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  • "Completely Sold on Birth Control":Rural Extension Work of the Kentucky Birth Control League, 1933–1942
  • Courtney Kisat (bio)

In August 1939, after years of seeking birth control for her rural patients, community health nurse Lutrella Baker from the Line Fork Settlement in southeastern Kentucky wrote to Jean Tachau, president of the Kentucky Birth Control League (KBCL) in Louisville. "At last I have some grand news to report," she exclaimed, "There is a new doctor at Pine Mountain Settlement School … [and] he is completely sold on birth control, especially as he sees conditions here."1 Tachau and Baker went on to organize supplies for the clinic at Line Fork, a successful outcome of rural extension work from the KBCL.

The birth control movement grew throughout the 1930s, and state affiliates of the American Birth Control League (ABCL) operated clinics that served thousands of women.2 The KBCL was the fifteenth state affiliate of the ABCL and like other state leagues, they successfully established birth control clinics in urban areas such as Louisville and Lexington. But unlike other states, the Kentucky State Board of Health did not support birth control as a public health initiative, so county clinics offered no form of contraception. The KBCL filled that void with state extension work in rural counties. The initiative [End Page 303] came from Tachau, an experienced social worker who drew from her networking skills and experience to build collaborative committees in rural communities. Rural Kentucky women who received birth control access in the late 1930s and early 1940s benefitted from this collaboration. Central to the state extension work of KBCL was the creation of community committees, which included ministers, teachers, librarians, nurses, and women's church groups. The KBCL was willing to recruit any person interested in establishing birth control services for the women of their county.3 Participants included a first-grade teacher in Edmonton, a USDA Home Demonstration Agent in Franklin, and a county health nurse in Daviess County, all of whom wrote the KBCL for information.4 Successful extension work was especially evident in Bell and Breathitt Counties, where the KBCL helped create community committees; in Madison County, where their efforts contributed to a strong local birth control initiative; and in Letcher County, site of the Line Fork Settlement. This study is a contribution to the growing literature of state-level birth control initiatives in the interwar period.5 It shows that despite the lack of support from the state, the KBCL impacted rural women in places where they were able to draw from social work methods to collaborate with people in those communities.

Between 1880 and 1930, progressive women's groups drove social, political, and economic changes in the Commonwealth. This included such initiatives as the Kentucky Equal Rights Association, founded by women in 1888, and the Kentucky Federation of Women's Clubs in [End Page 304]

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Map of KBCL extension work. Counties in light gray represent places where birth control clinics were established. Those in dark gray represent places in correspondence with KBCL. Map by author, all rights reserved.

1894. Women's clubs helped create the first county health department in Mason County in 1914, and by the late 1920s, health departments in every county of Kentucky. When Congress passed the Sheppard-Towner Act in 1922 to provide funding for health programs to benefit women and children, Kentucky legislators responded to women's advocacy and approved a measure to create a Bureau of Maternal and Child Health. The birth control movement in Kentucky was not the first reform driven by women, but rather a link in a long chain of maternalist policies in state reforms.6 From their first meeting in 1933, the KBCL worked to "help mothers have healthier babies, check the practice of induced abortions, and establish clinics in all sections of the state."7 They gained public support by promoting birth control [End Page 305] to improve maternal and child health and as an economic measure for poor families. The KBCL was especially visible throughout the state, first in the cities of Louisville and Lexington, and gradually in over forty rural eastern Kentucky counties.

Early professional social...


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