This book is a welcome contribution to the field of Chinese history. While childbirth is not a new topic in the field, few scholarly publications examine it in the context of the chaotic Republican period (1912–49). Drawing on primary sources from varied genres, ranging from government documents to popular magazines and annual reports, Tina Johnson makes her book not just about reproduction policies or practices, but also about the complicated interactions between multiple actors who sought to reform women's health care along biomedical lines: state officials, local philanthropists and elites, intellectuals, and the media, as well as foreign missionaries and other transnational agencies.
The book begins with a brief introduction to the key concepts and historiographical issues around which Johnson structures her study, including the importance of childbirth in the history of modern China, the significance of the Republican period in a Chinese history of childbirth, major differences between biomedicine and traditional Chinese medicine, the impact of modern science and biomedicine on Chinese childbirth practices, and the professionalization of midwifery. Several of the issues here could have received more sustained attention, such as the question of how to understand the Republican Chinese usage of the terms “xiyi” or “xiyao.” Johnson prefers to translate these as “scientific medicine,” instead of using their literal meaning of “Western medicine” (p. xxiii). However, her rationale for doing so is less convincing than a similar discussion in Connie Shemo's The Chinese Medical Ministries of Kang Cheng and Shi Meiyu, 1872–1937: On a Cross-cultural Frontier of Gender, Race, and Nation (Bethlehem, Pa.: Lehigh University Press, 2011), especially since Johnson uses the translation “Western medicine” elsewhere in her book.
Chapter 1, titled “Missionaries and Modernity,” provides a wealth of information on the roles that Chinese gentry philanthropists and foreign medical missionaries played in importing biomedical science, modern medical education, and biomedical institutions into China. It also examines important dynamics beyond the immediate scope of the missionary enterprise, notably the ways in which nationalism, modernity, biomedicine, reproduction, and public health became intertwined in Chinese reformist rhetoric at the turn of the twentieth century. Similarly, the chapter touches on several significant but often-overlooked issues, including how medical societies and hospitals in China were funded, Japanese influence on public health reform, and the role of consumerism in the growth of modern hospitals during the late nineteenth and early twentieth centuries. These topics deserve additional, deeper exploration and analysis by researchers in the near future.
Chapter 2 parses the new Republican ideals of “modern childbirth and modern motherhood” in order to understand the rapid changes in Chinese views of reproduction at this time. Johnson contextualizes these changes by tracing their continuities with older theories of reproduction from imperial China and by comparing them to population and eugenic theories then circulating in the West. These broader perspectives provide the foundation for Johnson's subsequent analysis of the way in which the Republican popular press—in particular women's magazines—constructed new models of reproductive medicine, obstetric practice, and infant care that both drew on and departed from older Chinese and foreign practices.
Chapter 3 explains how “midwifery in China was transformed from an apprenticed vocation into a scientifically trained profession” (p. 73). The author suggests that the professionalization of Chinese midwifery emerged from a confluence of developments: school-based, modern education (especially education for women), governmental initiatives in public health, the institutionalization of medical practice, and programs to retrain old-style midwives (jiesheng po). Citing Magali Larson's definition of profession (p. 103, note 122), Johnson argues that the establishment of the First National Midwifery School (FNMS) at Peking Union Medical College marked the rise of a midwifery profession in China. The relevance of Larson's definition of profession to the establishment of FNMS is not explicitly spelled out. Nevertheless, Johnson's discussion of FNMS founder Yang Chongrui and her advocacy of and rationale for the professional recognition of midwives in China helps to highlight the voices of Chinese medical practitioners.
The last substantive chapter analyzes the way in which the Republican state sought to manage births and bodies “at national, provincial, and municipal levels” (p. 126). In addition to discussing national governmental policies, the chapter provides rich and interesting information on rural midwifery programs sponsored by several municipal governments, the collaboration between missionary medical institutions and the state, and the roles played by the National Midwifery Board. The author also attempts to integrate legislative materials into her analysis, with an interesting discussion of the “Regulations on Registered Western Doctors, Obstetrists, Pharmacists, Prescriptions, Western Hospitals and the Red Cross” issued in 1913 by the Guangdong Provincial Government. It is highly problematic, however, to characterize this document as an example of “Guomindang” legislative efforts to regulate medicine and childbirth (p. 127). The Guomindang as an organization was founded in 1912, but what legislative power did it actually have in 1913, when the provincial governor of Guangdong was Chen Jiongming, appointed by the Yuan Shikai government in Beijing?
Minor issues aside, Childbirth in Republican China adds important new dimensions to our knowledge of this pivotal period, and Johnson effectively places her book at the intersection of several subfields of history. This book will thus interest readers from the fields of medical, social, and gender history, as well as those interested in the history of culture, education, and nation-building in modern China.
