Inclusive Health Services for Women: More than Just Tote Bags

In Silver City, New Mexico, a small print company has raised over seventy thousand dollars for Planned Parenthood through a simple tote bag. PP services are printed on the tote, in a list so long, it barely fits on the bag. Power and Light Press sell these bags “in the name of Planned Parenthood [as] a way to … ‘prepare for the incoming administration.’”¹ The tote also raises awareness about the expansive healthcare services PP provides, which are often overshadowed by the divisive debate over PP’s access to legal and safe abortions. The contribution by a New Mexico-based company to the national reproductive rights movement extends the state’s historical involvement with PP, reproductive autonomy, and maternal health from as early as the 1930s to the present.

In 1937, socialite Mary Goodwin initiated this involvement when she wrote to Margaret Sanger (founder of PP). Her letter asked Sanger for advice on establishing a birth control clinic in New Mexico.² Goodwin, along with a group of other socially and economically elite women, was “deeply moved by the State Statistics [sic], showing the rate of infant mortality and knowing that other charitable organizations were overcrowded.”³ They created the Santa Fe Maternal Health Center (SFMHC) as a solution to reduce mortality rates in the state. The facility offered a birth control clinic, prenatal and postnatal care, home visits by SFMHC nurses, STD testing, immunizations, donations of food and clothing, and general healthcare treatment. The Center’s patients were primarily poor, Hispanic women and children in Santa Fe and adjacent regions.⁴

The Center did not offer their services, however, without complications. In Catholic Santa Fe, the facility encountered harsh criticism from Archbishop Rudolph A. Gerken, who opposed the use of contraception. The Center was unable to receive funding from government sources because of their birth control clinic. As a result, it relied on private donations and fundraisers to maintain operation. The SFMHC board also clashed with Sanger over the type and frequency of their services. Sanger argued that the SFMHC’s general healthcare services overshadowed the birth control clinic. In 1938, Sanger ceased financial support of the Center because the board did not want to stop offering other medical provisions.⁵ Within the Center, patients struggled with their relationship with SFMHC staff, who were upper- and middle-class Anglo Americans. This racial and economic difference resulted in a complex power dynamic between patients and practitioners. The staff’s relationship with patients and the kinds of services the Center offered reveals important implications for race, class, and healthcare in New Mexico. Further, the dynamic illustrates a constant negotiation between healthcare professionals, social welfare volunteers, and the poor Hispanic community.

Perception of race and identity is complex in New Mexico. As Pablo Mitchell argues in Coyote Nation, racial categories of “white” and “Mexican” were often fluid. This flexible categorization was due to assimilation efforts by elite New Mexicans to assert a shared European ancestry with Anglo Americans.⁶ This categorization is evident in SFMHC medical records. Practitioners often varied in how they labeled patients, using terms like “Spanish American,” “Mexican,” or “white.” SFMHC staff assigned these racial identities regardless of surname and even labeled children within the same family as different ethnicities. Overall, the Center’s board strove to assimilate and educate patients to a new standard of living. Home visits, for example, encouraged middle-class homemaking and childrearing practices. SFMHC nurses, staff, and board members often criticized patient living conditions and their Catholic and Hispanic traditions. As then-president of the board, Peach Mayer, noted in 1942:

[gblockquote]From the point of view of educational value we feel that much has been accomplished. … The mother has been instructed in the care and feeding of the new baby, certain superstitions that have been prevalent have been done away with in many cases, and teaching in family diet, sanitation, boiling of water for dysentery patients and many other fields have been of great value to the very poor and ignorant of our community.⁷[/gblockquote]

The Center’s board viewed traditional practices as markers of ignorance. This stance illustrated the prejudices SFMHC staff maintained against their patients, even if the facility did provide a vital service to the community.

In spite of this problematic relationship, women continued to utilize the Center’s services. Patients would use the facility to advocate for certain treatments and services. They would also utilize the facility as an intermediary to communicate with other social welfare programs in the state. For example, in 1937, Peach Mayer sent a letter to the American Women’s Voluntary Service (AWVS) to request that the organization change the day of their Milk Depot. The day it was held on conflicted with a clinic the Center offered and “washday [which] means that it … sometimes [takes] considerable efforts for the mothers to get in to the Depot.”⁸ Mayer only knew this information because the SFMHC staff communicated with their patients. Practitioners listened to patient complaints about difficulties accessing certain services and related this information to the appropriate organizations.

A letter from a SFMHC patient also demonstrated this relationship. In 1940, Mrs. Tellez wrote to the facility and updated the staff on the state of her health and current treatments.⁹ The way the letter is written suggests that English was Tellez’s second language. In spite of this barrier, it was evident that Tellez trusted SFMHC staff and felt no shame disclosing private health information, including the use of contraceptive materials. As she states:

[gblockquote]the diaphragm has been satisfactory to me till [sic] today is in good condition. I need more jelly to cover diaphragm when use also I would like to have some more medicines. … I remain graceful of your treatments. Expecting to hear from you soon.¹⁰[/gblockquote]

Tellez requested more medication from the Center, specifying the treatment she felt she needed. This indicated that SFMHC staff allowed Tellez to dictate and control her own healthcare to a degree. At the end of the letter, Tellez wrote that she expected a reply. This final note illustrated her relationship with the SFMHC extended beyond clinic visits. Tellez understood that her health and ailments would be taken seriously and the Center would listen and respond.

These interactions demonstrate the complex interaction between SFMHC staff and patients. This relationship constantly wavered as determined by problematic assimilationist practices and legitimate concern for the community. The connection thrived, however, because the Center became a vital resource for medical and social welfare in New Mexico. The relationship between SFMHC staff and patients illustrates a healthcare- and reproductive-based relationship with shifting power dynamics and constant negotiation between two racially and economically different groups. The operation of the Center in New Mexico also demonstrates the long-standing connection the state maintained with national movements, such as the birth control movement, or, more recently, with Planned Parenthood.

In 1938, PP’s founder rebuked the Center for their inclusion of general healthcare with birth control. Today, however, PP would likely agree with the Center’s provision of multiple health services. The SFMHC, like PP, was committed to providing more than just reproductive care to its patients. This wide range of healthcare provision made the Center a vital asset to the community. Their services offered important medical services that were not readily available to most patients. While the facility was not without its faults, and the racial composition between patients and practitioners was problematic, the Center did fill a medical need. Similarly, today’s PP provides access to important female health services that goes beyond access to abortion, as demonstrated by Power and Light Press’s tote. As with the Center, these services greatly impact the health of the women who use them and are an important contribution to the medical landscape of any community.

Gianna May Sanchez

Gianna is a PhD history student at the University of Michigan. Her research examines the history of medicine in the 20th century American West with a focus on reproduction, women, folk healing, and medicine in Latinx communities. She also works on numerous public history, digital humanities, and museum projects.

• Gianna May Sanchez

  https://nursingclio.org/author/gianna-may-sanchez/

  Reproductive Justice and Midwifery on the US-Mexico Border