductive Subjects moves between scales, reading local, provincial, and national public health reports in China alongside the correspondence of international organizations and the writings of Chinese health professionals who studied and worked throughout Asia, Europe, and the Americas from the 1920s to the 1960s. By bringing together these dispersed archives, Reproductive Subjects outlines a global conjuncture—characterized by the flourishing of international organizations, unequal relations between putatively autonomous nation-states, the woman question, and the ascendancy of biomedical public health—that imbued Chinese women’s reproduction with global political significance. This project demonstrates the multifaceted political utility of maternal and infant health (MIH) resulting from the linking of demographic measures of mortality to medicalized notions of women’s shared yet variable capacity to reproduce and nurture. Though often framed within the rhetoric of Chinese nationalism, Chinese MIH remained critical to the broader work of foreign and international actors to manage international health and trade in the Pacific. These aims proved compatible—in fact, integral—to contemporaneous efforts to forge a Chinese state with the territory, population, viii and administration required