Content area
Abstract
In the 1920s and 30s, maternal and infant mortality and the fear that alcoholism, prostitution, and poverty were hereditary led health and welfare officials to turn their attention to Americans' reproductive health. During the ensuing decades, birth control, sterilization, and abortion became centerpieces of public health and welfare programs across the country. This dissertation explores these programs by focusing on a state that policy makers nationwide considered a model of public commitment to reproductive health: North Carolina.
Historians have interpreted state-sponsored sterilization as embodying state control over women's reproduction while describing increasingly liberal legislation regarding abortion and birth control as giving reproductive control to women. They have thus situated these technologies at opposite ends of the spectrum. But a simultaneous analysis of birth control, sterilization, and abortion in public health and welfare reveals a much more complicated and intertwined history. In describing the tension between progressive contraceptive policies on the one hand and coercive policies of population control on the other hand, this study demonstrates that all of these contraceptive technologies sometimes enhanced and sometimes limited women's reproductive autonomy. They have also all served the dual purposes of improving women's and children's health and controlling the sexual and reproductive behavior of the poor.
Four groups shaped the nature and delivery of reproductive policies throughout the twentieth century. First, social scientists, including eugenic scientists, offered theories about the origins and characteristics of poverty and proposed solutions involving the control of reproduction for the elimination of poverty. Second, leading health and welfare officials as well as the philanthropists who sponsored North Carolina's birth control and sterilization programs helped to shape public policy and the nature of reproductive services. Third, state and county officials in charge of implementing public health and welfare policies influenced the delivery of reproductive services. Finally, the experiences and responses of those who were targeted by the programs affected the implementation of birth control and sterilization programs, the policy making process, and theories on causes and treatments of poverty. This study examines the problem from the perspective of each of these groups.
