The Sheppard-Towner Act of 1921

The Sheppard-Towner Act of 1921, informally called the Maternity Act, was the first federal law to provide significant funding to help people in need. The purpose of the Act was "to reduce maternal and infant mortality." The legislation was supported by progressives, social reformers, and feminists including Grace Abbott and Julia Lathrop. It was part of a larger movement called "scientific mothering"—applying scientific principles and to the care of infants and children, and educating mothers, especially those who were poor or less educated.

Historical Context

At the time the legislation was introduced, childbirth remained the second leading cause of death for women. About 20% of children in the United States died in their first year and about 33% in their first five years. Family income was an important factor in these mortality rates, and the Sheppard-Towner Act was designed to encourage states to develop programs to serve women at lower income levels.

The Sheppard-Towner Act provided for federal matching funds for such programs as:

• Health clinics for women and children, hiring physicians and nurses to educate and care for pregnant women and mothers and their children
• Visiting nurses to educate and care for pregnant and new mothers
• Midwife training
• Distribution of nutrition and hygiene information

Support and Opposition

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Julia Lathrop.of the U.S. Children's Bureau drafted the language of the act, and Jeannette Rankin introduced it into Congress in 1919. Rankin was no longer in the Congress when the Sheppard-Towner Act passed in 1921. Two similar Senate bills were introduced by Morris Sheppard and Horace Mann Towner. President Warren G. Harding supported the Sheppard-Towner Act, as did many in the progressive movement.

The bill first passed in the Senate, then passed the House on November 19, 1921, by a vote of 279 to 39. It became law after it was signed by President Harding.

Rankin attended the House debate on the bill, watching from the gallery. The only woman in Congress at the time, Oklahoma's Representative Alice Mary Robertson, opposed the bill.

Groups including the American Medical Association (AMA) and its Section on Pediatrics labeled the program "socialistic" and opposed its passage and opposed its funding in subsequent years. Critics also opposed the law based on states' rights and community autonomy, and as a violation of the privacy of the parent-child relationship.

Not only did political reformers, mainly women, and allied male physicians, have to fight for the passage of the bill at the federal level, they also then had to take the fight to the states to get matching funds passed. 

Supreme Court Challenge

The Sheppard-Towner bill was unsuccessfully challenged in the Supreme Court in Frothingham V. Mellon And Massachusetts V. Mellon (1923), The Supreme Court unanimously dismissed the cases, because no state was required to accept the matching funds and no injury could be demonstrated.

End of Sheppard-Towner

By 1929, the political climate had changed sufficiently that the funding for the Sheppard-Towner Act was ended, with pressure from opposition groups including the AMA likely the major reason for the defunding.

The Pediatric Section of the American Medical Association actually supported a renewal of the Sheppard-Towner Act in 1929, while the AMA House of Delegates overrode their support to oppose the bill. This led to the walkout from the AMA of many of the pediatricians, mostly male, and the forming of the American Academy of Pediatrics.

Social and Historical Significance

The Sheppard-Towner Act was significant in American legal history because it was the first federally-funded social welfare program, and because the challenge to the Supreme Court failed. The Sheppard-Towner Act is significant in women's history because it addressed the needs of women and children directly at a federal level.

It is also significant for the role of women activists including Jeannette Rankin, Julia Lathrop, and Grace Abbott, who considered it part of the women's rights agenda beyond winning the vote for women. The League of Women Voters and the General Federation of Women's Clubs worked for its passage. It shows one of the ways that the women's rights movement continued to work after the right of suffrage was won in 1920.

The significance of the Sheppard-Towner Act in progressive and public health history is in demonstrating that education and preventive care provided through state and local agencies could have a significant effect on maternal and child mortality rates.