Midwives Old and New: Forging Medical Legitimacy in Wartime Sichuan, 1937–45

During China’s War of Resistance against Japan (1937-45), maternal and child health became a crucial aspect of building the nation and strengthening the race. Beginning in the 1920s, Dr. Yang Chongrui (楊崇瑞, Marion Yang) trained midwives in sterile methods to reduce the incidence of infantile tetanus and puerperal fever. Apart from saving the lives of infants and birthing mothers, this work marked certain behaviors—and people and locales associated with them—as backward. Women trained to view childbirth as a moment of possible contamination with invisible bacteria began to see traditionally-trained village midwives as ignorant for failing to understand the danger of bacterial contamination, and backward for resisting the bacteria-avoidant training.

This paper analyzes maternal and child health work in wartime Sichuan, the heartland of Free China and home to the wartime capital Chongqing, as an expression of the gender politics of scientific biomedicine’s dominance over indigenous medical practices. Young, unmarried women trained in sterile methods wished to bring women and infants through safe delivery, but in doing so they threatened the livelihoods of older village women whose professional legitimacy was based not in biomedical science but in birthing experience and local reputation. Although midwifery remained a female profession in China, the introduction of birthing forceps and silver nitrate eye drops unseated older village women from power and introduced a birthing regime guided by the principles of science and conducted by young, urban women who had access to formal education. Records from wartime Sichuan show that these young women relied on long established means of obtaining legitimacy—chiefly demonstrating their effectiveness in attending childbirth to the local community—to introduce a new form of legitimacy: institutionalized training grounded in germ theory. This paper illustrates how the power of biomedicine altered local relationships in wartime Sichuan.