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

While the scale of this study is broad in that I examine midwifery efforts nationwide, the
effects of modern midwifery during this period were very small. During the Republican and
Nationalist eras, the number of women who gave birth in hospitals or clinics, or were even
attended at home by a modern midwife or physician, was extremely small, yet significant. We
see a very rapid increase in modern medical births in the 1930s. When modern midwives were
available, people sought them out. Urban centers, where midwife-training institutions were
located, had the most midwives, and rural areas were left largely untouched. Although there are
no concrete figures for how many births nationwide were attended by old-style midwives or new
midwives, we can make some assumptions based on available sources. It is also difficult to
ascertain accurate maternal and infant mortality rates in China in this period, but some surveys
do exist. Contemporary medical modernizers estimated the overall annual mortality rate in
China in the 1920s and 1930s to be 25 to 30 per 1,000 people. The infant mortality rate (under
one year of age) was 250 per 1,000 live births. 44 Medical historian Xiao Wenwen estimates the
infant mortality rate from tetanus in China to be as high as 50 to 70 percent among those using
traditional midwives, and other estimates range from 20 to 80 percent. 45 In the 1920s, there were
an estimated 12,000,000 births per year in China, which means that anywhere from to 2.4 million
to 9.6 million infants died annually. 46
Even at the height of midwife training in the 1920s, the majority of women still utilized
old-style midwives. Dr. Marion Yang, head of the First National Midwifery School, asserted
that in Beijing, the center of midwifery training during the Nationalist era, fifty percent of all
44 In comparison, Japan’s annual infant mortality rate during this period was 18 per 1,000 and England’s was 12 per
1,000. Ka-che Yip, Health and National Reconstruction.
45 Xiao Wenwen, “Zhongguo Jindai Xiyi Chanke Xueshi (The History of Modern Obstetrics in Western Medicine in
China)” Zhonghua Yishi Zazhi (Chinese Journal of Medical History), 25.4 (1995): 204-10, J. Preston Maxwell and
Amos I.H. Wong, “On Puerpural Mortality and Morbidity,” National Medical Journal of China 16 (1930): 684-703.
46 John B. Grant, "Midwifery Training," (Peking: Peking Union Medical College, 1927).
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