INFANT AND MATERNAL WELFARE Lecture 15 Medicine, Disease and Society in Britain,

LECTURE AIMS AND OUTLINE From public health to social medicine - Physical deterioration and national efficiency Infant and maternal welfare: ‘Infant Welfare Movement’ - Social medicine agenda - Policies and education - How effective were measures? birth rate fell 35.5 to 30.5 (per 1,000 population) – 14% infant mortality increased from 146 to 156 (per 1,000 live births) – 7%

SOCIAL MEDICINE: Shift state interest from control of disease ( e.g. sanitary reform & vaccination)to the promotion of health By Improving social conditions Providing health education Increased provision of services - But not backed up usually with material assistance

THE BOER WAR AND NATIONAL EFFICIENCY The Boer War led to a specially appointed Committee on Physical Deterioration in The Committee explored why so many army recruits were unfit Committee report - no evidence of long-term physical deterioration in the British population, but they did make these recommendations: a) Medical inspections of children in schools b) Free school meals for the very poor c) Training in mothercraft.

R EPORT OF THE I NTER -D EPARTMENTAL C OMMITTEE ON P HYSICAL D ETERIORATION, 1904

P HYSIQUE OF YOUTH AS SHOWN BY W AR CF. EFFECTS OF TRAINING AND EDUCATION, C.1920

H UDDERSFIELD S CHEME : A DVICE TO M OTHERS, C.1905 ‘FEED WITH THE MOTHER’S MILK’ ‘If you really love your child and would do the best for it, feed it at the breast. (Out of 100 bottlefed children 50 died during their first year – out of 100 breast-fed children only 7!) ‘NEVER give the baby soothing syrups, fever powders, or anything of that sort. NEVER give the baby bread, or sops, or gravy, or any other food, except milk, till it is not more than seven months old…. Never use a feeding bottle with a long tube…’ (Annual Report of MOH Huddersfield 1905)

F EEDING B OTTLE WITH LONG TUBE, C.1913

G RAPH SHOWING DEATHS OF BOTTLE AND BREAST FED BABIES, 1898: PREVENTABLE CAUSES

INFANT MORTALITY End of the C19, Medical Officers of Health observed and analysed infant mortality. Education Act 1906: meals to be given to school children. Education Act 1907: established medical inspection of schools. Notification of Births Act 1907: local officer of health should be informed within 6 weeks of a birth so a health visitor could visit. System of notification was made compulsory in 1915.

INFANT MORTALITY Maternity and Child Welfare Act local authority to set up a maternal and child welfare committee - enabled local authorities to provide a range of services e.g. health visitors, day nurseries and food and milk. Ministry of Health Department devoted to infant and maternal welfare

The photographer’s caption for this vivid illustration of domestic poverty was ‘Distressing scenes in the East End. All the food in the house – a little butter, sugar and a nearly empty tin of milk. July, 1912’.

MOTHERHOOD AND EDUCATION General method of education was leaflets on infant management. Lectures (poorly attended) and infant consultations also offered. Voluntary agencies opened Schools for Mothers. First ‘School for Mothers’ – St. Pancras, Combination of classes and health talks, individual consultations, advice on feeding and weighing the baby. Infant welfare clinics Target audience = working class (poor with irregular earnings or small earnings).

ST PANCRAS SCHOOL FOR MOTHERS 1907

I NFANT W ELFARE C LINIC. ( C.1914 )

A CHARITY, FOUNDED IN 1907, THE S T P ANCRAS W ELCOME OFFERED A COMPREHENSIVE RANGE OF SERVICES TO MOTHERS AND BABIES. T HESE WERE NOT FREE, BUT AVAILABLE FOR A SMALL FEE. Leaflet advertising the new Mother’s and Babies’ Welcome in St Pancras, London, 1907.

B ABY W EEK, C.1924

CONCLUSION Infant and maternal welfare was an important part of the state’s objective to improve national efficiency. It is unclear whether infant and maternal welfare policies were primarily responsible for the fall in infant mortality. It did fall: From 128 (per 1,000 births) in 1905 to 105 in 1914 (babies dying before first birthday). Policies did carry a strong ideology of motherhood. Emphasis on better child-care and motherhood reinforced women’s traditional role. W-class women were thought to be in greatest need of instruction.

M ATERNTY : L ETTERS FROM W ORKING W OMEN, EDITED M ARGARET L LEWELYN D AVIES, 1915 (W OMEN ’ S C OOPERATIVE G UILD ) ‘From the time I married till just previous to the birth of my third child, my husband earned 28s. per week; then followed two years’ shortness of work. When my forth was born, we had no food or anything to eat… The past struggle left its mark on the physique of my children… My home was very dirty, the children got ragged, meals worse than usual… I have resorted to drugs, trying to prevent of bring about a slip… after the birth of my first baby I suffered from falling womb… doctors who attended me never told me anything concerning my babies or myself.’ Wages 30s, eight children, two still-born, three miscarriages.