For the second annual Nursing Clio Prize for Best Journal Article, honorable mention went to Sarah Mellors’s “The Trouble with Rubbers: A History of Condoms in Modern China.” An assistant professor of East Asian history at Missouri State University, she wrote this article in response to contemporary concerns about the low rates of condom usage in China. I had the pleasure of interviewing Sarah about her work, why histories of reproduction have been slow to develop in Chinese history, and what we can learn from China about contemporary reproductive justice debates.
Laura: Congratulations on receiving honorable mention for this prize, as well as for your upcoming book, Reproductive Realities in China: Birth Control and Abortion, 1911–2021 (Cambridge University Press, 2023)! With both projects growing out of your dissertation research, how does it feel to be coming to the end of such a long research process?
Sarah: It is both gratifying and an enormous relief. My doctoral research sought to historicize the One Child Policy—the national family planning mandate implemented in 1979 that limited Chinese couples to one child each. The One Child Policy first attracted my attention in 2009 when I was teaching English at a suburban middle school in China’s Guangdong province. I had heard about the policy’s harsh enforcement and the fact that transgressors were sometimes forced to undergo abortion and sterilization surgeries. To my surprise, my pupils often teased each other, joking that one student had cost his parents an additional 1000 yuan in fees or that another had managed to evade the policy altogether. In 2011, I was teaching English and history at Nanjing University of Aeronautics and Astronautics in Jiangsu province when I was asked to teach a compulsory class for university faculty and administrators. As I grew closer to my adult students, they confided in me about their personal lives. Many of my students, then in their 40s and 50s, had undergone multiple abortions in accordance with the One Child Policy, the violation of which could lead to heavy fines or even expulsion from the university.
This series of events—revealing the diversity of individual experiences under the One Child Policy—piqued my interest in studying the history of contraception in China from a grassroots perspective. Initially, I researched state responses to population policy violations for the Congressional-Executive Commission on China in Washington, DC. Then, as a graduate student in 2014, I began investigating how contemporary abortion and contraception trends fit into the longer narrative of the history of reproduction in China. Foregrounding women’s lived experiences negotiating China’s shifting population policies was a central aim of my research.
A lot has changed in China since I started this project. Most critically, the One Child Policy was officially abolished in 2015, and a Three Child Policy was enacted in 2021. Yet, my research remains relevant because official discourses about reproduction in China treat women’s bodies as tools of state power. Whether the objective is to limit population growth or encourage it, state policies are most concerned with producing the right number—and right kind—of babies to support national economic and political goals.
Laura: Your article looks to the past century to understand today’s “condom crisis” in China, in which low condom usage has led to higher rates of abortion and HIV/AIDS infections. You write that most academic research into condoms has been in fields like public health and the social sciences. Why do you think the history of contraception in China has been slow to emerge?
Sarah: Scholarship on sex, reproduction, and birth control in modern China has largely concentrated on the One Child Policy (1979–2015), which at the time that it emerged, fell within the purview of the social sciences with their emphasis on present-day issues. As the policy recedes into the past, though, state fertility policies and birth control trends, in general, are opening up as sites for historical exploration. Increasing recognition of the legitimacy of historical research about sex and sexuality, as well as access to a wider range of sources, are also facilitating this change. Yet, in more mainstream publications the One Child Policy still often overshadows other research concerning reproduction and contraception in China.
Laura: The Chinese story of sex education and birth control might feel familiar to Americans—including angst about morality, premarital sex, and abortion—but Chinese medical practices, ideas about gender, and the Communist era take the narrative in a different direction. What do you want readers to take away from this article?
Sarah: I hope this article reminds readers that technologies like condoms are always the product of the social, cultural, and political environments in which they exist. Therefore, we can’t understand why people do or don’t make certain reproductive decisions (or in cases where “choice” is not a determining factor, have certain reproductive outcomes) without paying close attention to environmental factors. Gender dynamics, moral convictions, and economic realities, among other things, all shape access to and attitudes toward birth control in critical ways.
Laura: At a time when reproductive justice is under attack here in the United States, what lessons can we take from China’s history?
Sarah: Although official discussions of birth control and abortion in China rarely focus on individual rights or feminist liberation, as is often the case in countries like the United States, uneven access to reproductive healthcare has had similar results in both places. The most vulnerable members of society—the poor and otherwise marginalized—always suffer the greatest hardships as a result of limited access to reproductive options. Before birth control and abortion were made widely available in China, women had to bear the burden of successive pregnancies, which took heavy tolls on their health and wellbeing. In many cases, seeking to escape financial ruin or public reproach (in the case of premarital or extramarital pregnancies), they resorted to dangerous back-alley abortions or home birth control remedies. Those women with access to greater economic and societal resources fared far better than their disadvantaged counterparts. In particular, a look to the past suggests that restricting access to abortion won’t make it disappear. The only thing such a policy can guarantee is that less privileged women will be denied access to safe abortions and the right to reproductive autonomy.
Laura: With your book coming out this year, I assume you are looking forward to new projects. What’s next on your research agenda?
Sarah: My second book-length project, “Growing Old in China: A History of Aging in the People’s Republic,” grew out of my earlier research and takes China’s growing senior population as its focus. According to official estimates, by 2050, half a billion people in China—one-third of the national population—will be at least 60 years old, yet access to eldercare has not kept pace with demand for it. Since the late 1970s, the rollback of the collective-era welfare system, uneven economic development, and inadequate access to healthcare have posed major setbacks for the elderly. Moreover, longer life spans and the One Child Policy have skewed the demographic structure, limiting the number of young people able to support and care for retirees. Drawing on archival research and interviews, my new project investigates how the aforementioned structural shifts have shaped experiences with health and aging in China.
Laura: Aging is such an exciting new frontier in historical work. Looking forward to reading more in the future. And congrats again on your wonderful article!