Globally, public health was an important facet of modern nation-state building. It created new practical relationships between the state and the people by improving health care and hygienic living conditions and ideological relationships through the dissemination of modern, scientific approaches to medicine. In the case of China, many scholars have devoted their research to understanding how hygienic campaigns functioned as parts of modernization initiatives. This dissertation contributes to the rich historic work on medicine and public health by examining the development of medical power through networks of birth workers in China and Taiwan. In the 1950s, both Chinese governments – the People’s Republic of China (PRC) and the Republic of China (ROC) – attempted to address concerns about infant and maternal health by improving midwife care and access to those services. Doing so required not only the training of women as midwives but also a dialogue with the public to build the credibility of these new, modern medical workers. In the first half of this dissertation, I argue that the governments attempted to support these midwives by trying to recruit locally and making modern medical terminology legible to would-be patients. Through their successes, the midwives were able to cultivate trust and authority with people in remote and rural areas, thus facilitating the reach of state-sponsored medicine. In the second half of this work, I shift the focus to the PRC, using the examples of barefoot doctors and family planning initiatives to show that the state began to use medical networks to exert medical power through birth planning mandates. The complex dynamics between state policies, medical care, and gender coalesced in the portrayal of women as paramedical workers and as the main purveyors of birth control. The state effectively leveraged the female barefoot doctors’ social and political roles in the service of its family planning initiatives. The creation of public health workers like midwives and barefoot doctors was about their ability to improve public health, but those medical networks also served additional purposes. They provided pathways of surveillance and enforcement of policies, whether that was about licensing and certification or about vaccine and birth control campaigns. The relationships built by the state with patients through medical care providers further reinforced biases from scientific medicine itself, wherein adopted systems of public health perpetuated colonial relationships of extraction and control, although in these cases they were internally focused.
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