Academic journal article Nursing History Review

Midwife and Public Health Nurse Tatsuyo Amari and a State-Endorsed Birth Control Campaign in 1950s Japan

Academic journal article Nursing History Review

Midwife and Public Health Nurse Tatsuyo Amari and a State-Endorsed Birth Control Campaign in 1950s Japan

Article excerpt

Abstract. Mrs. Tatsuyo Amari, a qualified midwife and nurse, served Japan's state-endorsed birth control campaign as a "birth control field instructor" in rural Minamoto Village of Yamanashi Prefecture just west of Tokyo. Her work sheds light on the role of female health-care workers in health and population governance in 1950s Japan. Amari not only facilitated the "top-down" transfer of the state-sanctioned idea of birth control and contraceptives, as did other birth control field instructors, but also enabled the "bottom-up" flow of knowledge about people's reproductive lives through her participation in the policy-oriented birth control research called the "three model-village study." Contextualizing Amari's engagement with the study elucidates how the state relied on the established role of female health-care workers as intermediaries between the state and the people. Finally, Amari's contribution to the scientific aspect of the campaign may motivate historians to recognize the politics around the participation of female health-care workers in the science of birth control.

Today the Japanese government expresses concerns over its declining birth rates, but half a century ago it proudly proclaimed that its birth control policy had tamed population growth. In 1951, the Japanese Cabinet decided that the government should set out to popularize birth control and a state-endorsed birth control campaign followed.1 Coinciding with the policy, birth rates declined dramatically over the 1950s. The government took credit, suggesting that the policy was reducing the birth rates. In practice, however, community-based midwives and public health nurses played a critical role in implementing the policy in the lives of millions of Japanese people. Many of these women took on the role of "birth control field instructors" (jutai chosetsu jicchi shidoin) to teach married men and women the new idea of contraception and to distribute contraceptives. Birth rates declined partly because of the "on-the-ground" work of these female health-care workers.

This article illustrates the important role of these health-care workers in the state-endorsed birth control campaign by analyzing and contextualizing the activities of Mrs. Tatsuyo Amari (1928-), a qualified midwife and public health nurse who served as a birth control field instructor in rural Minamoto Village of Yamanashi Prefecture, just west of Tokyo.2 In many ways, Amari was a typical instructor, so her story reflects the experiences of many midwives and public health nurses employed in the birth control initiatives.3 At the same time, she was one of a small minority of midwives in Japan who took part in the policy-oriented "three model-village study" and this made her particularly distinctive. Launched in 1950 and conducted by the NIPH in Tokyo, the study was charged to test the policy's practicability, with a pilot project to investigate whether contraception reduced birth rates.4 The study employed Amari for the pilot initiative to present a model to deploy nationwide, so for the most part what she did for the study can be considered representative of the activities of other field instructors. However, she also stood out from the other field instructors because of her contribution to the scientific aspect of the project.5

Amari's embodying both typical and atypical features provides us with a powerful lens through which to analyze the significant position midwives and public health nurses occupied in the birth control campaign and, more broadly, in state-led population governance during the 1950s when the campaign was at its peak. In contrast to the United States,6 for example, central authorities in Japan have actively intervened in population and reproductive health since the Meiji period (1868-1912), as the politics surrounding life became an increasingly intricate part of Japan's modernization process.7 The state assigned the role of purveyor of its health policy to midwives and public health nurses. …

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