The Sheppard-Towner Maternity and Infancy Act was the first federal program for social welfare. It was introduced into Congress in 1919 and signed into law by President Warren G. Harding on November 23, 1921. The Sheppard-Towner Act set up a federal administration that disbursed funds to individual states for the purpose of improving the health of America’s children. Originally set to expire in 1926, the act was renewed for an additional two years, but Congress allowed it to expire in 1928. Despite its brief tenure, the act improved the health of millions of American children.
The Sheppard-Towner Act emerged out of the efforts of Progressive Era reformers to improve the health of America’s children. The U. S. Children’s Bureau had been researching infant health since 1913. It discovered that the U. S. infant and maternal fatality rates were among the highest in the industrialized world. The studies of the Children’s Bureau suggested that better infant and prenatal care might have prevented half of the infant and child deaths. In addition, during World War I, one-third of American men were rejected by the draft board for medical reasons. These findings highlighted the need for better infant and maternal health care. Reformers also feared that state and local programs ignored women and infants in rural areas. To solve these problems, child welfare reformers, led by the Children’s Bureau, began a campaign to establish a federal program that would standardize child and maternity care across the nation.
The law passed in 1921 named the Children’s Bureau as the federal department in charge of overseeing state health programs. Each state’s legislature had to vote acceptance of the act. By June 1922, 42 of the 48 states had accepted Sheppard-Towner funding. After a state voted to accept federal funds, it received $5,000. A matching $5,000 grant was available for states that appropriated their own funds for child and maternity programs and additional funds were available based on state population. The Sheppard-Towner Act required each state to name a state agency to administer the programs. These agencies in turn had to submit a program proposal to the Children’s Bureau for approval. The bureau’s power to approve state programs meant that the state agencies addressing child and maternal health did so within the guidelines of the Children’s Bureau staff. The
Children’s Bureau supported, for example, professional public social service agencies and often rejected state programs run by private agencies.
Programs operating under the Sheppard-Towner Act reached hundreds of thousands of women and children through state agencies that ran child health and prenatal conferences and mothers’ classes. At the conferences, the agencies provided prenatal and infant health examinations. In 1924, for example, 303,546 children received examinations. New mothers attending mothers’ classes learned the importance of prenatal care. They were introduced to the child-rearing standards of the middle-class professionals in charge of the agencies. Child welfare advocates hoped that these temporary conferences would grow into permanent prenatal and infant care centers, which happened in a number of localities.
Sheppard-Towner agencies also instituted visiting nurse programs. Under these programs, a nurse employed by the agency visited pregnant women and new mothers. The purpose of the visits was to teach the women proper prenatal and infant care. The nurses helped improve the health of mothers and infants. For many women, particularly in rural areas, the nurses’ advice was their first introduction to prenatal care. In addition, nurses explained the value of sterilizing all items used during delivery. They also taught the importance of immunizations. Despite all of the benefits of the program, the visiting nurses could, at times, become intrusive in the lives of women. Because they promoted proper child-rearing techniques established by the Children’s Bureau, visiting nurses sometimes made new mothers feel inadequate. They counseled new mothers, for example, that children should be raised on strict schedules. They criticized mothers for keeping disorganized homes and told parents that they should not play with their children. There emerged, therefore, a tension between the Sheppard-Towner Act employees and the many mothers who did not subscribe to the Children’s Bureau’s standardized view of child-rearing.
The Sheppard-Towner Act eventually succumbed to the more conservative environment of the late 1920s. Medical professionals and other federal agencies such as the Public Health Service had worked for years to take over the functions of the maternal and child health care program. They put pressure on Congress to cut Sheppard-Towner money. After receiving a two-year appropriations extension in 1927, the Sheppard-Towner Act was allowed to expire in 1929.
See also mothers’ pensions; public health.
Further reading: Robyn Muncy, Creating a Female Dominion in American Reform, 1890-1935 (New York: Oxford University Press, 1991).
—Michael Hartman
World History
