The Beiping Child Health Institute was established on May 19, 1930, under the Municipal Health Department to “[investigate] conditions in Beiping relating to maternity and child health.”364 The Beiping Municipal Health Department was established in July 1928 after China’s capital
363 Ibid.
364 Marion Yang and I-Chin Yuan, "Report of an Investigation on Infant Mortality and Its Causes in Peiping,"
was moved to Nanjing, Peking’s name changed to Beiping, and its status changed to a special municipality. In the same year, the local municipality appointed a Beiping Maternity Welfare Commission in order to advise the Health Department in its maternity welfare work. In 1930, the City Health Department was abolished, the Commission’s name was changed to the Beiping Child Health Institute, and it fell under the domain of the Department of Public Safety. The Institute was meant to be a national model for other municipalities to follow. The FNMS cooperated with the National Midwifery Board to inaugurate the National Maternity and Child Health Programme through the Beiping Child Health Institute in July 1930. This provided the central health authorities with opportunities “to experiment with an urban plan for midwifery… and [give] the [FNMS] field training facilities.”365 The Institute was the “administrative
headquarters for city wide activities in the field of maternity and child health (at Jianlong
Hutong)” and would provide practical field experience for midwifery students.366 It was housed near the FNMS in a city-owned building and in 1932 had one physician and three midwives on staff.
The Institute was run by the Beiping Maternity and Child Health Committee, which consisted of nine senior medical and public health personnel in Beiping who were nominated the first year by the Director of the Institute. In subsequent years, a sub-committee on election recommended members to the Director for appointment. The term of office was one year, and committee meetings were held bimonthly at the Institute. Its primary responsibility was as an advisory body to the Institute, responsible for “unifying the maternity and child health facilities
365 "First Annual Report, FNMS," 3.
in the city, undertaking periodical investigation of problems connected with maternity and child health, and undertaking periodical supervision of midwives and maternity hospitals.”367
The objectives of the 1932-34 Plan for the Beiping Maternity and Child Health Movement, which was essentially the plan for the Institute, was twofold. First, it would “develop a standard for urban maternity and child health that will meet local conditions and provide teaching facilities for public health [workers], midwives, and field workers.” The second goal “was to develop a system of maternity and child health which will offer a full measure of protection to mothers and children under five years of age through maternity hospitals, maternity and child welfare centers, obstetricians, physicians, midwives, [and] other maternity workers.”368 More specifically, its duties were to research nutrition, infant and maternal mortality, and birth control. The plan also called for “unifying the maternity and child health facilities in the city;”369 controlling tetanus neonatorum; planning the establishment of midwifery schools, hospitals, and antenatal clinics; training and registering old-style midwives; publicizing midwifery education; and devising ways to raise money for this type of education. Its activities included mothercraft classes on the most up-to-date methods of child-care, a graduate association to promote maternal and child health, regional city health clinics in ante- and postnatal care, health propaganda through maternal and child health pamphlets and posters, “registration and supervision of midwives including refresher courses for modern and old-type midwives, statistics and investigation, which in addition to the general statistics, undertakes studies with relation to infant mortality, nutrition of children, and birth control.”370
367 "Fourth Annual Report, FNMS," Appendix I: Suggested Plans for Places Surveyed, viii. 368 Ibid., Appendix I: Suggested Plans for Places Surveyed, vi.
369 Ibid., Appendix I: Suggested Plans for Places Surveyed, vii. 370 "First National Midwifery School, Peiping," 2.
The 1934-37 Three-Year Plan called for establishing two maternity hospitals and five clinics for women and children throughout the city, and providing free smallpox inoculations and soybean milk to poor mothers and infants. Operating expenses in 1934-35 were meager,
amounting to $700 per month, most of which went to the salaries of the physician ($200), four midwives ($50 each), five assistants ($30 each), and two clerks ($20 each). The remainder went to office expenses. During the following year, the capital expenditures were as follows: each maternity hospital needed $1,800 per month, and the two soybean milk stations each required $200 per month. In addition, operating expenses were expected to increase to $2,000, including $750 for salaries, $1,000 for the maternity hospitals, and $250 for office expenses.371
One of the main responsibilities of the Institute was “registering, training, supervising, and controlling midwives,” which it began in 1930 on behalf of the Health Department.372 In fact, until 1930 this part of the Commission was called the Training Center for Old-Type Midwives. (After the Beiping Maternity Welfare Commission’s reorganization, the Center expanded its duties and changed its name to the Beiping Child Health Institute.) In 1931-32, the Institute planned to enlist at least 25 midwives to care for the poor who were unable to afford the help of even old-style midwives, and to build a municipal maternity hospital with at least 200 beds.373 In 1932-33, the Institute investigated, registered, and licensed 292 old-style midwives, of which 46 were disqualified, and licensed 43 modern midwives. That year’s Annual Report stated that the number of old-style midwives was decreasing, while modern midwives were increasing in number. In 1931-32, the Institute trained 49 old-style midwives and gave refresher courses to 24 “modern type” and 87 “old type” midwives. The following year included three
371 "Sixth Annual Report, FNMS."
372 "First Annual Report, FNMS." 373 "Midwifery Education."
refresher courses each for local modern midwives from unregistered schools, resulting in 19 additional registered modern midwives.374
The Institute also undertook initiatives in maternal health, especially regarding birth control, infant mortality, and children’s nutrition. By 1932, they had published a total of 1,800 leaflets and 12 sets of posters on these issues, plus 1,000 copies of a “Mothercraft Manual,” which sold out at 40 cents per copy within six months. In May 1933, a second edition of 3,000 copies was printed. The mothercraft class was “one of the most important and satisfactory of the activities,”for the mothers were to “teach and influence the other women they came in contact with” about modern methods of child-rearing.375 After completing the FNMS course, they were expected to “form mothercraft classes in their own homes for their neighbors.”376 Between May 1930 and June 1932, the Institute graduated a total of 59 students in seven mothercraft classes. However, 102 registered initially, so that means 43, or 58 percent, dropped out before
completing the course.
The Institute operated maternal and child health clinics as well, staffed in large part by FNMS students. By 1934, three maternal and child health centers were open under the Institute’s supervision in Beiping. Attendance was quite good, with 1,330 first visits and 757 return visits in 1930-31 (including antenatal, postnatal, children’s visits, and inoculations). In connection with this clinic, the Institute also ran a free delivery service. In 1930-31, there were 19
deliveries, and during the following year that number grew to 88.377 In 1931-32, midwives and physicians at the clinic attended 206 antepartum, 33 postpartum, and 276 infant cases, and made 36 home deliveries. In 1932-33, that number grew slightly to 1,358 first visits and 614 return
374 "Fifth Annual Report, FNMS."
375 "Fourth Annual Report, FNMS," 23. 376 Ibid.
visits, but with 150 free deliveries, nearly double that of the year before.378 In 1933-34, the number of new cases was 1,861, with 363 home deliveries and 110 referred to other institutions for delivery.379
In 1935, the Beiping Municipality took over the running of the Institute and dedicated further personnel and budget, so the FNMS withdrew from providing assistance, and Marion Yang resigned as its honorary director. This was in accordance with the Central Government’s policy, which was to initially assist in establishing maternal and child health work but to withdraw as local authorities were able to take over the work themselves.380