Childbirth, Maternity, and Medical Pluralism in French Colonial Vietnam, 1880–1945 reconstructs the history of colonial efforts to introduce ‘modern’ maternity and childbirth practices to Vietnam during the French colonial era. Using reproduction as a lens, Thuy Linh Nguyen illustrates the ways in which the colonial encounter – as it pertained to medicine – was one of adaptation, compromise, negotiation and transformation for both the Vietnamese and the French. In particular, the book examines how French efforts to relocate maternity and infant care into a clinical setting led to a pluralistic medical system due to misunderstandings, the failure of colonial physicians to recognise the cultural and religious significance of embedded maternity and infant care practices, and local resistance by indigenous medical practitioners and pregnant women.
Thuy Linh Nguyen’s detailed examination is based on French and Vietnamese archives encompassing medical legislation, administrative decrees, and medical reports regarding infant mortality, demography, maternity hospitals, medical budgets and colonial health care concerns. Statistical and administrative records are supplemented with personnel files of colonial midwives that provide rich material for understanding the midwives’ personal and professional lives. Thuy Linh Nguyen gains insight into Vietnamese perspectives on French ideas of childbirth and motherhood from daily public discussions in Vietnamese newspapers and magazines and from medical pamphlets and advertisements.
The author begins the book examining ‘The First Encounter’: the ways in which French physicians and researchers made a case for intervening in and revising local childbirth and maternity practices. They did so by drawing attention to high rates of infant mortality from umbilical tetanus, depicting traditional midwives (bà
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) as incompetent, and labelling childbirth customs such as the handling of the placenta and post-partum ‘lying by the fire’ backward and detrimental to good hygiene and maternal and infant care. Having set the stage, Thuy Linh Nguyen then examines the medical and social nature of the new colonial maternity hospitals in which Vietnamese women were first introduced to western biomedical models of childbirth. While the new maternity hospitals effectively combatted maternal and infant mortality and diseases for hospital attendees, racist and classist practices hindered the ability to extend effectively maternity care to rural areas.
The author elucidates this failure by examining the training and experiences of colonial midwives: professionals trained in the western biomedical tradition who were simultaneously collaborators in the colonial health care system but also subject to racist, sexist and social restrictions. Eventually acknowledging the symbolic, medical and practical value of bà
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, French physicians began to train and incorporate bà
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into the state’s health care system, enabling the indigenous population to choose culturally appropriate maternity services. Thuy Linh Nguyen argues that the resultant pluralism in maternity services ‘demonstrated the limits of colonial power and, at the same time, the perseverance of Vietnamese childbirth practices’ (p. 141).
The last two chapters focus on French introduction of ‘scientific motherhood’, part of French pro-natalist and social-hygiene campaigns during the Depression era, in order to improve infant and child health. The chapters trace the efforts of both colonial and Vietnamese medical and social workers in these campaigns. Despite overlapping but divergent concerns (colonial efforts were principally based in concerns with ‘empire and labour’, whereas Vietnamese intellectuals focused on the ‘preservation and improvement of Vietnamese racial health’), both place the burden on Vietnamese women to battle against infant mortality, racial degradation and national decline. A myriad of interested parties including Vietnamese intellectuals, government officials, medical professionals, private and religious associations and global food companies such as Nestlé sought to intensify women’s interest in motherhood and childrearing. As in previous chapters, Thuy Linh Nguyen illustrates how colonial ‘civilising’ efforts and Vietnamese traditions, in this case motherhood and childrearing practices, informed and yet bumped up against one another in order to demonstrate that colonial medical intervention was never a one-way causal process, but one of negotiation, local resilience and transformation.
Because each chapter reiterates key previous points, it is possible to read individual chapters on their own and still have a sense of what has transpired up to that historical moment. This rhetorical strategy is both a benefit and a drawback. While the reader benefits from being continually reminded of key previous points, at times the material feels redundant (for example, that one of the predominant factors contributing to infant mortality was the bà
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’s technique for cutting the umbilical cord).
Childbirth, Maternity, and Medical Pluralism in French Colonial Vietnam, 1880–1945 will be of interest to a range of scholars: those interested in the link between colonial medicine and empire building; the tensions inherent in introducing and implementing western biomedical values and practices in non-western medical contexts; how race, class, gender, and religious and cultural values inflect medical practitioners’ (both French and Vietnamese) provision of health care; the social and administrative processes through which plural medical systems emerge; how the Vietnamese have incorporated and transformed values and practices from elsewhere for their own benefit; and early examples of how Vietnamese women’s personal private reproductive lives became of concern to the state. Childbirth, Maternity, and Medical Pluralism in French Colonial Vietnam, 1880–1945 provides valuable historical antecedents to contemporary discussions on Vietnamese motherhood and the state’s concern with ‘quality children’. Thuy Linh Nguyen’s work provides a cautionary lesson for contemporary health care practitioners and administrators working in different cultural and geographic contexts. French colonial ‘civilising’ efforts, accompanied by attitudes of superiority and a failure to understand the importance of indigenous beliefs about the body, mirror contemporary global health care efforts designed to change values and behaviours so that they align with western biomedical practices. We would be well advised to heed these lessons from the past.
