A Poor Region with Backward Women: Tohoku and the Formation of Reproductive Policies in 1930s Japan

As the modern Japanese state took form after 1868, reproduction became the object of  new policies.  Abortion and infanticide were criminalized, access to birth control restricted, and midwifery and obstetrics were transformed into modern medical disciplines.  By the late 1880s, obstetrics was a required course for all medical students, midwifery schools had been established, and a professional organization for “obstetrical research” had been formed.   Although national statistics reveal the gradual rise in birth rates and a decline in fetal mortality, there was significant regional variation and the Tohoku region of northern Honshū was the target of criticism for its high rates of “failed pregnancies” and neo-natal and infant deaths.  In explaining this departure from the national “norm,” physicians, public health officials, and others pointed to several factors including the “tradition” in Tohoku of controlling family size by recourse to abortion and infanticide, poor standards of health and hygiene, lack of availability of health care facilities, and the poverty and “backwardness” of the region.

This paper explores the place of Tohoku in the formation of the reproductive discourse of the pro-natalist wartime state that took as its slogan, “give birth and increase the population.” In 1937 the government passed the “Infant and Maternal Health Law” but it was also calling upon women to give birth to at least five children, a goal that critics thought put an undue physical, economic, and emotional burden on women. Local physicians and others argued that government policies ignored the real problems that confronted women in impoverished rural villages, including the household requirement for their agricultural labor even during pregnancy and the family dynamic that made them subject to the mother-in-law’s authority.  I use the case of  Tohoku to explore the interplay between local medical professionals, their patients, and the state in relation to reproductive policies.