History of Women’s Healthcare in 20th Century Mongolia through the Lens of Menstruation and Abortion

This study examines how menstruation and abortion in Mongolia became politicized instruments of social and economic transformation across three eras: traditional nomadic, socialist, and post-socialist market economies. Drawing on health manuals, legal documents, and 2024 fieldwork, it reveals how state power reshaped women’s bodies, reflecting broader struggles over healthcare, gender equality, and demographic control. In pre-socialist Mongolia, menstrual blood was stigmatized as “polluting,” with fertility governed by nomadic pragmatism. Post-1921, the socialist regime dismantled Buddhist medical services, replacing it with Western-style hospitals and a female-dominated medical workforce by the 1970s. State-led hygiene campaigns, including 1950s school sex education and 1963 menstrual calendars, ostensibly normalized menstruation. Yet these tools covertly monitored, tying maternity leave to cycle tracking per the 1960s Women’s Hygiene manual — a example of socialist demographic engineering. Despite pronatalist policies such as the “Hero Mother” awards, abortion and contraception remained restricted until 1989. The 1940 Penal Code criminalized abortion except for seven medical conditions, forcing reliance on traditional methods. Post-1989 legalization triggered a birth rate collapse, aligning with Mongolia’s market economy transition. However, the 1998 Health Law’s clinic restrictions and privatized healthcare exacerbated access gaps: 72% of abortions now occur in Ulaanbaatar, underscoring rural-urban disparities. Socialist reforms framed women’s health as egalitarian but prioritized state control over autonomy. Menstrual calendars, while reducing stigma, served population management, and post-1990 privatization traded state oversight for market inequities. The study argues that genuine reproductive rights require redefining health as an individual right, not a state or market commodity. In tracing a century of upheaval, this research highlights the enduring tension between women’s bodies and political agendas.