Birth was, and still is, not only a biological event, but also a political one. In the early twentieth century, a time of often-tense U.S.-Japan relations and an anti-Japanese movement, the American sanba nonetheless managed to preserve midwifery, a Japanese cultural practice… Japanese immigrant midwives drew on modern Japanese approaches to deliver Americans.
Susan L. Smith’s book examines the political and social circumstances surrounding the U.S. arrival of the first generation Japanese immigrant midwives, also known as sanba. Smith’s transnational analysis begins in Meiji Japan. The active education and professionalization of sanba was just another initiative alongside similar efforts to promote Western medicine and prove Japan’s strength and its new “modern” status as an imperial nation.
The second chapter shifts to the sanba in the American West, namely California. The West imposed more lax regulations of midwives than the South, which was dominated by African American midwives assisting nearly 50% of African American births in the area. Despite national cries of the “midwifery problem,” Japanese American midwives in the rural areas went largely unregulated as physician access was already scare and unavailable.
The most interesting part of the book is the peek into the lives of Japanese American midwives in the incarceration camps. Nearly 120,000 Japanese Americans were “evacuated” and “relocated” to various “relocation centers” (read: incarcerated in prison-like camps) by the War Relocation Authority (WRA). In part due to the environmental conditions of the camps, which were established in undesired areas such as swamplands or deserts, and the anti-Japanese sentiment in the American public, the incarceration camps’ hospitals were severely understaffed. Despite the overburdened nature of the largely white health workers, Japanese American midwives were not actively employed. Smith argues that their idleness was not only due to the unsuitable conditions of barracks where home-birth would take place, but also disdain towards midwifery which was seen as “backwards” compared to “modern” Western medicine and distinctively Japanese.
Perhaps as a result of their underutilization in the WRA camps, midwifery was largely abandoned by the Japanese American community after World War II. Instead, the Nisei, or second generation Japanese Americans, echoed much of the larger white-American discourse around midwifery and deemed it an “unclean” and “outdated” practice. Maintaining her critical racial lens, however, Smith also argues that the community’s sudden departure from midwifery may also have been due to the post-incarceration fear instilled in Japanese Americans of what it means to not conform to white American standards. Both the deliberate withholding of midwifery knowledge by the Japanese immigrant midwives and the fierce rejection of midwifery’s culturally Japanese nature by the second generation Nisei contributed to the distancing of the Japanese American community from their traditional practices of midwifery.
For a more personal look at Japanese American incarceration, check out the Japanese American Relocation Digital Archive.