Childbirth transformation and new style midwifery in Beijing, 1926 – 1937

ABSTRACT

This article offers a comparative analysis of the transformation of midwifery practices in Beijing city and its rural neighborhood in China between 1926 and 1937. From the 1920s onwards, impelled by supports of governments, academic groups and foreign foundations, a reform of midwifery practices was triggered across China. Beijing was one of the forerunners in this reform. Through examining the midwifery regulations, the new style midwifery service, the midwife education/training programs, as well as the consequential influences on birth attendants and birth outcomes (neonatal, infant and maternal mortality rates) in Beijing’s first health district and the nearby Qinghe district, this article shows that in the urban district the trained birth attendants performed better than the untrained personnel in preventing neonatal deaths. Also, the growing use of trained midwifery contributed to the reduction of infant and maternal mortality rates in the urban community. However, because of the paucity of sources of rural areas, such positive outcomes cannot be ascertained in the rural district. Yet an obvious urban-rural divergence in midwifery services and maternal care is still observed.

KEYWORDS:

• Midwifery
• birth attendants
• neonatal, infant and maternal mortality
• Beijing

Acknowledgments

The author is grateful to the anonymous reviewers for their valuable and constructive comments and suggestions. The author is also thankful for the insightful advice from Christa Matthys, Geurt Collenteur, Maarten Duijvendak, Richard Paping, Vincent Tassenaar and Willem Jongman, as well as from participants of the European Social Science History Conference in Belfast (2018), the Economic, Social and Demographic History Seminar in Radboud University (2019), and the seminar at the chair-group Rural and Environmental History in Wageningen University (2019). The author acknowledges the Rockefeller Archive Center for providing digital copies of the reports concerning Beijing’s first health district during the 1920s.

Disclosure statement

No potential conflict of interest was reported by the author.

Notes

1. During the Republican era (1912–1949) the name of Beijing changed several times due to administrative reorganization and political upheavals. Before 1928 it was officially named ‘Beijing’, also known as ‘Peking’ and ‘Jingshi’, the latter of which meant the ‘national capital’. The name was changed to ‘Beiping’ in 1928 when the national capital moved to the southern China. It was changed to ‘Beijing’ in 1937 during the Japanese invasion and was changed again to ‘Beiping’ after the war ended in 1945. The name was reverted to ‘Beijing’ in 1949 and has been maintained till today. The shifts of the name could be seen from the titles of the primary sources, but in this article I consistently refer the city to ‘Beijing’ in case of confusions.

2. It should be noted that the management of the first health district station of Beijing was subject to different governmental institutions in different years, due to the administrative reorganization and the changes of names of the institutions. In specific, the station was administered by the Metropolitan Police Department (1926–1927), the Metropolitan Health Bureau (1928–1929), the Metropolitan Police Bureau (1930–1933), the Metropolitan Health Department (1934) and the Metropolitan Health Bureau (1935–1938) successively. These variations could be seen from the titles of the primary sources.

3. Peking Health Demonstration Station (1927, p.14). Folder 2735, Box 219, Series 3, RG 5, International Health Board/Division records, FA115, Rockefeller Foundation records, Rockefeller Archive Center. Beijingshi weishengju diyi weishengqu shiwusuo (1938, p. 7).

4. ‘Peking Health Demonstration Station (1927, p.13). Folder 2735, Box 219, Series 3, RG 5, International Health Board/Division records, FA115, Rockefeller Foundation records, Rockefeller Archive Center.

5. Peking Health Demonstration Station (1928, p. 19). Folder 2736, Box 219, Series 3, RG 5, International Health Board/Division records, FA115, Rockefeller Foundation records, Rockefeller Archive Center.

6. Peiping Health Demonstration Station (1929, p. 4). Folder 2737, Box 219, Series 3, RG 5, International Health Board/Division records, FA115, Rockefeller Foundation records, Rockefeller Archive Center.

7. The statistics of 1936 are missing because the report of this year is not found.

8. The result of the Independent Sample T-test shows that, based on the five-year data, the NMR of infants delivered by trained attendants (M = 0.0427, SE = 0.0020) was significantly (p < 0.05) lower than that by untrained attendants (M = 0.0631, SE = 0.0057).

Additional information

Funding

This work was supported by the China Scholarship Council [201606870027].