The Cost of Labor: Lillian Wald, Maternal Health, and the Politics of Birth Control

In late February 1929, a letter from Margaret Sanger reached Lillian Wald's desk at 265 Henry Street in lower Manhattan. Wald, the founder of public health nursing in the United States, had previously employed Sanger as a visiting obstetrical nurse. Sanger's decision to write to Wald stemmed from her first-hand experience of Wald's clientele and philosophy of public health nursing, which had also provided a significant catalyst for Sanger's establishment of the organization that would eventually become Planned Parenthood. Her brief note asked Wald for her name as a patron of a dinner to benefit the Birth Control and Research Clinic. Carefully adding the caveat that "[t]he use of [Wald's] name [did] not entail any further obligation,"¹ she tempered her request but sought to capitalize upon Wald's considerable sociopolitical cache. Though Wald graciously complied, she expressed her distinct preference that Sanger "please have that as a personal matter—not as a Henry Street Settlement one."²

Wald personally supported Sanger's campaign for women's access to contraception, but carefully dissociated her settlement house and public nursing service from officially affiliating with the fight for birth control. She approached this thorny issue differently from women like the lapsed Catholic Sanger and the Jewish anarchist Emma Goldman, who came from working-class families and represented competing voices within the movement's radical wing during its incipient stages. Instead, Wald drew from the maternalist model of social reform that she learned from her mother and aunts throughout her formative years in a middle-class acculturated Jewish home in Rochester, New York. Maternalism, premised on an essentialist conception of women as intrinsically predisposed to nurture and care, inspired the trajectory of her career in public health.³ She did not sanction birth control as women's right to free themselves from their reproductive organs, and thus attain full equality with men. Rather, Wald advocated behind the scenes for married women's access to birth control in order to facilitate their own, their families', and especially their children's health, as a facet of her programmatic public health endeavors. In line with the maternalist ideals that precipitated her public health work, Wald focused upon ensuring that married women had the requisite information both to protect their reproductive health, and to control their family sizes for the sake of their families' welfare.

Wald's attraction to maternalism, a popular "collective belief in gender differences based on motherhood as foundation for reform,"⁴ mirrored that of many other white middle-class American women of the time. Both American Jewish women reformers and their non-Jewish counterparts found in maternalism a resonant justification for their increased entry into the public realm. For American Jewish women, however, it held additional significance. Maternalist visions of women's rightful positions as members of the social body enabled them to forge a respectable path not only into the public realm, but into the milieu of white, middle-class, non-Jewish women pursuing similar work. It simultaneously enabled these women to engage in newfound public-facing activities outside of the home and offered them a means to garner increased respectability and acceptance among non-Jewish white women of the same socioeconomic stratum. Reshaping the ideology of maternalism in a Jewish framework, they adapted it to suit evolving American Jewish conceptions of womanhood that privileged motherhood and spiritual guardianship of the family and community. Maternalism enhanced their moral authority and legitimacy both within and beyond their Jewish communities and charted a gendered road into the public sphere that simultaneously invoked their Jewishness and exemplified their Americanness.⁵ These women's gendered expressions of Americanness and Jewishness mutually strengthened one another.

As Wald came of age, middle-class American Jewish women and their Christian counterparts built upon the previous generation's model of maternalism to guide their social and political action. Premised upon the idea that they had a mission "to nurture mothers in their maternal vocation in order to ensure that children would be nurtured to worthy citizenship,"⁶ Progressive maternalists...