Prenatal Care in the Rural United States, 1912-1929

In 1920, maternal mortality rates in the United States exceeded those of other industrialized nations. To redress this statistic, the federal Children's Bureau set its sights on improving access to prenatal care at a time when 80 percent of American women received none. In 1921, following lobbying by urban, middleclass progressive women working at or in support of the Bureau, the government legislated for prenatal care programs through the Sheppard-Towner Act. To date, historians have focused on how successfully women implemented the act's provisions, paying less attention to whether support for rural mothers reduced maternal mortality rates. Using Children's Bureau pamphlets, documents pertaining to the Sheppard-Towner Act, and letters written to the Bureau from poor, rural women, this article brings government workers, medical professionals, and the women they served into dialogue to analyze the first push to establish prenatal care for underserved American women and the obstacles that stood in the way.