Childbirth, Maternity, and Medical Pluralism in French Colonial Vietnam, 1880–1945 by Thuy Linh Nguyen (review)

Childbirth, Maternity, and Medical Pluralism in French Vietnam, 1880-1945 engages with the prevailing idea that colonies were used as laboratories for French experiments in modernity. Using archives in Vietnam and France, as well as published medical sources and newspaper sources, Thuy Linh Nguyen investigates the example of the French introduction of "modern" medical services in biomedical birthing and scientific childcare in colonial Vietnam. While the colonial administration attempted to replace the local maternity and childcare systems, this new system failed to supplant indigenous childbirth and childcare practices. Nguyen details the process by which the French medical system came to incorporate Vietnamese cultural practices into the maternity and childcare system. She argues that by the late colonial period, a plural maternity and childcare system developed in colonial Vietnam, one that compromised and coexisted with the indigenous cultural practices.

The chapters of Childbirth, Maternity, and Medical Pluralism in French Vietnam, 1880-1945 are organized thematically with a loose chronological approach to show the process by which the French biomedical system failed to take root in Vietnam and evolved as a localized system. Chapter 1 introduces readers to Vietnamese birthing practices in the late 19^th century, as the French government was establishing colonial rule over Vietnam. These practices included techniques used by traditional midwives called Bà mụ, including maternal diet, herbal medications, avoidance of metal medical instruments during birth, treatment of the placenta after birth, and the "mother roasting" tradition in which new mothers spent at least one month in seclusion in a birthing hut, laying on a bed over a charcoal stove. While 19^th century French observers saw these practices as barbaric or unhygienic, Nguyen shows that these practices served the purpose of relieving women's anxieties about birthing. As Nguyen explains, "mother roasting" helped postpartum women expel blood associated with pregnancy and birthing, blood that was said to attract bad spirits. Nineteenth-century French observers blamed high rates of infant mortality on what was believed to be unhygienic Vietnamese birthing practices and poorly trained Bà mụ, leading French medical practitioners to demonize Bà mụ. This reasoning became the basis for colonial medical practitioners to impose "modern" French medical practices in Vietnam, the subject of Chapter 2. Nguyen follows the process by which the French clinical maternity system developed in Vietnam based on an 1893 metropolitan initiative to provide free, "modern" maternity service. With its foreign medical and maternity practices, the French system initially failed to appeal to local women, who continued to patronize Bà mụ. Eventually French clinics adjusted to the Vietnamese cultural environment and allowed their patients to follow Vietnamese birthing traditions, including the "mother roasting" tradition. Nonetheless, the French biomedical system maintained racialist and inequitable practices that were endemic to colonial settings, and maternity hospitals were segregated between rich and poor, European and indigenous patients.

Chapter 3 explores the role of indigenous women working within in the French medical maternity system. In 1903, the French colonial government opened a school to train Vietnamese midwives in the French biomedical tradition. Graduates served on the front line of introducing French biomedical maternity services to the indigenous community in rural areas of Vietnam, as well as to Cambodia and Laos. Yet the program with its meager pay and remote stations had trouble recruiting and retaining Vietnamese midwives. The failures of the colonial maternity system in rural areas led the public health officials to change strategy. In 1927, as chapter 4 details, the colonial government began training a semi-professional corps of Bà mụ and deployed them to the countryside areas, where they offered patients a mix of French medical and Vietnamese cultural birthing practices. Nguyen argues that the incorporation of semiprofessional Bà mụ into the colonial maternity service resulted in the development of a plural maternity system in which the French biomedical model coexisted with the Vietnamese traditional system.

Chapters 5 and 6 address post-natal science in her analysis of...