전간기(戰間期) 일본의 산파와 ‘출산정치’

Japanese Midwiv es and the Politics of Childbir th in the Interwar Period

This thesis is an examination of the social dynamics of childbirth in Modern Japan based on the history of modern midwives during the interwar period. Midwife(産婆) was redefined as an occupation that required western, modernized knowledge and provided services in hygienic conditions by Isei(醫制) and Sanbakisoku(産婆規則), both of which were enacted during the Meiji Period. The newly qualified midwives gradually replaced the traditional ones. However, the role and status of the new midwives were weakened by the social change brought by World War I. To understand the relatively brief interval between the development and decline of new midwifery, it is important to evaluate the way of dealing with childbirth issues in Modern Japan and the power relationships between various agents involving childbirth. This thesis focuses on the history of social childbirth during the modern period as well as the history of midwives during the interwar period, with regards to the politics of childbirth . The politics of childbirth can be defined as the political process through which various agents such as government, midwives, physicians, pregnant women publicly control, interpret, and compete against one another on issues of childbirth. After W.W.I, change occurred not only in birth attendance from midwives to doctors or place of delivery from home to institutions, but also in the development of medical knowledge and technologies on the entire process of childbirth. The change, called the medicalization of childbirth , helped develop institutions and medical science. Specifically, the politics of population which was normalized and systemized after the outbreak of W.W.I and the rice riots(米騷動), hygenic birth attendant conditions supported by community maternity services and Health Insurance Law, the development of obstetrics and increase in physicians birth attendance and the popularization of medical knowledge about childbirth caused the medicalization of childbirth and weakened the role and status of midwives. It is certain that the medicalization of childbirth has been common in Japan since 1960s, but it is also clear that the change promoted during interwar period was one that excludes the role of midwives. The exclusion is verified by the National Midwifery Association s legislative movement for Midwifery Act(産婆法) in the 1930s. The midwives were experiencing financial difficulties as more childbirths were being covered by health insurance, and also because of growing competition, which was composed of physicians and medical practitioners. For this reason, the National Midwifery Associations called for the reinforcement midwives qualification and approval of their organization as a public corporation to protect midwives weakened position. However such efforts were opposed by other agents participating in the childbirth issues. Physicians argued for a hierarchy which placed the midwives in the lower strata of the childbirth process. Midwives could take charge of normal deliveries but could not treat patients by using drugs or medical operations. Also the government stuck to its policy to deliver modernized, hygienic childbirth conditions at a lower cost which proved to be another obstruction to the Midwifery Act.