What About the Mother?: Managing Infant and Maternal Mortality in Early 20th-Century Philadelphia

Recent innovations in maternal-fetal medicine allow physicians to treat birth defects in utero with cutting-edge advances like fetal surgery, preventing serious illnesses in several million infants born in the United States each year.  Though both the maternal and fetal body are involved in these therapies, maternal-fetal medicine is considered a branch of pediatrics.  This raises an important question with ethical implications: what happens to women’s health when maternal-fetal health is classified within a medical discipline dedicated to the health of infants and children?  This paper is a direct response to Mary D’Alton’s 2013 call to arms in the American Journal of Obstetrics and Gynecology in which she urged maternal-fetal specialists to reprioritize maternal health in the wake of recent and startling statistics: maternal mortality rates in the United States have not decreased in over three decades and maternal morbidity rates are on the rise.  My research demonstrates that this trend is far from new.  By focusing on maternal-fetal care in the city of Philadelphia, I demonstrate that D’Alton’s call is simply the latest iteration of a growing shift away from hospitals and medical techniques focused on the care of women and towards those focused on the care of fetal and infant bodies. My study historicizes the origins of this shift to turn of the 20th century campaigns across the United States to lower high infant mortality rates and traces the genealogy of this ethical switch through late 19th- and early 20th-century Philadelphia hospital, medical, and public health politics.