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

2. Lecture aims and outline Explore the relationship of infant mortality to national concerns (national efficiency, eugenics, war) Shift to interest in social medicine around turn of 20 th century Infant mortality and maternal welfare: ‘Infant Welfare Movement’ Consider balance between concerns of state and responsibility of families, i.e. mothers Legislative changes

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. 1876-1899 birth rate fell 35.5 to 30.5 (per 1,000 population) – down 14% 1876-1899 infant mortality increased from 146 to 156 (per 1,000 live births) – up 7%

4. ‘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 pointed out in 1907 that: BUT competing view here: ‘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 in Public Health in 1899 by William Butler (MOH conference)

5. ‘Social Medicine’, 1880-1930 Represents a shift in state interest from control of (usually infectious) disease (e.g. sanitary reform) to the active promotion of general health By – Improving social conditions – Providing health education – Increased provision of services -But not backed up usually with material assistance -Increasingly concerned with preventive medicine

6. 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’

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

8. 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 Quantity and quality

9. 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)

10. 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)

11. Feeding Bottle with long tube, c.1913

12. Graph showing deaths of bottle and breast fed babies, 1898: preventable causes

13. 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

14. 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)

15. 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’.

16. 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 1907. 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).

17. ST PANCRAS SCHOOL FOR MOTHERS 1907

18. Infant Welfare Clinic. (c.1914 )

19. 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. Leaflet advertising the new Mother’s and Babies’ Welcome in St Pancras, London, 1907.

20. Baby Week, c.1924

21. 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.

22. 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.