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45 two A Very National Infant Mortality Rate T he vulnerability of the newborn to sickness and death was certainly not a new phenomenon at the turn of the 20th century, but it was around this time that it became a major preoccupation for the Quebec elite.1 The introduction, in 1893, of a system for collecting demographic statistics throughout the entire province, making it possible to obtain more complete and more trustworthy data,2 probably encouraged this new awareness, but it was also part of a widespread trend in all of the West. At a time when industrial capitalism needed more and more workers, when several countries were experiencing significant declines in their birth rates, and when the Pasteur revolution led to an understanding of the causes of the diarrhoea that was responsible for a high proportion of infant mortality, the deaths of thousands of infants each year became more difficult to accept. By the end of the 19th century, reformers who were uneasy about the repercussions of industrialization and urbanization on social and family relations identified infant mortality as one of the numerous evils that had to be combated if the new capitalist social and economic order was to be sustained. Soon it was not only the rate of reproduction of the urban proletariat but that of the entire nation that appeared critical because of the number of infant deaths. The strong rise in nationalist feeling that animated Western societies at the dawn of the 20th century intensified fears and encouraged action. In Western Europe, as in North America, a child welfare movement came into existence, a vast coalition that included “maternalist” feminists, women volunteers, nurses, philanthropists of both sexes, members of the clergy, politicians and intellectuals, but in which the medical profession soon played a dominant role.3 Driven by nationalist and no doubt humanitarian sentiments, but also desiring to increase its social and professional prestige as well as its political influence, this medical elite would contribute significantly to articulating the principal constituents of social discourse on infant mortality. Its rhetoric, which very soon spread all over 46 babies FoR tHe nation the industrialized world, basically consisted of two propositions: that infant mortality was putting national and economic development at risk, and that the education of women in hygiene and child care by true specialists represented the best, and in fact the only, way to end the hecatomb. The mobilization around the cause of children’s welfare, which began in Quebec at the end of the 19th century and then became more widespread during the early decades of the 20th, was thus part of a trend that extended beyond its frontiers. However, the French-speaking Quebec doctors who made public statements on the subject had to confront a particularly worrisome situation, for infant deaths had reached record levels in the province, especially within the minority ethnic group (within Canada, of course) to which they belonged. Like their Canadian, Anglo-Quebec, and foreign colleagues , they constantly evoked their scientific knowledge to justify their claim to lead the campaign against infant mortality and establish themselves as the new “experts” in the eyes of mothers and the public authorities.4 But it was also in the name of saving the nation that they sought to assert their authority. It was difficult for these men, who were close to French-Canadian nationalist circles and immersed in the debates going on within them, to set aside their political convictions when making pronouncements on a topic as sensitive as the death of thousands of children. But nationalism did not only fuel and exacerbate doctors’ anxieties. Both before and after 1940 (by which time this mortality had decreased considerably), nationalist ideology provided them with a general interpretive framework to grasp what some called “our very national, murderous infant mortality.”5 Part of the medical discourse on infant mortality thus picked up the great themes and obsessions of 20th-century nationalism, among which the question of the birth rate and the reproductive role of women in ensuring the nation’s survival were prominent. The Nation in Peril, 1910–19406 The doctors whose interventions contributed most to the fight against infant mortality in Quebec came largely from the public health sector. The creation of the Board of Health of the Province of Québec (bHPQ) in 1886,7 under pressure from groups of reformers that included many doctors, had already allowed some of them to find a place within the public administration and take advantage of...

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