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ChAPTER 7 New Countryside, New Family The Discourses of Reproductive Risk in Postsocialist Rural China Qingyan Ma After three decades of economic reform and a massive effort toward “modernization construction” (xiandaihua jianshe), China has become an emerging world power. Challenging the image of modernity, however, is the huge gap in reproductive health that exists between China’s underdeveloped west and well-developed east. In the impoverished rural southwest region of China, exceedingly high rates of infant and maternal mortality sparked the creation of the Larger Shangri-la Project (LSP), involving multisector collaboration among local residents, NGOs, and official state family-planning agencies. Under the LSP, the National Population and Family Planning Commission of China (NPFPC) grouped together adjacent but administratively distinct territories across two provinces (Yunnan and Sichuan) and the Tibetan Autonomous Region because of their shared interest in ameliorating reproductive mortality rates. This resulted in the creation of an administrative area, the Larger Shangri-la Area. The contrast in maternal mortality statistics between the Larger Shangri-la Area and China’s eastern coast is astonishing. According to a report from Xinhua News Agency in 2005, the maternal mortality rate in Suzhou, a city on the eastern coast, was 24 per 100,000 live births, while in western China in Ganzi Tibetan Prefecture in Sichuan Province (part of the Larger Shangri-la Area) the rate was 1,119 per 100,000 live births—close to fifty times higher. This gap contradicts the state’s promotion of “constructing a harmonious society” under the current Hu Jintao administration, and consequently was used to justify reproductive intervention by the Chinese state in the Larger Shangri-la Area. One strategy proposed under the LSP for resolving the health gap between east and west was to increase hospital versus home births. Through the LSP, local residents were to be educated about the purported dangers associated with home birth and to adopt a belief in the biomedical definition of risk as it related to their reproductive practices. As a result, the current reproductive practices of the local people are the outcome of constant negotiation among public health experts, local officials, local health providers, and local residents. Moreover, the construction of risk, as differentially perceived by these multisituated and at times conflicting 141 actors, becomes an arena for the political control of outlying populations. In a country well known for a eugenically motivated birth-planning policy (Anagnost 1995; Greenhalgh 2008), the LSP targets minority ethnic populations residing in the borderland in particular, encapsulating the state ideology toward Chinese nationalism , borderland security, and family planning. This chapter examines the current reproductive practices of those ethnic groups (Lisu, Naxi, Tibetan, and Han) living in Weixi Lisu Autonomous County in northwest Yunnan Province—now a part of the Larger Shangri-la Area—and explores the discourses of reproductive risk as conceived by various parties influenced by their relation to biomedical knowledge and hierarchies of power. Focusing on how the Chinese state’s intervention in reproduction and the promotion of hospital birth is challenged by poverty, class-stratified ecological residence patterns, and ethnic differences in Weixi County, this chapter looks at specific reproductive social policy as it is administered to a stratified population with varied understandings of risk. As state-level reproductive interventions in People’s Republic of China have historically been tied to political motive and rationale (Anagnost 1995; Greenhalgh 2008), such a multilevel construction of risk is analyzed in the context of postsocialist rural health care reform and population policy as articulated by the Yunnan Health and Development Research Association (YHDRA). This statesanctioned NGO, made up of public health experts, governmental officials in charge of public health, and social scientists concerned with researching medicine and health, is responsible for initiating, implementing, and evaluating the LSP. This chapter looks at how the discourses of reproductive risk generated by YHDRA and articulated through the LSP impact the attitudes and actions of the minority ethnic populations of Weixi County. Research for this chapter was conducted in the Weixi Lisu Autonomous County and in the capital city of Yunnan Province, Kunming, in the summers of 2007, 2008, and 2009, during which I interviewed public health experts from YHDRA, local village doctors, and obstetricians working in the county hospital and local villages. I also conducted participant-observation in meetings between the members of YHDRA and local state officials.1 For several months pursuant to this research in China, I followed up on the progress of the project via YHDRA’s website. An Overview of...

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