The professional experience of rural midwifery in China during the transition from traditional to modern birth practices (1950s–1970s): A qualitative study

Background

Although home births have been largely discontinued in contemporary China, traditional birth attendants (TBAs) historically played a pivotal role in enhancing maternal and child health, particularly in rural areas.

Aim

This study explored the transformation of TBAs in China from the 1950s to the 1970s, focusing on their gradual shift from traditional to modern midwifery practices. By drawing on oral histories from TBAs, the research seeks to enrich the historical understanding of midwifery development in China.

Methods

A descriptive phenomenological methodology was adopted to explore the professional experience, perspectives, and sociocultural contexts of TBAs. Data were gathered through semi-structured, in-depth interviews.

Findings

Analysis yielded five major themes and four sub-themes: (1) Intentional staff selection; (2) Purposeful pre-service training, with two sub-themes including (a) variation in training duration and the rarity of retraining, and (b) a predominantly practical, hands-on focus; (3) Accumulation of practical experience, with two sub-themes including (a) advocacy for natural childbirth with minimal intervention, and (b) practicing based on experience and contextual adaptation; (4) In-home postpartum care; (5) Recognition of professional value.

Conclusions

During the transitional phase from traditional to modern midwifery in China, TBAs were provided with limited yet pragmatic training before assuming their roles. Despite the inherent safety risks and a lack of formal medical oversight, TBAs made critical contributions to maternal and neonatal health in the context of severely limited medical infrastructure. Their presence and practices not only addressed urgent reproductive health needs in underserved areas but also gradually facilitated the shift of childbirth from the domestic sphere to institutional hospital settings.