The history of childbirth provides unique insights into the interaction between medical practices, cultural meanings and religious beliefs. It brings both state and non-state actors into the intimate space of the family home. It also addresses a domain of knowledge traditionally controlled by women. In Childbirth, Maternity and Medical Pluralism in French Colonial Vietnam, 1880–1945, Thuy Linh Nguyen brings together these different strands to examine the transformation of birthing and childcare practices in French colonial Vietnam and the pluralist system that emerged at the intersection of French and Vietnamese medical traditions. Building on the insights of Nancy Rose Hunt in her pioneering work on the Belgian Congo, Nguyen understands the gradual medicalisation of childbirth in Vietnam not through the prism of Western priorities and policy achievements but rather as a ‘negotiated process whereby both French medicine and Vietnamese practices displayed compromises and adaptations to coexist with each other’ (p. 2).1 In this lucid and captivating study, Nguyen draws on a wide range of colonial-era sources in both French and Vietnamese to uncover a never-before told story about the diversity of everyday experiences that shaped the delivery of infant and maternal health care in early twentieth-century Vietnam. The book’s first chapter provides the reader with an introduction to Vietnamese birthing rituals including the roasting (nam lua) custom of burning a charcoal stove under the bed of a new mother, supervised by a midwife referred to as a ‘bà mu’. French observers deemed these practices, especially the early retrieval of the umbilical cord, as dangerous and unhygienic, responsible for high rates of infant mortality due to tetanus. The colonial state consequently sought to medicalise the profession by introducing required formal training for midwives, new regulations and licensing, as well as the opening of Indochina’s first maternity hospital in 1904. One of the book’s most interesting contributions is the finding that the biomedicalisation of childbirth actually ‘fostered rather than undermined traditional values’ (p. 6). As Nguyen details in Chapter 2, this new cohort of French-trained midwives faced a multitude of challenges, not least the ability to gain the trust of clients in rural areas, and eventually withdrew to urban hospitals and clinics. By the late 1920s, the colonial administration tapped the previously maligned bà mu to fill the gap in rural service coverage, provided they complete a short training programme on modern obstetrics and refer difficult deliveries to provincial hospitals. This embrace of the bà mu came out of necessity and spelled the death knell for the colonial state’s monopoly on childbirth. It also, Nguyen argues, marked the rise of a more dynamic, adaptive and affordable system that allowed for the persistence of certain Vietnamese traditions alongside Western forms of hygiene. In the remainder of the book, the author charts the development of a patchwork system that included midwives trained in different traditions (French, Vietnamese and Franco-Vietnamese) administering to different groups of clients, elite and indigent, in both country and city. This is a work of the history of medicine but it is also importantly a work of women’s history. In particular, Nguyen sheds new light on the role of female medical intermediaries who served as cultural brokers between local communities and the French medical system, and the difficulties they encountered within the colonial bureaucracy including forms of both racial and gender discrimination. This story also points the lens at Vietnamese mothers who became the objects of intensified interest on the part of the colonial government, various private and religious associations, global infant food companies like Nestlé and Merlin, medical professionals and Vietnamese intellectuals, who all sought to redefine the meaning of Vietnamese motherhood in the 1920s and 1930s. In some instances, this implied a retreat to more traditional values and in others encouraged the development of a new scientific spirit and consumerist ethic. Nguyen takes great care to show how local experiences within Vietnam were shaped by the concomitant rise of the pro-natalist and social hygiene movement in France. However, while she is adamant that this is not a story about Vietnam as a kind of ‘modernity laboratory’, where ideas and policies were merely translated to a colonial context, Nguyen does not end up escaping the trope of modernity entirely. She writes, for instance, that ‘medical modernity was an uneven process’ (p. 6) and that ‘Vietnamese women either benefitted little or were excluded from the true progress of modern medicine’ (p. 74). These and other similar statements suggest a rather teleological view of science that, in its Western image, has been somehow thwarted or delayed. Still this is a fine work of historical scholarship and will be of great interest to scholars working in the fields of Vietnamese studies, the history of childbirth and childcare, gender and women’s history, and the history of colonial medicine and public health. Footnotes 1 Nancy Rose Hunt, A Colonial Lexicon: Of Birth Work, Medicalization, and Mobility in the Congo (Durham, NC: Duke University Press, 1999). Published by Oxford University Press 2017. This work is written by a US Government employee and is in the public domain in the US.
Social History of Medicine – Oxford University Press
Published: Feb 1, 2018
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