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“Why does Congress wish to have mothers and babies die?”

It takes a rare political personality to gain regular air-time on today’s political pundit shows. Former Ohio State Senator Nina Turner is one of those personalities. If anyone is going to grab precious minutes on air it’s Turner, a politician who wore a T-shirt emblazoned with the words “GOP — Get Out of My Panties” on the Ohio senate floor in 2012. Personally, I’m already a fan of Nina Turner just because I’m a bit of a political wonk — plus, I’d like the GOP to keep their minds off my nether regions too.

It was during an MSNBC interview in early April 2016 where Turner artfully turned a discussion on presidential hopeful and Ohio Governor John Kasich’s claim that he has numerous bipartisan success stories, into a conversation about the plight of African-American and working poor people in the country. She stated, “It is a disgrace not only in our state [Ohio] but all across this country that African-Americans, from birth, struggle.” Particularly striking was Turner’s discussion of the surprisingly high rate of infant mortality in the state of Ohio, and how these numbers affected the black community at greater levels than other groups. Even though Turner has firmly opposed Kasich’s move to limit women’s access to healthcare, she acknowledged during the interview some of the bipartisan accomplishments in addressing infant mortality, particularly black infant mortality, happening in the state of Ohio.

Ohio ranks 45th among states in infant mortality rates. The only states lower on the scale are Mississippi, Louisiana, Alaska, Alabama, and West Virginia. Ohio’s infant mortality rate in 2013, the last year the CDC posted official numbers, was 7.33 per 1,000 births. That is 21 percent above the national average of 5.96 per 1,000 births.

According to CDC statistics, the U.S. ranks 27th in its incidence of national infant mortality, well behind countries such as Finland, Czech Republic, Greece and Hungary.

M.F. MacDorman, T.J. Mathews, A.D. Mohangoo, and J. Zeitlin, “International Comparisons of Infant Mortality and Related Factors: United States and Europe, 2010,” National Vital Statistics Reports, 63 no. 5 (Hyattsville, MD: National Center for Health Statistics, 2014), 1.
M.F. MacDorman, T.J. Mathews, A.D. Mohangoo, and J. Zeitlin, “International Comparisons of Infant Mortality and Related Factors: United States and Europe, 2010,” National Vital Statistics Reports, 63 no. 5 (Hyattsville, MD: National Center for Health Statistics, 2014), 1.

Fortunately there are steps being taken at the national level to remedy these dismal numbers. In February of this year, Wisconsin Congresswoman Gwen Moore submitted legislation in the House aimed at standardizing national guidelines for the collection of data following an infant or child death. The Reducing Unexpected Deaths in Infants and Children Act would increase local and state funding to gather more complete data after an infant or child death, and expand support services for grieving families. Congresswoman Moore commented, “With thousands of stillbirths and babies dying suddenly and unexpectedly every year in the United States, this stark reality demands our attention, our concern, and most importantly, our swift action.” She also stated, “as one of the wealthiest nations in the world, I find it shameful that America’s infant mortality rate rivals that of many developing countries. My bill – The Reducing Unexpected Deaths in Infants and Children Act – provides valuable support to states, municipalities, and organizations to help understand and combat child and infant death. We have the resources and capacity to prevent these tragedies from occurring.”1

These statistics and Moore’s intentions are not new. During the Progressive Era, women reformers used similar tactics to highlight America’s high infant mortality rates. Numerous debates took place in the House and Senate over how the state should protect the health of mothers and children. In 1912, the U.S. Children’s Bureau became the first government entity formed to specifically address maternal and child health in the United States.

Scientific studies performed by the U.S. Children’s Bureau during the mid-1910s showed in stark numeric detail how appallingly high America’s infant mortality rate was. In 1900, the estimated national infant mortality rate was 100 per 1,000 live births, resulting in over 230,000 infant deaths per year. The maternal mortality rate was 15,000 per year.2 The actual numbers were probably much higher as official data was never exact. The United States did not have a uniform system in place to adequately register births. There were pockets in America, like New York City, working towards more accurate birth records but the majority of states had no systematic programs to gather the data. Rural areas were the least accounted for.3

Julia Lathrop, first Bureau Chief of the US Children's Bureau, and staff. (Harris & Ewing/Library of Congress)
Julia Lathrop, first Bureau Chief of the US Children’s Bureau, and staff. (Harris & Ewing/Library of Congress)

For a country that prided itself on an elevated standard of living and increasing wealth, a soaring infant mortality rate was unacceptable to many Americans, especially the women reformers who headed the Children’s Bureau. In response to these statistics, Bureau Chief Julia Lathrop called for a nationwide program to combat the problem. She insisted that the program should include public health nurses, pre- and postnatal care for mothers and babies, and accessible healthcare for babies and children.

The campaign for such a program was immediately taken up by women’s organizations across the country and reached Washington. Montana Democratic Senator Janette Rankin sponsored the first bill in 1918, proposing Lathrop’s plan. Other iterations of the bill were introduced in 1918, 1919, and 1920. Lathrop’s proposed program finally converged in the “Sheppard-Towner” version, so named because of the co-sponsorship from Morris Sheppard, D-TX, and Horace Mann Towner, R-IA. Over twenty-one national women’s organizations kept up a strenuous letter-writing campaign to their congressional leaders to push the bill out of committee. The newly-formed Women’s Joint Congressional Committee, a coalition of lobbyists and major women’s organizations including the Women’s Christian Temperance Union, National Mother’s Congress, and the National Consumers’ League, mounted an intense lobbying campaign. Major women’s magazines like Good Housekeeping, McCall’s, and Ladies’ Home Journal also publicized the bill and encouraged their readers to write to Congress.

US Children's Bureau poster, c. 1905 and 1945. (Harris & Ewing/Library of Congress)
US Children’s Bureau poster, c. 1905 and 1945. (Harris & Ewing/Library of Congress)

Women bombarded their elected officials with letters promoting the Maternity and Infancy Act. One senate staffer joked that “I think every woman in my state has written to the Senator.”4 With pressure from female constituents and the uncertainty of how powerful newly enfranchised women voters would be, the bill was allowed to pass to the chamber floor for discussion.

Both the House and the Senate held hearings on the Maternity and Infancy Act. In a 1920 hearing before the Senate Committee on Public Health, social reformer and president of the National Consumers’ League Florence Kelley expressed her extreme exasperation with the slow passage of the bill. She asked pointedly:

“Why does Congress wish to have mothers and babies die?”

Referring to the inaction of Congress to pass the bill she stated, “actions speak louder than words, and inaction shrieks to Heaven at the present time.”

She then asked again, “Why does Congress continue to wish to have mothers and babies die?”5

So here we are almost exactly 100 years since Kelly’s testimony and we are still grappling with this basic question — are we going to let babies die?

Statistically speaking, infant mortality for American women as a whole has fallen dramatically since the early twentieth century, but there is shocking disparity when broken down by race. Nationally, black infants die at much higher rates than white infants in the U.S. Although the Children’s Bureau did investigate infant mortality based on race, their primary findings were that populations with higher rates of poverty had a greater percentage of infant mortality. This correlation between poverty and infant mortality still stands today, but examining the relationship between race and poverty is further highlighted in the disparate numbers between white and black infant mortality rates. Nationally, 11.1 black infants died per 1,000 live births in 2013, compared to 5.96 deaths for white babies in the same period. That means black babies were dying at a rate 2.2 times higher than white babies. Ohio’s rate of black infant mortality in 2013 was 13.57 per 1,000 births, the second highest nationally. The disparity in the Ohio numbers mirror the national average, where more than twice as many black babies die than white. According to the CDC, in the 39 states where this information could be calculated, nowhere was infant mortality equal among black and white babies.

Obviously there is nothing different about white and black mothers and babies — the difference is the kind of systematic poverty and extreme income inequality prevalent in the United States. So although the overall percentage of infant mortality in the U.S. has dropped since the early 20th century, the disparity between black and white infant mortality is still at an extremely high level. That is why the numbers from Ohio are so shocking.

What is so interesting is how the language used by female reform politicians today, like former Ohio Senator Nina Turner and Congresswoman Gwen Moore, mirrors the language used by so many reform-minded women in the early 20th century. A century has passed since debates over the Sheppard-Towner Act lit up congressional hearings, yet the problem of infant mortality in America is still with us.

Further Reading

For more information on measures to combat infant mortality in Ohio you can read about the Cradle Cincinnati program.

Notes

  1. Congresswoman GwenMoore, “ Moore Introduces Bill to Reduce Infant and Child Death,” Press Release, February 12, 2016.Return to text.
  2. House Committee on Labor, Hygiene of Maternity and Infancy (Washington, D.C., 1919), sec. The Committee of Labor. Return to text.
  3. “IT IS MOTHERS’ PROBLEM: Infant Mortality Must Be Solved by Them, Says Wilbur Phillips,” New York Times, November 11, 1910. Return to text.
  4. Richard Meckel, Save the Babies: American Public Health Reform and the Prevention of Infant Mortality, 1850-1929 (Baltimore: The Johns Hopkins University Press, 1990), 210. Return to text.
  5. Committee on Public Health and National Quarantine Unites States Senate, Protection of Maternity and Infancy (Washington, DC: Government Printing Office, 1920), sec. Committee on Public Health and National Quarantine. Return to text.

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