SHEPPARD-TOWNER ACT

The Sheppard-Towner Act, officially the National Maternity and Infancy Protection Act, was passed by Congress in April 1921. It provided matching funds to states for prenatal and children's health centers. The legislation was introduced in the House of Representatives in 1919 by Montana Representative Jeannette Rankin (1880–1973), the first woman elected to U.S. Congress. In December of that year, two similar bills were introduced in the Senate, one by Morris Sheppard, and the other by Horace Mann Towner. Women's advocacy groups joined the Children's Bureau (a federal statutory agency founded in 1912 and a leading force in the child welfare movement) to vigorously support passage of the legislation. In the wake of winning suffrage, American women proved a formidable lobbying force. Further, statistics provided a strong case for government support of a health program dedicated to the needs of women and children. At the time, childbirth was the second leading cause of death for women; one in five children died during their first year of life; and one in three died before the age of five. The Sheppard-Towner Act was passed into law sixteen months after it was introduced.

Under the legislation, using matching federal funds, states established health centers where nurses and physicians cared for pregnant women, infants, and children, and taught women prenatal, delivery, postnatal, and infant care. The program's objective was to reduce maternal and infant mortality rates, which, in studies carried out by the Children's Bureau, were revealed to be higher among lower income groups. Research showed that as family income doubled, the infant mortality rate dropped by 50 percent. Activists concluded that an outreach program was necessary to instruct all women, regardless of their circumstances, on proper health care for themselves and for their children. The health program set up by the Sheppard-Towner Act was formulated in 1917 in the Children's Bureau's annual report, authored by reformer Julia Lathrop (1858–1932), the head of the agency. Lathrop proposed a nationwide effort modeled on a New York City program, run by pediatrician Sarah Josephine Baker (1873–1945), that gave inner city mothers access to health care and provided routine physical examinations for children. Baker headed a New York City health care program that reduced the city's infant mortality rate to the lowest of all major cities worldwide. When the Sheppard-Towner legislation was passed, Lathrop became its administrator.

The Sheppard-Towner Act remained in force until 1929, when Congress failed to renew funding for the program. Critics charged that lawmakers had fallen prey to the influence of the American Medical Association (AMA) and others, who viewed the federally supported health care program as moving the nation one step closer to socialized medicine. This fear was shared by prominent physicians who exited AMA's Section on Pediatrics to found the American Academy of Pediatrics (AAP).

Though the program was relatively short-lived, its influence was lasting. The funding provided by the Sheppard-Towner Act helped countless women and children. The clinics also raised awareness of the importance of preventive health care in lowering mortality rates of expectant women and children. Another improvement was the introduction of the idea that state and local agencies could play an important role in personal health.

See also: Family and Medical Leave Act, Nineteenth Amendment