Modern mothers in the heartland: Maternal and child health reform in Illinois, 1900-1930

During the Progressive Era, Illinois women launched a lively campaign to reduce maternal and infant mortality. A maternalist ideology highlighted women's responsibility for private family health and empowered them to join local public health reform efforts on a variety of levels--as policy-makers, middle-level volunteers, and clients. But the campaign was equally influenced by the precepts of socioeconomic class. Illinois health reformers urged both urban immigrant and native-born rural women in the state to "modernize" their mothering techniques, taking control of health care through the adoption of the preventive health and hygiene techniques that had become a central feature in the urban middle-class woman's domestic training. This study's local-level perspective reveals the essentially interactive nature of maternal and child health reform, as reformers and clients negotiated the final outcomes of policies and programs. Both urban and rural mothers took upon themselves the task of improving the health of their own families and communities. The Illinois campaign peaked during World War I in a patriotic effort spearheaded by the Women's Committee of the Illinois Defense Council, a crusade that raised new questions about the public/private boundaries of health reform. A critical sea-change in the nature of maternal and child health reform in Illinois took place after 1923, when the General Assembly failed to pass legislation allowing the state to participate in the federal Sheppard-Towner Act. Maternalist health reformers could not translate the wartime public enthusiasm for baby-saving into grassroots political power. An alliance of medical professionals and business leaders raised an alarm about increased government involvement in the private business of motherhood and challenged the maternalist orientation of preventive health care provision. By the 1920s, the public meaning of health reform had changed dramatically; the "modern" mother was now redefined as the informed and conscientious consumer of health care goods and professional medical services within the privatized household. Maternal and child health reform efforts continued to champion women's special responsibility for health in the absence of a health care infrastructure that would enable all mothers and children to carry out the mandate.