BUILDING THE NATION THROUGH WOMEN'S HEALTH: MODERN ...

However, Yang was drawn to the plight of women during childbirth. She knew it was a
crucial factor in improving the general public health of any population. She repeatedly
encountered cases of tetanus neonatorum and puerperal sepsis in PUMC’s OB/GYN department
and at the First Health Demonstration Station, two preventable diseases that greatly contributed
to China’s high infant and maternal mortality rates. In a letter dated 1928, probably sent to John
Grant, Yang asserted that the 6,000,000 annual preventable deaths in China occurred primarily
among infants and childbearing women, and that it was “impossible for the limited medical
personnel to undertake all the medical work necessary” to remedy this tragedy. 312 Although
several hospitals had established training programs in the previous 30 years, there was neither
centralized regulation nor supervision of any midwives. Yang wrote that “the main
responsibility for the excessive deaths among the mothers and babies may be laid on the
untrained group [of midwives],” which she estimated to number 400,000. 313
Yang had the idea to retrain old-style midwives but was concerned she would not be able
to reach them all. She then thought to give specialized training to a group of talented
individuals. Yang discussed the problem at length with J. Preston Maxwell, then head of
OB/GYN at PUMC. He suggested accepting women with only elementary school qualifications
and training them in short courses of two or six months, and then sending them out to train the
jieshengpo. This would be an efficient way to quickly reduce the high death rates associated
with childbirth. However, Yang recognized an important long-term problem: the Chinese had a
long-standing distrust and superstition surrounding childbirth, and of midwives as unscrupulous
old hucksters. If Yang and her cohorts did not address the need to improve the image of
midwives, these old ideas would continue, both preventing talented women from entering the
312 Yang, letter to John B. Grant(?), 1928.
313 Ibid.
124