1. Karen’s section, pages 259-265, Trachoma Eradication through Alleviating Threat of Incompetent Midwives

2. Trachoma Eradication Project Carried out by nurses of the U.S. Public Health Service Cause of trachoma unknown at the time Furthered via unusual exposure to wind, dust, sun and the “common towel”

4. Trachoma Attacked conjunctiva (membrane lining of eyelids) Granulations formed and thickened eyelid Later granulations replaced by scar tissue Scar tissue contracted causing lid to pull inward and eyelashes rubbed against eye Partial or complete blindness followed

5. Combating Epidemic Trachoma in the Appalachian Mountains Special hospitals established in rural areas of Virginia, West Virginia, Arkansas and Missouri Project aimed at very primitive mountain districts where roads were impassable by car One nurse road 3000 miles on muleback in a single year

6. Promotion of Maternal and Child Health Greatest advance in early 20th century was recognizing importance of nursing and medical care throughout prenatal period Prenatal clinics resulted in decrease of mortality and morbidity from toxemias of pregnancy and cardiac, renal, metabolic, venereal, and associated complications

7. Children’s Bureau Created 1912 3 main groups 1- maternal and infant welfare 2- special groups of children handicapped by physical or mental problems or through delinquency 3- problems related to the child in industry Field studies performed to determine causes of existing high rate of infant mortality

8. Children’s Bureau 200 studies over 15 years presented in 195 special bulletins Compiled, analyzed and tabulated laws relating to child labor, juvenile courts, illegitimacy, sex offenses against children, mother’s pensions, and interstate placement and adoption of children Actively cooperated with child welfare and children’s code commissions in revision of state laws

9. Children’s Bureau Field studies and statistics indicated preservation of mother’s and babies depended on expansion of prenatal care and improvement of care at delivery Surveys showed many births attended by untrained and unskilled midwives 1st cause infant mortality was failure to obtain competent prenatal care followed by gastrointestinal diseases related to contaminated milk/water supplies, unhygienic surroundings, and improper feeding methods

10. A cozy chat with mothers and babies back in '37. Public health nurses, or "County Demonstration Nurses," as they were called, brought the message of good health and well-baby care to rural Wisconsin residents who were in need of adequate medical care. The nurse identified and counseled Wisconsin families in a variety of places. Sometimes they meet their clients at temporary health centers. More often, they met in client's homes.

11. Public health in a public setting. Here, a nurse goes over charts on infant mortality, demonstrating that proper infant care really could be a matter of life death. Often mothers had many children at a very young age. To be twenty-one years old and pregnant with a fourth child was no exception.

12. Workers Stringing Beans, Baltimore, MD June 7, 1909 National Archives and Records Administration Records of the Department of Commerce and Labor, Children's Bureau Record Group 102 ARC Identifier: 52321

13. Large wall panels such as this one were regular features of child welfare exhibits sponsored by the U.S. Children's Bureau during its early years. As a method of popular education, they aimed to reach parents and citizens with messages about everything from the life-saving qualities of breast milk to the dangers of poverty, ignorance, and bad surroundings.

14. The Sheppard-Towner Act Bill introduced April 21st, 1921 by Senator Morris Sheppard of TX Called for the public protection of maternity and infancy through a method of cooperation b/t the U.S. government and various states Elizabeth G. Fox, national director of the Red Cross Public Health Nursing Service spoke for the bill Senator James A. Reed of Missouri opposed the bill as this position should not be assigned to women “who have chosen to remain in a condition of single blessedness” Reed proposed amendment to title of bill to read as “A bill to authorize a board of spinsters to control maternity and teach the mothers of the United States how to rear babies” – it didn’t pass After vote of 63 to 7 bill was passed and signed into law November 23rd, 1921 by President Harding Senator Morris Sheppard

15. Work of the Sheppard-Towner Nurses Nurse sent to community to initiate maternity and infancy program Home visits important part of work of child hygiene nurses Need for medical attention was stressed as many women had no concept of the value of physician care during prenatal period

16. Alleviating the Threat of Incompetent Midwives In the nation as a whole midwives attended approximately 30% of all deliveries, in Louisiana and Mississippi that percentage was 50% Many midwives illiterate and superstitious Sheppard-Towner funds used to teach them about importance of cleanliness