Birth and Death in Modern Britain: Infant Welfare to Incubator Babies

From Cradle to Grave (HI278) Lecture 2
Birth and Death in Modern Britain:
Infant Welfare to Incubator Babies
Lecture Outline
• Infant mortality
• Social Medicine 1880-1930
• National Efficiency, Empire Concerns
and Eugenics
• Infant and Maternal Welfare
• Legislative Changes
• Motherhood and education
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%
‘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)
‘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
‘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
• Improving social conditions
• Providing health education
• Increased provision of services
- But not backed up usually with material
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’.
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
b) Free school meals for the very
c) Training in ‘mothercraft’
Report of the
Committee on
Deterioration, 1904
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.
Infant Welfare
• Response to concerns about declining
• 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)
Huddersfield Scheme:
Advice to Mothers, c.1905
• Schemes often relied on key individual efforts – e.g. Mayor
Benjamin Broadbent, MOH William Moore
• ‘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
(Annual Report of MOH Huddersfield 1905)
Infant Welfare Clinic. (c.1914)
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.
• 1906 Education Act: meals to be given to school children
• 1907 Education Act: established medical inspection of
• 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
• 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
• 1946 Family Allowances
Voluntary Sector
• 1904 Infants’ Health Society
• 1905 National League for Health, Maternity
and Child Welfare
• 1910 Women’s League of Service for
• Women’s Co-operative Guild (est.1883)
Bottle with
long tube,
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
‘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.’
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.
• 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.