Reproductive Health, Reproductive Rights: Reformers and the Politics of Maternal Welfare, 1917-1940 (review)

Mention the early twentieth-century struggle for the improvement of maternal and infant health, and the work of the United States Children's Bureau under the leadership of Julia Lathrop usually comes to mind. Similarly, mention the struggle for birth control in the United States, and the career of Margaret Sanger takes immediate precedence. Robyn L. Rosen's book adds significantly to our understanding of both reform movements by focusing on four women who do not appear in many of the history books, but whose work for these causes illustrates the complexity of the issues faced by their champions.

Elizabeth Lowell Putnam (1862-1935), a descendant of illustrious Massachusetts families who married into an equally prominent one, was essentially conservative—opposed to women's suffrage and to a federal role in social welfare—but a dedicated advocate of voluntary programs for maternal and infant welfare, especially prenatal care and clean milk. Ethel Sturges Dummer (1866-1954), a wealthy Chicagoan, was an ardent feminist who blamed the difficulties of motherhood on women's subordinate position in society and espoused the plight of unwed mothers, financial support for all mothers, and an end to the "double standard" that denied the sexual needs of women. Mary Ware Dennett (1872-1947), born and raised in Massachusetts, equated women's right to control their fertility with their fundamental right to information, and focused on congressional reform of censorship laws. Blanche Ames (1878-1969), another upper-class Bostonian, used her financial resources and leadership skills to promote physicians' right to disseminate birth control information and devices in a state where the ultraconservative legislature refused to alter prohibitive laws.

Rosen makes clear the degree to which each of these women was affected by her personal background. Their many interactions are carefully described, as are the various organizations that they created or with which they were associated. The author also relates their activities to myriad political and social currents that determined their effectiveness. Late nineteenth-century progressivism, which advocated reform in many spheres of American life, was the seedbed, while the public health movement provided the impetus, for improved maternal and infant health. But socialism, pacifism, feminism, the labor movement, women's suffrage, scientific medicine, social science, eugenics, "free love," and the Depression of the 1930s were among the powerful forces to which the four protagonists reacted personally, and with which they had to contend in the public sphere.

Rosen skillfully uses the varied attitudes and activities of her protagonists to demonstrate the difficulties that any reform movement faces. By a thorough analysis of their theories and strategies she shows why there were so many failures along the way, why ultimately federal welfare programs for women and children prevailed, and why it was Margaret Sanger who became, at least in most circles, the heroine of the birth control movement. Sanger's eventual realization that the way to promote birth control was through an alliance with the medical profession may have alienated people like Dennett, who remained a stalwart proponent of direct access to information for all women, but it was the successful strategy. Physicians could claim that provision of birth control information to married women was a proper part of their professional responsibility, and most judges and legislators accepted their position.

The book is the latest publication in the series Women and Health: Cultural and Social Perspectives, edited by Rima D. Apple and Janet Golden, and is a welcome addition to the field. It will be especially useful in women's studies and for those who examine the history of women's health or American reform movements. I do quibble with the dates used in the title, since the four biographies include much information that precedes World War I. Rosen concludes by pointing out that too many issues that...