Modernizing Fertility: International Network of Social Knowledge, Contraceptive Technologies, and Family Planning Programs between Taiwan and the United States, 1950s-‐1960s

黃于玲(State University of New York at Binghamton Sociology)— Modernizing Fertility: International Network of Social Knowledge, Contraceptive Technologies, and Family Planning Programs between Taiwan and the United States, 1950s-‐1960s ,指導教授:Dr. Benita Roth

The Birth of Large-­‐Scale Fertility Control Programs

In 1948, the Rockefeller Foundation sent a research team of social scientists and public health experts to the Far East. The team spent three months investigating the conditions of public health and demographic trends in Japan, Korea, China, Taiwan, Hong Kong, Indonesia, and the Philippines. The report, published in 1950 by the Foundation, addressed the team’s observations of these societies. The death rates in postwar Asia dropped quickly due to improvements in sanitation, medical, and food supply. These advances in “death control” were more attainable than broader social-economic changes that, according to the historical demography of Western Europe and North America, were the keys to lower fertility. These population experts were concerned with the demographic trends of East and Southeast Asia for they might not  be identical to the Western trajectory. Given Asia’ greater population base (over one billion people at the end of World War II) and its lack of social prerequisites—such as modernization, urbanization, decreasing illiterate rates, and increasing educated women—for reducing fertility, the Rockefeller team worried that it might take much longer than in the West to slow down the population growth and complete demographic transition in Asia. This result was “overpopulation” that would retard the region to modernize its people, economies, and societies (Balfour et al., 1950).

Less than two decades later, by the mid-1960s the same group of American population scientists had changed their perspectives about the vast population in Asia. They no longer considered that the low birth rates were the result of social changes. Instead, fertility reduction became  “a  means  of  hastening  the  process  of  modernization.”  Equally  important was the development of population establishment and contraceptive research that supported this thought. In his lecture to the Ceylon(1) Association for the Advancement of Science in 1964, Dr. Frank Notestein, a prominent American demographer, addressed: “for the first time in history we appear to have methods that are appropriate to meet the needs of the weakly-motivated,  illiterate and impoverished elements of the population. Given suitable organization for the dissemination of information, service, and supplies, there is no reason why all people everywhere cannot  restrict their childbearing as they see fit,” Notestein then concluded that with “the new awareness of the problem by peoples and governments, and the new and extremely powerful methods of regulating fertility, I think we are entitled to new optimism” (Notestein 1964).

In the same year, the Taichung Study in Taiwan proved that large-scale family planning programs(2) were feasible. Dr. Sam Keeny, the Population Council’s representative to Asia and the Taiwan Provincial Maternal and Child Health Institute’s consultant, commented that it was time for the Taiwanese government to stop carrying on its family planning programs covertly— previously  most  family  planning  services  provided  through  civilian  organizations that were supported by the provincial government and no official endorsement from either provincial and central governments. If the government could advocate family planning publicly, the programs could enlist more social groups’ supports and do the work more effectively (UDN 1964). The provincial  government  soon  launched  an  island-wide  family  planning  program  and  Taiwan became an exemplar for the American population experts to show the world that fertility limitation at the national level was possible. This was contrast to fifteen years ago when fertility control was prohibitive. The family planning administrators recalled that when the Joint Committee of Rural Construction initiated to disseminate the information of rhythm method to married couples in 1949, their action stirred up political water. The pressure from politicians and the military forced them to stop the project immediately, because any action related to limiting population growth was regarded as opposition to the Kuomintang regime’s state-building and the initiators were blamed as Chinese Communist Party’s allies.

The above scenarios reveal two noteworthy changes between the late-1940s and 1960s. First, to reduce fertility at a national scale was not feasible to the American demographers during the early postwar years until the idea became realized via national family planning programs in the less-developed societies beginning in the mid-1960s. Second, a state like Taiwan, which once considered population as the nation’s strength, became to embrace fertility limitation at its primary economic-cum-health policy from the 1960s, in which American experts were heavily involved. These two changes were actually connected. In this thesis, I analyze why and how population control via large-scale fertility limitation programs became thinkable, desirable, and feasible in postwar Taiwan and the role of Americans in this shift.

The international campaign to limit population growth and to lower high fertility rates is a history when low fertility is becoming the main concern to many countries in the twenty-first century. Yet we just began to understand the various aspects of this history that greatly transformed human reproduction in the second half of the twentieth century. To unveil the historical contexts, actors, and processes of this transformation is not an easy task. For one thing, its complex nature demands researcher touch upon “the history of technology and medicine, of demography and diplomacy, of political economy and cultural formation” (Connelly 2003: 122). Indeed, government-supported family planning programs from the 1960s involved a set of factors, from sexuality, reproduction, and childrearing at individual and familial levels to collection and application of social knowledge, medical practices, and state’s population  planning and governing techniques.

The campaign’s transnational characteristics also make it challenging to historicize the origin and formation of family planning programs as a dominant measure to govern population. By international, I refer to the roles that local and foreign institutions and individuals, aid programs, and international non-governmental/intragovernmental organizations took in setting  up the fertility reduction projects in less-developed societies. Extant historical accounts of population control have shown why the some developed countries, the United States in particular, became interested in limiting the world’s population growth and how they mobilized to make the campaign a crucial concern in the United States (e.g., Caldwell and Caldwell 1986; Critchlow 1995, 1999; Donaldson 1990; Harkavy 1995; Mass 1981; Petroni 2011; Sharpless 1995, 1997), but the studies on what American organizations and individuals did abroad and how they interacted with local people during the early period of international population control campaign are just emerging (e.g., Baron 2008 and Bier 2008 in Egypt; Connelly 2008 and Takeshita 2012 in global; DiMoia 2008 in South Korea; Connelly 2006 and Hodges 2004 in India). To grasp transnational feature of this history, we need more single-country accounts that examine the international connections with the main donor—the Americans institutions and population experts.

Nevertheless, my thesis does not only add one case study to the existing critical studies about  family  planning  programs.  The Taiwan case is significant to this global history of reproductive politics for two reasons. First, the Taiwan programs, starting with the Taichung Study (1963-1964), was a pioneer to demonstrate that, through state interventions, fertility control was doable in cost-effective measure. To American population controllers, the Taiwanese government, and other developing countries, these early programs offered scientific legitimacy and practical instructions to boost the confidence of the international agencies and actors who were interested in controlling fertility at the mass level. Second, Taiwan’s family planning programs produced a lot of surveys and evaluations, which provided rich socio-demographic and medical data. Dr. Ronald Freedman, sociologist and the most influential American advisor to Taiwan’s family planning programs, noted that these data were uniquely complete to observe the demographic transition. To me, these reports and papers picture the programs’ reasoning and practice. In this study, I explore the emergence and formation of national family planning programs in 1960s Taiwan as a product of a specific historical era and circumstance, in which  the international flows of socio-demographic knowledge, contraceptive technologies, and population policies were initiated, developed, and contested by American experts and Taiwanese technocrats/specialists.

(1) Ceylon is the former name of Sri Lanka until 1972.

(2) According to World Health Organization’s definition, family planning “allows individuals and couples  to anticipate and attain their desired number of children and the spacing and timing of their births. It is achieved through use of contraceptive methods and the treatment of involuntary infertility. A woman’s ability to space and limit her pregnancies has a direct impact on her health and well-being as well as on the outcome of each pregnancy.” Although family planning is often used interchangeably as birth control—i.e., individuals and couples’ reproductive practice, the organized efforts to promote and provide family planning services often beyond or exclude the intention to enhance women’s reproductive health and well-being. In this dissertation I use large-scale family planning programs to refer the government-supported or state-endorsed works to provide family planning information and methods as state interventions in order to reduce fertility rates and limit population  growth  for state’s agenda and interest. These programs reached its peak in the 1960s and 1970s, including in Taiwan, which is my thesis’s focus.

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