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​​Reproductive injustice in mid-20th century Britain and America

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​​This seminar will examine the values of public health work targeting maternal and child welfare in the twentieth century. Ariel Hart will interrogate the social, political, and radical implications of new mid-century US public health surveillance programmes; Michael Lambert will consider the role of UK Medical Officers of Health in perpetrating reproductive injustice. ​ 

​​Black pregnancy-related mortality and public health surveillance 

​The 1921 Sheppard-Towner Maternal and Infancy Protection Act provided the first federal funds to combat maternal mortality and initiated a chain of regulatory and data collection projects across the United States. Together, government-funded surveillance by white midwives and punishment for deviance from state policies facilitated the demise of the traditional practice of black midwifery. In her study of black midwifery in the south, Gertrude Jacinta Fraser discovered “In Virginia for example, birth registration campaigns would become the focal point of efforts to control and eliminate midwives and, in the end to leave poor and African American women with greatly reduced access to reliable and familiar assistance during childbirth”  Black midwives were criminalized so profusely that the practice of black midwifery nearly disappeared altogether, with a resurgence only happening in recent decades. 

​In recent years, advocates have pushed for increased data collection and reporting as a means to achieve reproductive justice and decrease black pregnancy-related mortality. Using state maternal mortality reports from the late 1930s and early 1940 alongside the personal Louis H Dublin correspondence, I interrogate the social and political lives of these metrics of public health surveillance and evaluate their radical potential. In addition, I conduct a black feminist historiography to connect the colonial legacy of the ledger, to conversations of assigning accountability for black death in the mid-19th century and modern calls for increased documentation. Ultimately, answering the question: does public health surveillance align with a black abolitionist feminism bioethic? 

​​Public health and reproductive injustice in mid-20th century Britain 

​This paper considers Medical Officers of Health (MOsH) as public health leaders in perpetrating reproductive injustice during mid-twentieth century Britain. Maternal and child welfare were abiding areas of professional concern from their Victorian heyday which continued into the Elizabethan era. Lacking a clear philosophy under the National Health Service (NHS), public health was increasingly defined by actions rather than words. It is here that reproductive injustice occurred, with policies pursued in the interests of the public health, defending the imagined ideal of the normal citizen as part of the post-war settlement. MOsH were in the vanguard, articulating medical expertise, service legitimacy, and population health concerns.  

​This injustice has three strands in terms of public health leadership. Firstly, the forcible adoption of the children of unmarried mothers, which was undertaken purportedly in the best interests of both mother and child. Secondly, the conditional use of birth control for socially undesirable populations – mainly Commonwealth migrants and poor working-class families – which emphasised the power of the state rather than entitlements of welfare. Thirdly, the deployment of eugenic ideas in interventions with so-called ‘problem families’ which legitimised punitive measures against a distinct population. In each case MOsH provided leadership through their actions despite no clearly defined policy or legislative framework existing. This paper highlights the comparative invisibility of this injustice at the time given the isolated, individual, and seemingly private circumstances in which they occurred, despite being central to preserving a particular ideal of the public health.​ 


​​Ariel Hart, University of California

Ariel Hart is a PhD Candidate in Sociology and a ​medical student at the University of California, Los Angeles. Their current research examines the black birth center movement as an experiment in abolitionist futurity. They serve as the co-chair for UCLA's Black Feminist Initiative and have an extensive background in anti-racist public health research and teaching.  

​​Michael Lambert, Lancaster University Medical School

Michael Lambert is a Research Fellow at Lancaster University Medical School. His research explores the social history of social policy in twentieth century Britain and its Empire, particularly the relative roles of the state, welfare, and professional expertise.  

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