Babies for the Nation: The Medicalization of Motherhood in Quebec, 1910–1970 by Denyse Baillargeon (review)

Babies for the Nation is an ambitious history of the “medicalization of maternity” in Québec from 1910 to 1970. According to Baillargeon, this involved a socio-medical transformation in the management of pregnancy, childbirth, and the care of young children. In this process, Québec women were convinced that maternity was an event that required the intervention of medical professionals, mainly physicians and affiliated professionals and organizations. While the medicalization of maternity is a common theme in the history of health care, as Baillargeon points out, a central political concern that animated this transformation in Québec was the problem of high infant mortality, reported at times to be the highest among industrialized nations.

The book is grounded in exhaustive research offering up an impressive array of historical detail. A through investigation of medical literature and health policy occupies the first chapters, where Baillargeon shows how maternity was placed at the centre of efforts to preserve and maintain the Québec nation, prompting many players to engage in a “medico-nationalist” discourse and offer solutions for high rates of infant death. As the author notes, the high reported rates of infant mortality might require some interrogation, as Québec reporting was subject to different practices than in other parts of Canada, probably counting stillbirths as infant deaths for a variety of faith-based and ethical reasons. Whatever the count, infant mortality became highly politicized by the turn of the century. Baillargeon links pronatalism in Québec with growing concerns in many industrialized nations that medical intervention in maternity was required to develop and maintain a productive labour force, concerns only brought into sharper relief by the two World Wars.

As was the case elsewhere, medicalizing maternity also served the interests of physician organizations, who sought to convince women that medical professionals were the only legitimate and trustworthy source of information about child and prenatal care. The medical profession proceeded on the basis that child health would be won by targeting the childbearing and rearing practices of Québec mothers. Highlighting the unequal gender relations between male physicians and their female patients –and Baillargeon observed the early to mid-century bias against female physicians endemic to the profession in Québec –the author critiques doctors who attributed mortality rates to the ignorance of mothers rather than material want and poverty. Such discourses placed responsibility for the health of French Québec infants squarely in the hands of Québec mothers. In this way, the politicization of maternity, which preceded medicalization, not only blurred the divide between public concerns and private life as it increased the prestige of physicians, it also helped to embed them as experts in the creation and implementation of health policies in the province.

The chapters that follow describe the services implemented and offered by a variety of public and private organizations. These include major players such as the Victorian Order of Nurses from 1898–1947, the Metropolitan Life Insurance Company from 1910–1953, and the Assistance maternelle de Montreal (amm), a philanthropic organization aimed at Catholic mothers, founded in 1912. The author offers incredible detail on the variety of services and service structures among towns and cities across the province and between urban and rural areas. These services were served up alongside a generous helping of advice and health information disseminated through an ever-widening array of media, documenting the plethora of public lectures, radio and television, films, advertising, newspaper and magazine columns, and brochures and pamphlets. We also learn how reliant on the support of women’s groups, women volunteers, nurses, and clergy the medical authorities were to ensure the dissemination and acceptance of their precepts, especially before mid-century. While the rising authority of the medical profession is significant, Baillargeon argues that it was the development of these multivaried free services that gave real momentum to the medicalization process. She notes that the interaction among such...