1. From Cradle to Grave (HI278) Lecture 2 Birth and Death in Modern Britain: Infant Welfare to Incubator Babies

2. Lecture Outline Infant mortality Social Medicine 1880-1930
National Efficiency, Empire Concerns and Eugenics
Infant and Maternal Welfare
Legislative Changes
Motherhood and education

3. Falling births and rising deaths
1857- Registrar-General reported the number of deaths of children under the age of one (deaths first registered in 1838) – giving formal recognition to the infant mortality statistic and highlighting high number of infant deaths.
birth rate fell 35.5 to 30.5 (per 1,000 population) – down 14%
infant mortality increased from 146 to 156 (per 1,000 live births) – up 7%

4. The Medical Officer of Health (MOH) for Marylebone (1907)
‘It is of concern to the nation that a sufficient number of children should annually be produced to make good the losses by death; hence the importance of preserving infant life is even greater now than it was before the decline of the birth rate’.
The Medical Officer of Health (MOH) for Marylebone (1907)
Quote 1: As cited by Anna Davin, ‘Imperialism and Motherhood’, History Workshop Journal 5 (1978), pp.9-66, p.11
Quote 2: William Butler, “The value from a public health standpoint of the declining phthisical death rate”, Public Health, Vol 11 (Oct 1898–Sept 1899), pp , p.326.

5. ‘A multitude of weaklings is less to be preferred than a handful of virile men and a healthy people pruned of its decadents by a high mortality amongst its children is better than a degenerate race weakened by the survival of its effete progeny’.
Article from Public Health in 1899 by William Butler (MOH conference)

6. ‘Social Medicine’,
Represents a shift in state interest from control of (usually infectious) disease (e.g. sanitary reform) to the active promotion of general health
Improving social conditions
Providing health education
Increased provision of services
- But not backed up usually with material assistance

7. 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’.

9. The Boer War 1899-1902 and National Efficiency
Recruitment statistics showed up to 40% of army volunteers were unfit – poor teeth, skin, too small, too weak, rickets, poor eyes etc.
This led to a specially appointed Committee on Physical Deterioration in 1903 to investigate why
1904 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’

10. Report of the Inter-Departmental Committee on Physical Deterioration, 1904

11. Eugenics
A ‘science’
Middle-classes – ‘limiting selves out of existence’
Poor were breeding out of control
Leading to physical and moral weakness/degeneracy
Called for control of unsuitable breeding
Concerned with quantity and quality.

12. Infant Welfare Response to concerns about declining populations
Similar responses throughout Europe and North America (scientific motherhood)
France a leader in initiatives
Dr Stephane Tarnier
(incubators, prematurity)
Dr Pierre Budin
(infant welfare reform)

13. Huddersfield Scheme: Advice to Mothers, c.1905
Schemes often relied on key individual efforts – e.g. Mayor Benjamin Broadbent, MOH William Moore
Key message: ‘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)

15. Infant Welfare Clinic. (c.1914)

16. Maternity: Letters from Working Women, edited Margaret Llewellyn Davies, 1915 (Women’s Cooperative Guild)
‘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.

17. Legislation 1906 Education Act: meals to be given to school children
1907 Education Act: established medical inspection of schools
1907 Notification of Births Act: local officer of health should be informed within 6 weeks of a birth so a health visitor could visit. (compulsory in 1915)
1911 Maternity Benefits through NI – 30s to husband for wife
1913 Maternity Benefit directly to mother
1918 Maternity and Child Welfare Act: LAs to set up maternal and child welfare committee and provide range of services eg health visitors, day nurseries, food, milk.
1919 Ministry of Health: with dept for infant and maternal welfare
1946 Family Allowances

18. Voluntary Sector (examples)
1904 Infants’ Health Society
1905 National League for Health, Maternity and Child Welfare
1910 Women’s League of Service for Motherhood
Women’s Co-operative Guild (est.1883)

19. Feeding Bottle with long tube, c.1913

20. Motherhood and Education
The root of infant health must be the mothers
Working-class mothers viewed as ignorant, irresponsible, immoral
Mothers targeted through:
Leaflets on infant management
Lectures (poorly attended)
Infant consultations
Lady Health Visitors
Voluntary agencies opened Schools for Mothers. E.g. The ST Pancras School for Mothers This Offered:
Classes and health talks
Individual consultations
Advice on feeding
Weighing the baby
Meals for nursing mothers
Used as a model for other centres – 446 Infant welfare centres 1917
Target audience = working class (poor with irregular earnings or small earnings).

21. ‘I don’t think they kept anything like enough eye on the middle classes. Actually I think they assumed we would manage but we weren’t managing…they thought if you were middle class and educated you were okay. And I remember this one time, the baby would be crying and crying and crying, and I can remember the health visitor coming in and asking me was I alright, and of course being good, stiff-upper lip, middle-class girl I said, ‘Oh yes, I’m fine’, but I wasn’t, I could have battered that child.’

22. ST PANCRAS SCHOOL FOR MOTHERS 1907

23. Leaflet advertising the new Mother’s and Babies’ Welcome in St Pancras, London, 1907.
A charity, founded in 1907, the St Pancras Welcome offered a comprehensive range of services to mothers and babies. These were not free, but available for a small fee.

24. 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), 30 in 1950, 9 in 1985.
Policies upheld a strong ideology of motherhood.
Emphasis on better child-care and motherhood reinforced women’s traditional role.
Working-class women were thought to be in greatest need of instruction.