2 - Birth Control in Practice

Summary

Chapter 2 focuses on the praxis of birth control and abortion during the Republican era. Although sterilization and abortion were criminalized, contraception was neither explicitly endorsed nor banned. Yet, at times, local police cracked down on those who sold or consumed these products. In spite of the law, a wide range of contraceptive and abortive techniques were available to women in urban China. Grounded in folk practices, traditional Chinese healing, and Western medicine, abortion was the most prevalent form of fertility regulation that appeared in the historical record. Tiaojingyao – patent drugs and homemade herbal decoctions that blurred the line between abortifacients and emmenagogues designed to induce regular menses – were also particularly common, and by their nature, difficult to police.

Li Shenhua, a nineteen-year-old woman from Beijing, was working at the Third Branch Clothing Factory in Tianjin. When Li, who was not married, discovered that she was six months pregnant, she sought help from a doctor. The doctor refused to help her abort the pregnancy, so Li reached out to a colleague, Guo Bao, a thirty-nine-year-old married woman working at the same factory. Guo agreed to help Li induce an abortion through massage, but during the procedure, Guo noticed that Li was vomiting white foam and called the factory doctor for help. He gave Li an injection and administered oral medication, but she died soon after. Later when investigators found Li, her vagina was dilated and bleeding. The umbilical cord still connected her belly with that of a small lifeless baby boy. Moreover, Li’s lower abdomen was red and swollen and had the marks of repeated hand-rubbing. Guo was charged with committing an abortion that led to death.¹ Were situations like this common in urban China in the early twentieth century, or was this simply an anomaly? If the former, what kinds of women were undergoing abortions or using birth control and in what contexts? What motivations drove them to employ birth control or resort to abortion?

This chapter broadly examines birth control and abortion in practice during the Republican period, an era when these topics garnered considerable attention worldwide. As Chapter 1 argues, questions of morality, modernity, women’s rights, and national stature all undergirded these discussions. At the level of individual practice, though, the circumstances in which women employed birth control or underwent abortion were most often connected to patriarchal social pressures and financial challenges.

While the rest of this book takes birth control and abortion in Shanghai, Tianjin, and Luoyang as its focus, this chapter investigates Beijing rather than Luoyang because the latter was small and underdeveloped during this period, leaving little in the form of written records.² Moreover, Luoyang and Beijing shared some important similarities. Although Republican Beijing was much more populous than Luoyang, both cities had relatively little industrial development. Like Luoyang, Beijing was also never divided into separate Chinese and foreign administrative domains, allowing it to retain a greater degree of autonomy than port cities like Shanghai and Tianjin.³

In Shanghai, Tianjin, and Beijing, abortions were the most prevalent forms of contraception that appeared in historical records. Using court records and advertisements, this chapter demonstrates that abortion seekers and practitioners of abortion drew on techniques taken from folk traditions, traditional Chinese healing, and Western medicine. Some women, for example, used patented pills or herbal decoctions available in pharmacies and through midwives to induce abortion, while others used acupuncture needles or surgery to terminate their pregnancies. Whereas sterilization and abortion were criminalized at the national level, birth control was neither explicitly endorsed nor banned for married couples.⁴ Therefore, when available, some women relied on contraceptives or medicines with contraceptive properties. Yet, most evidence of fertility regulation comes from court records charging women with surgical or medicinal abortions.

This chapter also reveals that some of the most common rationales for undergoing abortion – adultery, premarital intercourse, and sex among “chaste” widows – cut across class and geographic lines and had little to do with elite concerns about improving population quality or fortifying the nation. Nonetheless, poor, uneducated women and women at the margins of society bore the brunt of laws regulating abortion and were the primary target of public censure. In contrast to wealthier women, whose abortions were largely shielded from public scrutiny, lower-class women were singled out for being “loose” and “backward,” traits believed to threaten the prevailing social order.

Abortion or Menstrual Regulation?

What types of birth control products and methods for inducing abortion were available in urban China at this time, and who was using them? The medical marketplace in China’s largest cities, particularly in port cities with large migrant populations, thrived from the late Qing era onward, introducing the populace to an assortment of medicines at several different price points. In this way, consumers of different statuses and class backgrounds could draw on a panoply of products and procedures for their medical needs. Practitioners with varying degrees of expertise – from licensed Chinese and foreign doctors of Western medicine to itinerant peddlers, unlicensed Chinese medicine healers, and druggists selling contraceptive and abortifacient drugs – also coexisted within this marketplace.⁵

China’s first clinics dedicated exclusively to Western birth control emerged in the 1920s. Inspired by the work of Margaret Sanger, a female gynecologist named Yang Chao Buwei established a birth control clinic in Beijing in 1925, where she distributed contraception and information about it.⁶ However, the police raided and shut down the clinic.⁷ In 1930, Yang Chongrui (Marion Yang), a leader in the Chinese birth control and midwifery modernization movements, established another birth control clinic in Beijing. She was responsible for training a generation of midwives to administer birth control, and although the clinic closed in 1933, Yang’s students would go on to serve in medical institutions across China.⁸ Yang Chongrui had primarily hoped to alleviate the burdens of working-class women, but she reported that most of her patients belonged to the middle and upper classes.⁹ Given her goal of empowering women, the most common birth control products offered in Yang’s clinic were diaphragms, sponges, and “vaginal plugs” (yindaosai).¹⁰ Following these models, during the 1930s, other small birth control clinics were established (albeit for short periods of time) in major cities like Shanghai and Nanjing to circulate information about sexual hygiene and distribute contraceptives.¹¹

Unlike using or selling contraception, performing an abortion was illegal according to all versions of the Republican criminal code. That policy only changed when therapeutic abortion was legalized in 1935, allowing for abortion if a woman was too sick to carry the pregnancy to term. According to the 1928 draft of the Republican criminal code, the advertising of abortion services was also strictly prohibited.¹² As part of efforts to regulate and professionalize the medical industry, the Nationalist government ordered that advertising the abortifacient properties of drugs would result in a pharmaceutical company or pharmacy losing its license to sell medicine.¹³ Building on the framework set forth at the national level, in 1929 the Shanghai and Beijing governments banned the promotion and dissemination of drugs with contraceptive, abortifacient, or aphrodisiac properties.¹⁴ In 1935, the Tianjin municipal government followed suit.¹⁵

Enforcement of the new mandates varied by location but was often sporadic.¹⁶ In Shanghai, the municipal police conducted a few searches of drugstores, confiscated suspicious drugs and books, and charged certain newspaper owners with disseminating illegal material. In one case from 1937, Shanghai police investigators disguised themselves as customers and exposed two pharmacies selling “obscene” products. The owners of the two pharmacies were charged with selling a variety of aphrodisiacs, contraceptives, and sexual aids, including 8 eight-pack boxes of condoms, 22 boxes of disease-preventing contraceptives, 7 bottles of gujing pills to fight nocturnal emissions, 483 sex guides, and 5 vaginal warmers (believed to aid female arousal).¹⁷ All of the offending products were seized. The pharmacies were also charged with advertising these products in print.¹⁸ In a similar case from 1930, a Shanghai pharmacy was charged 900 yuan for selling aphrodisiacs (chunyao) and Baoyulin-brand contraceptive tablets.¹⁹ Likewise, in 1935, the owner of the Yongde Pharmacy in Tianjin’s Japanese settlement was charged with advertising and selling forbidden patent medicines, including those that purportedly enabled the user to quit smoking and drugs, with implied abortifacient properties. The pharmacy owner was arrested and charged 400 yuan, and his goods were confiscated.²⁰ Despite the risk of being charged fines and having their property seized, individual pharmacists, pharmacies, and medicine companies continued to advertise and sell these types of products.

Police also occasionally raided medical clinics suspected of offering abortions or advertising abortion services. In Tianjin, for example, under pressure from a Catholic home for children, the municipal government ordered the Ministry of Health to crack down on practitioners of abortion, arguing that abortions were harmful to society.²¹ Police similarly penalized abortion clinics that illegally advertised their services in periodicals, as in the case of the Tianjin Ming Medical Clinic (Ming zhenliao), which openly advertised that it offered abortions.²²

Contraceptives, although rarely the sole focus of police crackdowns and never the cause for sentencing in court cases, occupied a tenuous legal and social position. In many parts of the world in the late nineteenth and early twentieth centuries, contraception was denounced on the grounds that it promoted immoral behavior.²³ Similarly, the Guomindang authorities viewed contraception as encouraging abortion, extramarital sex, or both and therefore policed the sale of prophylactics. Moreover, as in the United States in the nineteenth century, the association of contraception with “pornography” – texts and images deemed harmful for public consumption – made it vulnerable to further censure.²⁴ In addition to issues of morality, the lack of clarity about the difference between contraception and abortion further tarnished birth control’s reputation, and as a result, contraceptives at times drew suspicion from the authorities.

The fuzzy line between legal medicines that happened to prevent pregnancy (emmenagogues) and illegal ones that prevented carrying a pregnancy to term (abortifacients) made policing abortion and contraception even more difficult. Charlotte Furth and Francesca Bray argue that in Traditional Chinese Medicine (TCM), a regular menstrual period was believed to indicate health and balanced qi, “a vapor taken to constitute the essence of matter.” If amenorrhea occurred due to either pregnancy or illness, this indicated the existence of a menstrual blockage – the result of imbalanced levels of yin and yang, the complementary types of qi.²⁵ Therefore, during the eighteenth and nineteenth centuries, if a woman’s menses were irregular, this might lead her to consume tiaojingyao or tongjingyao, medicines that induced menstruation, which in turn would prevent pregnancy.²⁶ While a doctor might be reluctant to help a woman arbitrarily terminate a pregnancy, medicines for inducing menses could be purchased from private sellers and apothecaries.²⁷

Scholars of medicine note that emmenagogues bring on (delayed) menstruation regardless of whether a woman is pregnant. Abortifacients destroy the fertilized ovum and/or cause the uterine lining in which the embryo is implanted to be expelled. In the early stages of pregnancy, embryos and fertilized ova simply look like menstrual blood.²⁸ Therefore, there has always been a fine line between emmenagogues and abortifacients. Records show that, at various points in history, women in Europe, the Americas, Africa, and Asia all experimented with these techniques, but the degree to which abortifacients and emmenagogues were viewed as unique technologies differed across cultural contexts.²⁹ In China and parts of the West, marketers specifically advertised abortifacients as emmenagogues or “patent medicines” to make them more palatable to the public.³⁰

Yet, the blurry distinction between emmenagogues and abortifacients was no secret. In 1938, the Shanghai newspaper Huamei wanbao chenkan (Chinese-American Evening News Morning Edition) published a political cartoon titled “Treating Life as Trifling Matter” (ba xingming dang zuo erxi) decrying the use of abortifacients. In the cartoon, a man explains to a grieving woman: “Even if you are sick, do not take abortifacients! Now we need to perform a memorial service!” The man is referring to the death of a young woman, mentioned in an accompanying article, who consumed an abortifacient (dataiyao) to simultaneously treat her blood stasis and terminate an unwanted pregnancy.³¹ The article contains religious undertones but does not explicitly mention the sanctity of fetal life in a Christian sense. Instead, the overarching message is that abortifacients and emmenagogues are dangerous.

The use of emmenagogues as abortifacients took on a new form in the globalizing and modernizing context of the Republican period, in which many areas of life, particularly medicine, became commercialized and commodified. Much as science came to be seen as a panacea for China’s problems as a nation, health products became the cure for individual ailments, so that the individual body could be strengthened along with the nation as a whole. Newspapers began advertising commodities to be bought as part of a modern health regimen, products that denoted a modern, consumerist lifestyle.³² Convenience was part and parcel of the commodification of health, and customers increasingly demanded affordable drugs that could be purchased easily without having to consult a potentially costly medical practitioner.³³

Relatedly, so-called wonder drugs and health-boosting cure-alls (buyao), which have a long history in China, gained new authority in the era of mass media and commercialization. As Eugenia Lean has argued, in the early 1900s, doctors, pharmacy houses, and apothecaries advertised wonder drugs or elixirs claiming to cure a wide range of health problems – from loss of energy and nocturnal emissions to opium addiction and even death.³⁴ The language of Western biomedical science and flashy advertisements lent an air of legitimacy and expertise to druggists’ and drug companies’ claims. However, Western medicine was also viewed as lacking the personal engagement between doctor and patient that is common with traditional practitioners. The fact that Western medicine depicted health and illness in terms of dissected organs within a physical body, rather than as an immaterial system of interacting meridians, further contributed to this sense of medical alienation.³⁵ To overcome this stigma, advertisements utilized the holistic language associated with TCM – a vocabulary more familiar to consumers than the alienating and impersonal language of Western medicine – to sell their products.³⁶

If one opens a Chinese women’s magazine or newspaper from the 1920s or 1930s, the likelihood of encountering advertisements for various products marketed as emmenagogues is particularly high (although these advertisements can be found in the late Qing period as well). The notion of emmenagogue pills that ensured menstrual harmony merged nicely with the idea of cost-effective, premade tablets as cures for everything – including unwanted pregnancy. More specifically, these advertisements couched the utility of tiaojingyao and tongjingyao in terms of TCM – they enabled menstrual regularity or harmony, which fit within and appealed to a particular conceptualization of menstruation as signifying wellness. While framed in terms of qi and bodily balance, the drugs themselves were premade, packaged, and marketed in a highly impersonal way.³⁷

Advertisements conveyed to varying degrees the link between regular menstruation, health, and pregnancy: While some used more veiled language about promoting menstrual regularity, others explicitly claimed to prevent or terminate pregnancy. Examining advertisements for tiaojingyao and tongjingyao from the 1920s and 1930s provides concrete examples of these different advertising techniques. Take, for example, a 1931 edition of the magazine Funü shijie (Women’s World), which advertised a product called Yue yue hong. The product name might refer to the flower China Rose (which can be used to regulate menses), or Yue yue hong can be translated as “monthly red,” a possible euphemism for menstruation. The fine print of the advertisement reads:

Women’s medicine = fixing menstrual blockages and improving blood circulation

This is an extremely effective formula for improving blood circulation. The Western name of this medicine is “emmenagogue pills” and it is suitable for women’s systems.

It melts easily in the body, so the treatment is very safe and fast.

Effectiveness: Good for treating women with blood deficiency in blocked or astringent meridians, blood stasis, post-partum discharge, or other unclear symptoms.

The advertisement was published by Wuzhou Pharmacy Publishing, the head office of which was located in Shanghai with branches in various provinces and port cities. The pills sold for 1 yuan per bottle, or a dozen bottles for 10 yuan.³⁸ By invoking the term “emmenagogue” in English (prominently written in all capital letters), the company wanted to appear foreign and cutting-edge. Yet, the text merged the notions of “improved circulation” and “blood stasis” in TCM with the Western medical concept of “amenorrhea.” In keeping with the language of modern advertising, the product is framed as effective, fast, and safe – features critical to the modern female consumer. The strategic marrying of the familiar language of TCM with Western product design and visual motifs was not unique to birth control advertisements but could be found in advertisements for all sorts of patented medicine (marketed as “new medicines” or xinyao) during the Republican period.³⁹

Advertisements for Yue yue hong, like an increasing number of advertisements in early twentieth-century China, took young women, rather than male heads of households, as their target consumers.⁴⁰ Perhaps this was a tacit acknowledgment that mobilizing female consumers was a necessary condition for capitalist profit. The Yue yue hong advertisement even defined “women’s medicine” to educate potential consumers about which products they should desire and the ways in which consumption is central to modern subjectivity. The sketch of a woman on the bottle (Figure 2.1) was also part of attempts to project modernity; adding visual representations of products and silhouettes of beautiful women to advertisements was a popular marketing strategy that emerged in the 1910s and remained popular through the 1930s.⁴¹ In this context, women and their bodies became overtly central to consumerist modernity.

Figure 2.1 Advertisement for “Yue yue hong” emmenagogues, 1931.

Source: “Yue yue hong,” Funü shijie (Women’s World) 17, no. 7 (1931): n.p.

As for emmenagogues and contraceptives, other advertisers were more explicit about the fact that the products they were selling were intended to prevent pregnancy, rather than only emphasizing the medicines’ therapeutic functions. An advertisement for a drug called “Speton: Ideales Anticoncipiens,” featured in a 1931 edition of the magazine Funü shijie (Women’s World), sought to market fertility regulation to the mobile, assertive, and busy modern woman (Figure 2.2). The advertisement prominently displayed the product’s Latin name, which literally translates as “Ideal Anti-Pregnant.” This was meant to denote foreign status and reliability, as well as the allure of Western medicine. The advertisement also featured the image of the bird wrapped in rope – an ensnared version of a stork, known for delivering newborn babies. As in certain parts of the West, storks appear in some Chinese stories about fertility, so the imagery would have been meaningful to both Chinese and foreign consumers. The advertisement reads:

Preeminent birth control medicine

Absolutely no oil; common, pure, and effective

For leucorrhea (vaginal discharge) and neighboring tissues

Inflammation, corrosion, and other illnesses in the body cavities

Disinfectant is effective like something miraculous

Various pharmacies sell it.

According to the advertisement, the drug was produced by a foreign-owned company, manufactured at the Taylor Chemical Factory, and sold exclusively in China by the manager’s office in Shanghai. While “Speton” was first and foremost a birth control medicine, like many other miracle drugs or “new medicines” of the time, it served a number of other functions. Not only could it supposedly prevent conception without the use of oil (which many vaginal inserts used to trap sperm during intercourse), it also cured several vaginal and abdominal illnesses and even boasted “miraculous” disinfectant properties.⁴²

Figure 2.2 Advertisement for “Speton” contraceptives, 1931.

Source: Funü shijie (Women’s World) 17, no. 7 (1931): n.p.

Other related products, which have received greater scholarly attention, were “Birth Control Friend” (Zhiyu liangyou) and “Lady’s Friend” (Ta de you). Michelle King dates advertisements for Birth Control Friend to less than a year after Margaret Sanger’s first visit to China in 1922, and one advertisement for Birth Control Friend even claimed local demands for birth control in the aftermath of Sanger’s visit created the impetus to produce these types of products. Birth Control Friend was purported to be able to prevent pregnancy, alleviate feminine discharge problems, and even prevent men from contracting venereal disease.⁴³ While this product was advertised as being “for external use only,” King posits that it was almost certainly a vaginal suppository because of its claims to prevent transmission of venereal disease, a topic that is rarely mentioned in advertisements for products labeled as either emmenagogues or contraceptives. In this gendered scenario, the woman was presumed to have a venereal disease that her relatively pure male lover was afraid of contracting – a motif present in many writings on sexually transmitted diseases from the Republican period to the present. This suggests that not only were the target customers for Birth Control Friend middle-class men, rather than so-called modern women, but that advertisers also appropriated women’s bodies to assuage male concerns about unrestrained female sexual desire. According to King and others, Chinese men preferred vaginal suppositories over other contraceptives because they were easy to use and did not diminish the male sexual experience, a trend the advertisers of Birth Control Friend undoubtedly recognized.⁴⁴

Advertisements for Lady’s Friend were similar to those for Birth Control Friend in many ways. However, the former highlighted the drug’s contraceptive properties by featuring the Chinese word jieyu in large, prominent letters on the left side of the advertisement. Like Birth Control Friend, the use of the word “friend” in the name evokes a kind of modern intimacy and trust between the user and the product. The full advertisement reads:

“Lady’s Friend” topical pills are the most effective medicine for contraception.

It is generally recognized that this medicine is used by women with frail bodies and blood deficiency who are not suited for childbearing and are familiar with modern living and economic circumstances.

(Introduced by a world-famous Western doctor).

Tested by the Central Health Laboratory and proven non-toxic.

Each box is one yuan two jiao and comes with Chinese-language instructions available on request by letter.⁴⁵

As with the other products, this one was sold by a company headquartered in Shanghai and was retailed at all major pharmacies. While the focus was on the drug’s ability to prevent pregnancy, the language suggests that the target consumers were women who should not conceive for health reasons, rather than women who solely wanted to have sex for pleasure. The reference to modern living and economic circumstances alludes to the fact that raising children was costly and time consuming, factors modern consumers and independent women took into consideration.

Yet, Lady’s Friend still sought to position itself as a product for women with some means and an eye to Western-influenced consumer culture. The claim linking Lady’s Friend to a world-famous Western doctor, for example, lent an air of worldliness and legitimacy to the product. Furthermore, the fact that the product did not come with Chinese-language instructions was likely an attempt to feign foreign origins or to target foreign and bilingual consumers. At its price point of 1.2 renminbi per dozen, Lady’s Friend would also have been more costly than comparable domestically produced old-style products like qipao yaofen, an inexpensive foaming spermicide popular among the urban poor.⁴⁶ Despite efforts to appeal to the allure of Western medicine, though, one article in the Shanghai newspaper Shenbao proclaimed that contraception like Lady’s Friend would save the nation and allow China to be reborn as a nation free from foreign subjugation.⁴⁷ Such a claim reveals the simultaneous appeal of foreign medicines and the distrust of their imperialist origins.

Advertisements for products like Birth Control Friend and Lady’s Friend were not limited to Shanghai. For example, throughout the 1930s and 1940s, the periodical Xin Tianjin Huabao (New Tianjin Pictorial) continually featured advertisements for Tingyundan (literally, stop pregnancy pill). At the cost of 5 yuan for a two-year supply, this medicine was marketed as a simple way to protect women from dangerous pregnancies that, if not prevented, might need to be aborted. Advertisements for Tingyundan could be found alongside those for venereal disease clinics, tongjingyao, and medicine that treats gonorrhea. According to the advertisements, Tingyundan could be purchased at pharmacies in both Tianjin’s Japanese and French settlements.⁴⁸

Not all emmenagogues were mass manufactured and as prominently advertised as those just mentioned; some were clandestinely made and sold by local druggists, peddlers, and even midwives.⁴⁹ In a case from Beijing in 1932, the police looked into a series of crimes – bribery, heroin trafficking, and the outbreak of a fight over the price of a rickshaw ride. This led the police to discover that a man named Hu Shoushan was manufacturing emmenagogues (tongjingdan). The police report alleged that “[a] very large the number of people were purchasing this medicine for use as an abortifacient” while claiming to not know the true effect of the drug. As a result, Hu was charged with disseminating illegal medicines.⁵⁰ In another case from Beijing, a young woman surnamed Jian, who was four months pregnant, sought an abortion. Fearing that her father and brother would find out about the pregnancy and her sexual relationship, Jian allegedly purchased an abortifacient (dataiyao) at a local drug store owned by a woman surnamed Yang. Suspicious investigators soon uncovered a stash of illegal abortifacients in the shop, and Yang was charged with selling illicit drugs.⁵¹ As these and many other cases illustrate, emmenagogues and abortifacients were not difficult to purchase in China’s major cities.

Western drugs with abortifacient properties were also available for purchase in urban China. In some instances, these medicines were marketed explicitly in terms of biomedical family planning, whereas in other cases they were sold to treat other illnesses and misused to induce abortion. Carbizone (jiabuxi) tablets, a type of American birth control pill introduced to China by Margaret Sanger, were available for purchase in Shanghai as early as March 1923.⁵² Similarly, the Shanghai Bai’er Pharmaceutical Company – a subsidiary of the German multinational pharmaceutical company, Bayer – published a booklet in 1938 advertising a variety of products including Rivanol, a potent abortifacient used in China from the Republican era to the present in second-trimester and late-term abortions.⁵³

Quinine (a medicine used to treat malaria) could also be purchased in pharmacies in large cities and could induce abortion. Cinchona, the active ingredient in quinine, was mainly imported from the Dutch East Indies, but to meet the overwhelming domestic demand for this malaria medicine, in the 1930s farms in Yunnan began experimenting with cinchona cultivation.⁵⁴ In fact, quinine was even endorsed in Republican and Mao-era sex guides and appears in a wide range of abortion cases from the Republican period through the Mao era.⁵⁵ Take for example the 1947 case of a young couple living on Nanjing Road in Shanghai. The husband was an employee of the China National Goods Corporation, where he earned a humble salary. In the seven years the couple had been married, the 22-year-old wife had given birth to five children, of which three had survived. When the young woman became pregnant again, she feared that the family could not afford to take care of another child. First, she tried consuming some type of acid to abort the fetus, but it simply made her throw up. She knew that quinine was used to treat specific illnesses but that it could trigger a miscarriage when taken in large quantities. For this reason, she overdosed on it. The toxicity of the medicine caused her uterus to contract and release the fetus, but she bled continuously until her face turned blue and her heart gave out.⁵⁶ Other cases suggest that this was a fairly common last resort for poor women without access to other types of contraceptives or abortifacients.⁵⁷

Some women even formulated emmenagogues and abortifacients from scratch at home. In one case from Beijing in 1945, a 36-year-old unemployed married woman named Jiang Liu was having an affair with a 20-year-old unemployed man named Zhou Shulin, who lived in a nearby alleyway (hutong). Eventually, Jiang’s abdomen became swollen and hard, and soon after, became soft. Jiang was charged with colluding with Zhou to abort the pregnancy and cover up evidence of the affair. The method of abortion used was a concoction made from black soybeans taken orally.⁵⁸ Jiang was sentenced to seven months in prison for committing adultery and having an abortion, while Zhou was fined and sentenced to four months in jail for committing adultery and harming Jiang.⁵⁹

Other women utilized a variety of abortion techniques associated with traditional medicine. These included consuming herb mixtures orally in tea or inserting a blend of toxic insects, as well “ox knee” (tu niuxi), musk, and monkshod root, into the cervix.⁶⁰ References to these types of abortion appear in a wide variety of sources from the imperial period through the present. In fact, Matthew Sommer uses court records and works of fiction to chronicle the use of these methods since the late Qing dynasty. The type of herbs used, however, differed by region according to local flora and medicinal practices. The insertion of ox knee root into the cervix was a common abortive technique used by native healers in Shanghai and southern China during the Republican period.⁶¹ In one case from 1940, Zhou, a 25-year-old married woman working as a live-in maid in Shanghai, became pregnant. Fearing she would lose her job due to the pregnancy, she paid a traditional Chinese healer, Yao, and his wife to perform an abortion on her. Yao inserted a “daikon-shaped item” (luobo zhuang de dongxi) into Zhou’s cervix, which induced abortion. Unfortunately, Zhou could not stop bleeding and after she died in the hospital, Yao was sentenced to three and a half years in jail and a fine of 300 yuan.⁶² In another case from Shanghai, a 33-year-old woman named Gui Xu who was several months pregnant sought out an elderly local healer to help her undergo an abortion. The healer inserted herbs roots into Gui’s uterus. After successfully aborting the pregnancy, Gui threw the body of the male fetus into the toilet. Her crime was only discovered when Gui admitted herself to a hospital because she was suffering from poisoning (from the herbs). In Gui’s case, she survived the abortion and the aftereffects.⁶³ Many women who used such herbal methods consequently suffered from sterility, as depicted in the novel The Obsessed, by Liu Heng, which director Zhang Yimou later adapted into the film, Ju Dou. Herbal abortifacients were definitely one of the most common forms of fertility control that entered the historical record, and in later chapters we will see that similar methods were practiced in various parts of China in the Mao era and beyond.

Acupuncture was another method used to induce abortion, but it was more common in northern China, where acupuncture was popular.⁶⁴ Traditional healers inserted one or more needles just under 3 inches long through the abdominal wall to stimulate uterine contractions and premature delivery.⁶⁵ Like many other abortion techniques from this period, needling (dazhen or zhazhen duotai) did not always successfully induce abortion, and at times it could be dangerous or even fatal. In one case from 1921, a young woman paid 5 silver dollars (wu kuai da yang) to the middle-aged owner of a local shop for abortion through needling. When the pregnancy failed to terminate, the young woman consumed an abortifacient. The case sparked public criticism of back-alley abortion clinics, where healers preyed on the poor and ignorant.⁶⁶ A British medical missionary living in Beijing and working at Peking Union Medical College in 1928 observed cases of needling with even more catastrophic consequences. In two cases, the needle broke off or got lost in the abdomen and had to be removed surgically. In a third case, a 43-year-old woman, who had become pregnant through adultery and wanted to hide the evidence from her husband, attempted abortion through needling. After being needled four times, the fetus emerged, but the woman died of abdominal inflammation (peritonitis).⁶⁷ Like other abortion methods, abortion through needling was extremely risky.

In addition to medicinal abortions and those performed through massage or needling, surgical abortions were also somewhat common in urban China and they often took place in privately run health clinics or in STD clinics that offered abortions on the side.⁶⁸ A number of foreign and Chinese-run public hospitals and clinics simply refused to treat women seeking abortions or treatment for postabortion health problems (excessive bleeding, infection, etc.) because the hospital did not want to be associated with illegal abortions.⁶⁹ In some cases, Western philanthropic hospitals in Shanghai even reported abortion seekers to the local police and helped with community surveillance.⁷⁰ Given these realities, women who could afford more expensive treatment in Shanghai (and to a lesser degree in other cities) sought out private clinics, staffed by both foreign and Chinese practitioners of Western medicine. In these types of establishments, services were many times more expensive than self-administering abortifacients or seeing a native healer, but the chances of getting caught were also much lower and the facilities more sanitary.⁷¹

In fact, some of the same doctors who held legitimate positions at hospitals or health clinics secretly performed abortions on the side to make extra money, not least because a single abortion could cost several hundred yuan at a Western-style clinic.⁷² One court case, for example, alleged that the director of Panlin Hospital in Shanghai, Pan Jiahe, earned an additional 1,000 to 2,000 thousand yuan per month performing clandestine abortions. He was accused of throwing the fetuses into a nearby river at night or cremating and burying the remains, evidence that was used to convict Pan.⁷³ Similarly, in a case from 1931, the director of Huifen Medical Clinic, a health clinic located in one of Beijing’s hutongs, was charged with regularly performing illegal surgical abortions. Police investigators found that the director, Wang Guoqing, was not only selling heroin but also burying fetuses in a small grave at the base of the western wall of his courtyard. Wang was a 30-year-old pharmacist from Wuqiang county in Hebei province with a wife and three children. According to Wang, the abortions he was charged with performing were done to save the lives of pregnant women who were sick and experiencing difficult pregnancies. Wang maintained that he did not perform abortions for healthy women but that occasionally women who had undergone an abortion (elsewhere) brought the corpses to him to be buried nearby. The police uncovered the remains of several babies, as well as heroin, and Wang was convicted on both accounts.⁷⁴ Had the case been brought to trial after 1935 when therapeutic abortion was legalized, Wang may have been able to evade punishment if he could convincingly argue that the pregnancies were life threatening.

As these cases illustrate, numerous methods for inducing abortion were available to urban women, though they all involved some degree of risk. Some women ingested tiaojingyao or tongjingyao, which could regularize menstruation and abort unwanted pregnancies but could also prove dangerous. Other women, often in dire circumstances brought on by poverty or patriarchal social norms, resorted to medicinal or surgical abortions. For its part, the public press oscillated between demonizing these women and painting them as the hapless victims of avarice and oppressive Confucian values.

The Trouble with Rubbers

It is worth noting that despite the ubiquity of abortion and abortifacients, contraceptives like condoms still had a limited presence in Chinese cities. Reports from pharmacy raids, like those mentioned earlier, and other records also reveal that throughout the Republican period, imported condoms (baoxiantao or guitoutao) were sold in drugstores. To prevent the transmission of syphilis, condoms were distributed at hospital-sponsored birth control clinics in major urban centers, particularly in port cities with their thriving prostitution industries.⁷⁵ Sexual hygiene guides and news articles explaining how to procure and use products like the “French Letter” condom (ruyidai) were also common in urban areas.⁷⁶ But, perhaps because of the association of condoms with prostitution and infidelity, condoms were never very popular. Historian Yuehtsen Juliette Chung observes that although foreign-funded condoms were available at Peking Union Medical College in the 1920s, “the idea of using condoms did not seep into Chinese men’s mentality.”⁷⁷ Indeed, men’s dislike of condoms globally, as well as in China, was and remains one of the key reasons for the gendered bias of much of the literature on contraception. When asked why they did not use condoms, many men cited the fact that they diminish the male sexual experience.⁷⁸

The limited popularity of condoms can be attributed in part to certain assumptions about medicine and the body. As discussed earlier, in TCM, the balance of yin and yang governs bodily health. Daoist teachings argued that men needed a certain amount of female yin to balance out their abundant yang. Excessive sex could drain a man of his yang, but an appropriate amount of sex would benefit him by replenishing his yin. A man could receive yin from female orgasms, but he himself should try to limit emission of his seminal essence (jing) so as to avoid depleting his finite qi and causing illness.⁷⁹ Hence, the practice of “cultivating life” (yangsheng) – preserving jing through proper sleep, diet, temperature regulation, and even engaging in intercourse without releasing semen – arose.⁸⁰ Following this logic, using condoms would enable a man to have more intercourse, thus depleting his jing while not allowing him to gain any of the complementary advantages of women’s yin. Writing in 1941, sexologist Yao Lingxi raised this concern with respect to condom use.⁸¹

Condoms were also associated with other health risks for men. When Margaret Sanger visited China in 1922, she argued that frequent use of the withdrawal method or condoms could cause men to suffer from nervous disorders (shenjing shuairuo de bing).⁸² For this reason, she encouraged female contraception instead.⁸³ Similarly, in 1946, one vocal female advocate of birth control, Zhen Ni, published an article in Xin funü yuekan (New Women’s Monthly) warning that using a condom too often can lead to neurasthenic disorders among men, an argument that draws on the language of Western biomedicine and speaks to the ubiquity of misinformation masquerading as scientific advice.⁸⁴ Taken together, concerns about the negative side effects of using condoms may have served to deter potential customers. This may also account for advertisements promoting condoms as a tool for male sexual enhancement, a marketing ploy meant to circumvent the issue of condoms’ perceived health risks.⁸⁵

Condoms rarely appear in legal records because they were not explicitly banned. When they are mentioned in the archive, it is often not in connection with birth control. Instead, condoms were often used to transport illegal drugs. In 1932, for example, a husband and wife in Shanghai were charged with illegally transporting more than ninety condoms full of morphine as part of a large-scale crime syndicate.⁸⁶ Similarly, in 1948, the Tianjin Municipal Bureau of Health investigated a case in which a woman was caught trafficking morphine and opium in rubber condoms.⁸⁷ This suggests that, at the very least, people were aware of the existence of condoms but were not necessarily using them as prophylactics.

Perhaps yet another reason why condoms were not a popular form of contraception was their high failure rate and the fact that they were not very comfortable. Despite advertisements with slogans like “Flexible and Comfortable, Won’t Break Easily” (Rouren shuchang buyi pohuai) and “Soft Texture and Durability” (Zhidi meiruan jingjiu naiyong), according to a 1942 clinical study at Shanghai Women’s and Children’s hospital, condoms had a failure rate of 42.8 percent.⁸⁸ Before the 1850s, most condoms in the United States and Britain were made from intestines. Rubber condoms were first developed in the nineteenth century when Charles Goodyear invented vulcanized rubber. By the 1920s, latex condoms, which were more pliable, less combustible, and better suited for mass production on the assembly line, had begun replacing rubber condoms in the West.⁸⁹ In China, however, rigid rubber condoms remained standard until the 1960s, and their limited elasticity made them uncomfortable to use. They also came in restricted sizes and could break easily. Fish-skin condoms, said to be more comfortable, could sometimes be procured, but these were even more difficult to obtain.⁹⁰ For these reasons, condoms seem to have been a less used contraceptive option in the Republican period despite their popularity elsewhere.

During the late Republican period, access to condoms grew in some places and became more restricted in others. In the wake of the Anti-Japanese War, American army surplus goods, including large quantities of condoms, became available for purchase in street markets and pharmacies in Shanghai and other major cities.⁹¹ In fact, American condoms – said to look like “milk grapes” (niunai putao) – were so prevalent, people used them to make balloons bearing slogans like “Long Live the Republic of China” (zhonghua minguo wan sui).⁹² Seeking to corner the condom market, one woman allegedly purchased 960 boxes of condoms (three condoms per box) from the army surplus store to resell.⁹³

In theory, condoms were also plentiful in Japanese-occupied Manchuria. During the war, the Japanese army distributed millions of “Attack No. 1”-brand condoms, which soldiers were required to use when having sex with “comfort women.” ⁹⁴ Likely in response to the soldiers’ refusal to use condoms, Manchuria Medical University published guidelines for preventing the spread of venereal disease, encouraging readers to use condoms.⁹⁵ In reality, though, Chinese comfort women reported that condoms were scant at temporary comfort stations on the front line. Comfort women and local laborers, in fact, were tasked with washing and recycling used condoms.⁹⁶ Moreover, given the power dynamics and brutal circumstances underlying the comfort women system, male soldiers refused to use condoms and comfort women had no way to resist them.⁹⁷

In regions of China where fighting was taking place between the Nationalists and the Communists, condom supplies were also very limited. According to one anecdote from the 1940s, a young man and woman, both of whom were serving in the People’s Liberation Army, were given permission to get married. On their wedding night, their commanding officer gifted them some condoms that had been taken from the Nationalist army because the couple was not allowed to have children immediately. In less than a month the condoms were used up, but when the couple asked for more, they were told that condoms were in shorter supply than tanks.⁹⁸ Indeed, access to condoms varied greatly during the 1940s.

In addition to condoms, sexual hygiene guides during the Republican period also recommended the use of the withdrawal method, abstinence, and washing after sex to prevent conception. One guide advised that women wash out their vaginas to drown the sperm (nichu jingfa) “the way that prostitutes do.”⁹⁹ Other recommended birth control strategies included inserting foam powder, a foaming spermicide applied to a sponge (later proven to be dangerous), cervical caps, and concoctions of cocoa butter and acetic acid, into the vagina prior to sex.¹⁰⁰ Gail Hershatter even speculates that infertility caused by acute sexual transmitted diseases such as syphilis may have prevented higher rates of pregnancy among Republican-era prostitutes, an argument that could be applied to the population at large since venereal disease seems to have been widespread in major cities.¹⁰¹

In short, written records suggest that condoms were not a very popular form of birth control during the Republican period. Although it is impossible to venture a guess as to how frequently they were used since their sales were not uniformly monitored, it would seem that public perceptions about health worked against the popularization of condoms. Moreover, difficulties accessing condoms, which needed to be imported and were often costly, meant that they were not available to the majority of people.

Abortion in the Records

In contrast to condoms, because performing an abortion was illegal during the Republican period, most evidence of abortions comes from court records. Therefore, in theory, one could use those records to estimate the number of prosecuted abortions in certain Republican cities. Still, enforcement of the abortion law was both uneven and unsystematic, further complicating efforts to estimate contraception and abortion rates.¹⁰² Abortion records in the archives of major Chinese cities make up only a fraction of the total crimes on record. Beginning in 1910, when the national criminal code was restructured, crimes such as abortion were re-categorized as police contraventions.¹⁰³ Therefore, as part of the expanding role of the police in urban governance, police were permitted to settle abortion cases outside of the standard legal process, a practice that remained more or less unchanged until 1949. As a result, crimes such as abortion were not reflected in local crime statistics, making it even more challenging to estimate to what extent abortion was practiced and policed.¹⁰⁴ In addition, criminal records – particularly in Shanghai – tended to highlight the offenses of lower-class women, who often first saw inexpensive native healers. If these abortions resulted in serious aftereffects, the abortion seekers would be forced to go to the hospital, where they might be turned in to the authorities.¹⁰⁵ Women who underwent abortions in more hygienic settings with trained medical practitioners likely would have no need to visit the hospital and risk being caught. Based on this skewed evidence, the primary form of birth control in urban China seems to have been abortion via the consumption of tiaojingyao, or tongjingyao, application of herbal concoctions, or related methods.What were the most common rationales for undergoing abortion? Adultery (tongjian) and premarital sex as the impetus for consuming tongjingyao or inducing abortion is a recurring theme in Republican abortion records (and those from later periods). Although infidelity was eventually decriminalized for unmarried women and widows in the late Republican period, numerous records cite fear of evidence of an affair as the reason for a woman in an extramarital relationship seeking to prevent or terminate her pregnancy.¹⁰⁶ Cases of premarital sex resulting in abortion were also fairly frequent, as young women or their family members sought to cover up the shameful evidence of intercourse before marriage, an act that could make those young women unmarriageable.¹⁰⁷ In one case, two young women even traveled from their rural villages to Shanghai to undergo abortions after premarital sex.¹⁰⁸

Quite a few abortion cases also involved widows who had intercourse after the deaths of their husbands.¹⁰⁹ Though no longer married, so to speak, the widows were expected to preserve their chastity out of loyalty to their husbands and husbands’ families. Appearing unchaste not only was shameful but also made the widows ineligible to receive pensions from their deceased husbands’ families, which could leave the widows penniless.¹¹⁰ In other circumstances, the widow’s lover – who was often already married – arranged for her to have an abortion without her permission, probably to protect himself from charges of adultery. This happened in the case of a 34-year-old Jiangbei widow, Shen Xu, whose married lover, Xiang Shijun, paid a Chinese medicine healer 30 yuan to insert herb roots into Shen’s womb and induce abortion.¹¹¹ Many such cases ended in death, legal penalties, or both.¹¹² Evidently, abortion seekers, such as those who had committed adultery, engaged in premarital sex, or violated their vows of chastity, often were left with few options aside from abortion if they did not want to face legal and social backlash.

While court records suggest that abortion in Republican cities transcended socioeconomic boundaries, I offer two brief observations with respect to the class and occupational dimensions of urban abortion. First, according to the records I viewed, the majority of abortion seekers caught by the police were factory workers, domestic servants, or other working-class individuals, who likely had little education.¹¹³ This is not particularly surprising, given that in Republican cities, factory work, entertainment, domestic servitude, and prostitution constituted some of the primary forms of female employment.¹¹⁴ This finding also fits with Susan Rigdon’s and Ling Ma’s conclusions that middle- and upper-class women who underwent abortions did so in more hygienic and expensive clinics.¹¹⁵ Such clinics offered greater privacy and protected abortion seekers from the law, and thus few of these cases can be found in court records.¹¹⁶

Second, abortions among actresses, courtesans, prostitutes, and other female entertainers were also fairly common, but the media tended to play up the link between these professions and voluntary or coerced abortion.¹¹⁷ Numerous articles discussed the hardships singers, prostitutes, and famous actresses faced, criticized their occupations and individual morality, and decried the practice of undergoing one or more abortions.¹¹⁸ The fact that prostitution was legal for most of the Republican era and that differences in status among entertainers, courtesans, and prostitutes diminished over that period undoubtedly contributed to this trend.¹¹⁹ Public denouncement of entertainers and prostitutes betrayed elite male anxieties about national stature and reflected the growing association of these professions with social disorder and cultural backwardness, rather than with the cultivated courtesans of the nineteenth century.¹²⁰ In this way, abortion became a tool through which to criticize modernity, capitalism, and women in the public sphere.

Returning to the case in the chapter’s introduction, this background knowledge provides useful context for interpreting the case of Li, the 19-year-old migrant factory worker in Tianjin. Li likely resorted to abortion for both social and financial reasons: to hide evidence of premarital sex and to retain her job at the factory. Like many other young women in similar situations, Li solicited the help of a woman, Guo, with some amount of training in traditional abortion practices. When the abortion took a deadly turn, Guo turned to a trained physician for help but to no avail. As a working-class woman who sought the help of a traditional woman healer, Li’s and Guo’s circumstances were precisely the type that the authorities cracked down on.

Birth Control and Abortion: Theory versus Practice

What can be ascertained from investigating birth control and abortion practices and the debates surrounding them? On the one hand, there was indeed a disconnect between the lofty notions of modern nationhood mentioned in Chapter 1 and the concerns of ordinary women presented in this chapter. While intellectuals had the privilege to reflect on the fate of society, the meanings of modernity, and the intelligentsia’s collective role in ensuring healthier babies, in reality, women who used birth control or underwent abortion did so for practical reasons framed by individual or familial concerns – not wanting an affair to be discovered, fearing the loss of a job due to pregnancy, or concern about the detrimental social implications of premarital sex. Moreover, elite discourses, consumer culture, the law, and medical hierarchies worked together to position affluent, educated women as the face of modernity, leaving lower-class, uneducated women as the socially undesirable residue in need of reform. Indeed, the languages spoken by vocal intellectuals and birth control users/abortion seekers barely overlapped. Rarely if ever did working-class women articulate birth control or abortion in terms of eugenic progress or individual sexual rights. For these women, the need to control births was more than a theoretical or existential issue.

On the other hand, debates in the public sphere may very well have shaped access to and policing of emmenagogues and abortifacients. Advertisements for medicines with abortifacient properties, as we have seen, were fairly ubiquitous, tacitly endorsing female agency at least in the realm of individual consumption and subtly promoting the notion that one’s body was one’s own domain. Although abortifacient use could still result in legal sanction, by not policing contraception and at times laxly enforcing abortion laws, national and local authorities created a space in which women could make some of their own reproductive decisions without state intrusion. Ling Ma, for example, argues that sometimes judges lessened sentences for abortion seekers because they acknowledged that abortion was often a product of poverty, coercion, or dire circumstances.¹²¹ This selective policing of reproduction might suggest that powerholders were engaging to a degree with ideas about individual rights and modern subjectivity. However, the link between elite eugenic concerns and individual contraceptive or abortion practices is more tenuous.

Conclusion

Exploring the range of contraceptive and abortive techniques available to women and those they chose to employ demonstrates that abortion was the most common form of fertility control that made it into the historical record. Yet, abortion – particularly as it relates to emmenagogues with their questionable function – took on many forms derived from folk practices, traditional Chinese healing, and Western medicine. Although less popular, contraceptives similarly consisted of a broad and elusive assortment of medicines ranging from patent medicines to technologies endorsed by trained medical specialists. Regardless of one’s demographic background, three of the main reasons for seeking abortion were adultery, premarital sex, and intercourse among “chaste” widows. Yet, lower-class women dominated both the court records and the media reports on abortion.

As Chapter 2 will show, these trends, concerns, and priorities with respect to birth control and reproduction did not simply disappear with the founding of the People’s Republic. Rather, certain practices were temporarily suppressed or reconfigured to fit within a Communist framework and deployed as part of the party’s modernizing agenda, with its emphasis on economic growth.