Babies for the Nation: The Medicalization of Motherhood in Quebec, 1910-1970

CHAPTER 3. Let Us Have the Mother and the Child Is Ours

71 three Let Us Have the Mother and the Child Is Ours T eaching women to become mothers was no doubt one of the great medical undertakings of the 20th century. This is shown by the hundreds of articles on the topic published in professional journals, and by the many publications written by specialists—obstetricians, pediatricians , and public health doctors—all filled with advice intended for women about different aspects of maternity, whether pregnancy, the delivery, or care for the newborn and young children. Until the early 1970s, men, who made up the vast majority of the medical profession, were convinced that they had the answers in the fight against infant mortality, and, armed with this assurance, they promoted new norms dealing with every aspect of human reproduction, including, at the top of the list, regularly consulting a physician. This desire to medicalize maternity was supported by the progressive evolution of knowledge, techniques, and treatments, yet it was not inspired by medical progress alone. On the contrary, medical discourse regarding the maternal practices to be condemned or encouraged, the kinds of behaviour to be eliminated or inculcated, was heavily influenced by the economic, political, and ideological context. This rhetoric simultaneously reflected and reinforced class and gender hierarchies and never lost sight of the social advancement of members of the medical profession or the defence of their economic interests. In the long term, instruction in hygiene, combined with certain medical discoveries and with a decline in poverty, did indeed bring about an improvement in the mortality rates of babies and women in childbirth. Nevertheless, the process of medicalizing maternity was legitimized by arguments that incorporated a broad range of preconceptions and prejudices totally unrelated to the scientific objectivity to which physicians laid claim, while their discourse, behind a mask of humanism, aimed first and foremost to dominate an area that previously was the preserve of women. 72 babies FoR tHe nation The Ignorance of Mothers Up to World War II there was no doubt in the minds of French-Canadian physicians that mothers bore the primary responsibility for infant deaths. In this respect, their discourse, far from being exceptional, was modelled on the writings of the Western medical community, using the same points, the same arguments, and sometimes even the same anecdotes. Liberally quoting the words of their French and British colleagues,1 they were in accord with them in claiming that ultimately all the sources of infant mortality could be reduced to “a central cause that explained them all: tHe ignoRanCe oF MotHeRs.”2 Ignorant of the appropriate care required by their children and of the elementary principles of hygiene, women were also said to show complete indifference toward their responsibilities, especially their duty to breastfeed. In the best of cases, they were guilty of a failure to apply the precepts of good nutrition and infant hygiene, but in all cases it was mothers ’ carelessness that condemned their children to the grave. The best way to eradicate infant mortality was therefore to combat the ignorance, indifference , and negligence of mothers by bringing them scientific enlightenment , a mission that only physicians, with their scientific training, could accomplish. There is no doubt that physicians at the beginning of the century were aware that a much higher percentage of infant deaths occurred among the Bulletin sanitaire, vol. 12, nos. 4–12 (April–December 1929), p. 67. Reproduction authorized by Publications du Québec. Let Us Have tHe MotHeR anD tHe CHiLD is oURs 73 working class: Dr. René Fortier, for instance, admitted in 1911 that “the causes for infant mortality are often social in nature.”3 Yet for him, as for the majority of his colleagues, the factor was not poverty alone. While recognizing that it forced families to live together in poorly ventilated, unhealthy, or downright insalubrious housing, he considered above all that poverty gave rise to types of behaviour that put the survival of the newborn at risk: “The excessive mortality in poor neighbourhoods can be better explained by ignorance than by the poor hygienic conditions prevailing in the child’s environment,” affirmed Dr. Séverin Lachapelle in a report submitted to the Montreal municipal authorities in 1912.4 Before the 1940s, when diarrhoea represented numerically one of the major causes (if not the major cause) of infant mortality,5 doctors maintained that breastfeeding was the obvious solution for this problem, and that in this respect the degree of...