PART II — Four Decades Of Action For Children (1912-1952)
By: Dorothy E. Bradbury, Assistant Director, Division of Reports Children’s Bureau
Chapter IV — THE COMING OF THE MATERNAL AND CHILD WELFARE PROGRAM (1934-1940)
THE ACTUAL STRUCTURE for the maternal and child health and child welfare programs under the Social Security Act was erected during the period of recovery from the great depression-and it was here that the Bureau put its major effort during these years. On November 23, 1934, President Franklin D. Roosevelt named Katharine F. Lenroot, Chief of the Children’s Bureau to succeed Grace Abbott. Miss Lenroot had joined the Bureau’s staff as a special agent in January 1915 and had served in the Bureau continuously thereafter.
As the twenties and the thirties passed, it became evident that the facts gathered in studies of special groups of children had wide effect on all children through the development of standards that influenced State legislation and local practice. For this reason in the next two chapters the Bureau’s activities are not divided into “all children” and “special groups of children.”
The bitter experience of the depression showed how tragically dependent large elements of the population were upon some kind of protection against economic hazards. Since the effects of economic distress bore heaviest upon the children and took many forms, they reached far into the future. The recommendations presented by President Franklin D. Roosevelt to Congress as a basis for theSocial Security Act represented months of study by the Committee on Economic Security-a committee including the Secretary of Labor, Chairman; the Secretary of Agriculture; and the Federal Emergency Relief Administrator.
In the fall of 1934, the Committee on Economic Security asked the Children’s Bureau to assemble the facts and make proposals for Federal legislation on children’s programs which could be included with proposals being developed by the Committee on unemployment compensation, old age insurance, public assistance for the aged, and general public health.
On the basis of the facts presented by the Bureau and its proposals, the Committee’s report recommended the expansion of the mother’s maternal and child health programs, medical care for crippled children, and child welfare services.
The Social Security Act was signed into law by President Roosevelt, August 14, 1935, bringing into being these children’s programs in the same legislative package with the typical Social Security provisions. Funds became available in February 1936.
Since ultimately a decision was reached that title IV, aid to dependent children, was to be a program of cash payments to mothers of children deprived of their father’s support, to which eligible children would have a right by law, responsibility for this part of the Bureau’s proposal was placed in the Social Security Board.
Title V included Federal aid for three types of work in the States–maternal and child health, medical care for crippled children and child welfare services–to be administered through the Children’s Bureau. Thus the children’s programs under the Social Security Act began in the midst of a great depression and devastating drought–in the days when many teenagers took the road to relieve their parents of another mouth to feed, when families lacked the basic necessities of life, when young people finishing school faced a bleak and jobless world.
Within a few years, economic depression gave way to defense preparations and unprecedented industrial activity.
Children’s Programs Underway
In getting underway–and in carrying out the three children’s pro-grams for which it was given responsibility under the Social Security Act–the Bureau in characteristic fashion turned to advisory groups for advice and guidance. Advisory groups were immediately set up for each of the programs. For the most part, these were professional people concerned with the technical aspects of the program. An overall Advisory Committee on Maternal and Child Welfare Services including both technical and lay people was established also to make recommendations on overall aspects of these programs. In addition special committees on various technical problems of the programs were appointed, e. g., a special committee on maternal welfare; an advisory committee in training and personnel for child welfare.
The soundness of the planning and the dispatch with which the programs got underway bore strong evidence to the value of the advice given to the Bureau by these groups. They made a rich contribution to helping the Bureau chart the course of the children’s programs.
Maternal and Child Health
Within 9 months of the time when maternal and child health funds became available, all 48 States, Alaska, Hawaii, and the District of Columbia were cooperating. This prompt action on the part of the States was due in large part to the experience gained during the existence of the Sheppard-Towner Act-an experience that stood the States in good stead. The funds granted to the States for maternal and child health services were used, under the administration of the State health departments, to pay for physicians, dentists, public health nurses, medical social workers, and nutritionists, to help mothers and children living, for the most part, in rural areas. These mothers and children were reached through prenatal and child health clinics held in centers accessible to them and through school health services. Many others were reached through home visits by public health nurses.
Some few mothers and children were given medical and hospital care, but the program as set up by States in the first years was primarily one to develop preventive health measures and training for professional personnel rather than actual medical or hospital care.
In the years between 1936-40 many changes in program occurred. The scope of service widened to include demonstrations and special projects showing how new knowledge could be put to work. Improvement of maternity care and care of newborn infants was progressive and special programs for the care of premature babies developed as training centers. All of the States used some of their funds for the training of professional personnel to provide these services.
From the start the maternal and child health programs under the Social Security Act gave the Bureau an opportunity to work with States in planning special projects and programs aimed at the conditions and circumstances affecting infant and maternal mortality. As will be described in more detail later, this was possible because the act called for demonstrations to be part of the program in each State and part of the funds given to each State were granted without matching requirements. With these funds the States frequently undertook new work, developed experimental programs that were not possible with their State and local funds. As an example: special programs for the care of premature infants in hospitals equipped and staffed for the purpose were soon developed by several States; these were used as training centers for medical and nursing staff from hospitals in these and other States. The Bureau’s consultation services to States on how maternity care and care of new-born infants might be improved were stepped up enormously.
In January 1938, a Conference on Better Care for Mothers and Babies brought together a group of men and women, who were actively enlisted in the struggle to make life safer for American mothers and babies. Early in 1937, the Special Committee on Maternal Welfare appointed to advise the Children’s Bureau in its administration of the maternal and child health services under the Social Security Act met to consider problems which had been met up to that time in the maternal and child health services under the Social Security Act. The committee unanimously agreed that extension of services to permit care of mothers at childbirth was an outstanding necessity.
In October 1937, the Bureau called a small conference of representatives of medical, professional, and lay groups concerned with this problem. This group recommended that a national conference be called and served as the planning group for it. The “Conference on Better Care for Mothers and Babies” was the result and called together about 500 delegates–health officials and representatives of nearly 100 national organizations, professional associations, and health and social agencies–to canvass the whole problem of maternal care. They came from every State and Alaska and Hawaii.
At the opening session facts presented revealed the size and complexity of the problem in a report entitled The Need Today. Here are a few highlights from this report: “In more than 2 million families in the United States in a single year, the birth of a baby is the most important event of the year, but in more than 150,000 of these families the death of the mother or baby brings tragedy. Committees of physicians in many parts of the country, after careful evaluation of the causes of death of individual mothers, are reporting that from one-half to two-thirds of these maternal deaths are preventable.”
Saving the mothers, and making good care available for the mothers would save many babies, too. Great strides had been made in the United States in cutting down the baby death rate. But the babies saved were mostly over one month of age. Almost no progress had been made in saving those who die in the first month of life- no progress at all in saving those who die the first day of life.
The report of the committee on findings, after reviewing the evidence concerning the unnecessary loss of maternal and child life in the United States, the opportunities presented for saving life, the inadequacy of medical and nursing care, and recent advances in provision of such care, found that “preserving the lives and health of mothers and babies is of such importance to all the people that it warrants immediate and concerted national consideration and national action.” At the close of the final session, a small committee called at the White House and presented its report to the President.
With the Social Security Act the Bureau at last had an opportunity to bring together on a permanent base fact finding, consultation, and program planning and assistance to States in developing action in the maternal and child health field.
Crippled Children
The program for crippled children was the first program of medical care based on the principle of continuing Federal grants-in-aid to the States. This program was particularly significant because of the variety of care that had to be coordinated since the care of children with crippling conditions is complex-medical, health, nursing, medical-social, physical and occupational therapy and psychological services, care in hospital clinics and private offices.
Training for this type of multi-professional work with individual children in group settings such as clinics was necessary and had to be carefully planned for different types of conditions. Gradually the State programs were directed toward one objective–physical, social, and emotional restoration of the crippled or handicapped child. The first step in the operation of the crippled children’s program as set forth by Congress was to find the children. The injunction was unusual. The Federal Government was saying in effect, do not wait for these children who need care to be brought to you; find them–wherever they may be–and bring them in. All States arranged for clinics to be held throughout the State, either on an itinerant or permanent base; diagnostic services were made available to all children. Children were given the full-range of service available under the program.
By April 1, 1937, State plans of services for crippled children under the Social Security Act had been approved for 42 States, Alaska, Hawaii, and the District of Columbia. By the end of fiscal 1938, the program was in operation in every State but one. These programs were administered in each State by an agency designated by the State–in about two-thirds of the States by State health departments. Each State determined the types of crippling or handicapping conditions to be included in its program.
From the beginning State programs accepted handicapped children who needed orthopedic or plastic treatment. But as additional funds became available, States broadened their interpretation of crippling conditions. In 1939, Congress made additional funds available for crippled children’s services, with the understanding that part would be used to assist States in developing programs for the care of children with rheumatic heart disease. Ultimately special projects were started for the care of these children in some 29 States. The programs started in 1939 and 1940 were the forerunners of many types of special projects that extended and strengthened the crippled children’s program immeasurably.
Child Welfare
During several decades prior to 1935, many voluntary agencies and an increasing number of public agencies in many urban areas and a few States developed activities for the care and protection of children who were neglected, abused or abandoned by their families, or whose families were unable to provide for them, for a variety of reasons, such as illness, death, desertion, etc., or whose mothers worked for economic reasons.
Institutional care was giving way to foster family care for urban children. Adoption programs, programs of care for unmarried mothers, day-care centers–all these and more had developed in cities.
Child welfare workers trained at schools of social work for these types of work ‘were known in cities, serving usually in private agencies, but in some States and localities in public agencies. They were depended on to arrange for care for many children who had to be removed from their own homes.
Little of this kind of help existed for children in rural areas. The Children’s Bureau studies of child dependency in rural areas in several States showed that families with children in rural areas had the same problem as those in city areas, but very little was being done for them. Most rural areas were without child welfare workers and resources for children who had to be cared for away from their homes were lacking.
In the years between 1912 and 1935 the Bureau had studied many of these services and given much consultation to States and communities in developing them. But the child welfare services under the Social Security Act represented an entirely new type of Federal-State cooperative program.
Some States with no pattern of public programs for child welfare in 1935 had to start from scratch. Others built on what they had, improving the quality or coverage of service. Each State made its own plans, within the provisions of the act in ways best suited to its needs and resources. States called on the Children’s Bureau for technical consultation on various aspects of their programs and for help in working out their plans for the use of Federal funds.
Many States and communities turned to the Bureau for special help and advice on the adequacy of care provided juvenile delinquents. A committee on training schools for socially maladjusted children was set up by the Bureau in 1936 in response to requests from State training schools for assistance in evaluating institutional methods and promoting the development of more effective treatment programs. The 1937 report of the Bureau described typical requests from States or localities for consultative service received during the year in the area of juvenile delinquency. These requests were concerned with the adequacy of care provided for juvenile delinquents, planning community programs for the prevention and treatment of delinquency, and juvenile court legislation and administration.
Because of the small amount of money available to each State, on the advice of a professional advisory committee including representatives of public and private agencies, the Bureau decided to use the funds for the employment and training of staff and services to children rather than for the maintenance of children in foster care. By March 15, 1938, 45 States, Alaska, Hawaii, and the District of Columbia were cooperating with the Bureau.
Who were the children receiving help under these State programs? Some of the children were in difficulty in their own homes or in their own neighborhoods, some were children known to the county public assistance workers; some were handicapped children known to the crippled children’s agencies; some were children in jails or known to the juvenile courts; some were children in institutions for the care of delinquent or dependent children.
Some were boys and girls for whom a foster home had to be found because of neglect, sickness of the parents, delinquency, or dependency. The child welfare worker’s responsibility was not only to find the home but to see that a satisfactory adjustment was made in it and that plans were laid for the child to return to his own home as soon as possible.
Some were unmarried mothers; some were couples who had no children and wanted to adopt a child. For all these children and more the child welfare worker was the spokesman, arousing communities to the need for making appropriate provisions for their care at home or elsewhere.
Research
During the early years of this period, the general research program of the Bureau was curtailed in meeting the demands of the recovery period, chiefly in connection with the development of the children’s programs under the Social Security Act. But even though the focus of the Bureau throughout this period was on getting the grant-in-aid programs underway, a number of important studies and investigations were undertaken.
Foster care
Studies of foster care during these years were concerned chiefly although not exclusively with methods and problems involved in placing children in foster homes of various types. They included a summary of the laws on interstate placement of dependent children, public care of dependent children in Baltimore, a study of the adoption procedures used in various States, foster-home care for mentally deficient children.
Juvenile delinquency
A number of studies started during the early thirties were carried over into this period, notably the Chicago demonstration probation project and the study of institutional treatment of delinquent children. In addition a demonstration of community methods of prevention and treatment of the behavior problems of children was begun during 1937 in St. Paul, Minnesota and carried on until 1943. The study was confined to a neighborhood of 20,000 persons-a neighborhood small enough for study purposes and yet large enough to provide a good cross-section of a metropolitan community. The children involved were typical of those to be found anywhere–their behavior problems presenting the usual run of truancy, pilfering, school failure, inability to get along with other children.
Infant and Maternal Mortality
A number of important studies in maternal and infant mortality were carried on during these years. In 1940, the Bureau published its first study of stillbirths based on 6,750 stillbirths occurring in 223 hospitals in 26 States. The study showed clearly that improvements in both prenatal care and delivery techniques were essential in the prevention of stillbirths. Other studies undertaken during these years included: A study of how the high infant mortality of Memphis–the highest of all cities of 100,000-might be reduced; studies of the metabolism of premature infants in cooperation with New York Hospital and the Cornell University Medical School; and studies of incubators for premature infants with the Bureau of Standards.
Child Labor and The Fair
Labor. Standards Act
During the recovery years, 1933-40, in the field of child labor, the Children’s Bureau:
- Studied the unemployment problems of youth.
- Worked out the child-labor provisions of the NRA codes
(later declared unconstitutional). - Studied the effects of the Agricultural Adjustment Act and
the Sugar Code Act of 1937 on child labor in industrialized
agriculture. - Administered the child-labor provisions of the Fair Labor Standards Act.
The passage of the Fair Labor Standards Act by both Houses of Congress on June 4, 1938, marked not only the attainment of a long-sought goal–a Federal law setting a floor to wages and a ceiling for hours in interstate industries-but opened the way for the establishment of a national minimum standard for child labor and provided methods of enforcement.
For child labor, the act established a general minimum age of 16 and a minimum of 18 in occupations hazardous or detrimental to health or well-being. The administration of the child-labor provisions of the law was assigned to the Children’s Bureau. Because of its administration of the first child-labor law, the Bureau knew the elements that had to go into such a program.
Under the new law the Bureau developed agreements with most of the State Departments of Labor and Education to act in its behalf in looking at systems of employment certification, in providing certificates of age to be filed with employers for their information and protection, and in carrying out much of the inspection and enforcement program.
On February 3, 1941, the United States Supreme Court declared the Fair Labor Standards Act constitutional and thus the child-labor provisions became a permanent standard for the protection of children.
1940 White House Conference on
Children in a Democracy
The Fourth White House Conference was held in January 1940, during the first year of World War II and about a year before the United States became involved in the war. Recovery from the great depression was essentially complete but world tensions were rising; defense industries and new communities were growing tremendously creating many health and social problems, plans for drafting young men for the military forces were underway. Families were moving from place to place to find employment.
Because of all these factors, the conference discussions were largely centered on social and economic matters. They served to keep a national focus on children and their requirement in a democratic way of life. The Conference paved the way for the National Commission on Children in Wartime established in 1942.
For children the years 1934-40 were hazardous, indeed. Yet the ill winds of depression and the defense period brought some good in terms of more knowledge of child growth and development, vast new areas of knowledge of chemotherapy and nutrition of utmost importance in the reduction of maternal and infant mortality and the improvement of health and greater community conscience about children’s difficulties.
But World War II was getting to its slow but deadly start- and all that war portends for children and their families was in the offing
BUREAU IN WARTIME (1940 -1945)
WAR DISRUPTED the lives of families–and of children. Once again, the Bureau adapted its programs in an effort to cushion for children the effects of an emergency. First we will take an overview of the Bureau’s activities in war-time and then move on to a more detailed account of some of them.
An Overview
The Bureau worked on the development of special programs to meet wartime conditions faced by children and families, and cooperated with other Federal agencies and national organizations in an effort to throw additional safeguards around mothers and children, sometimes working directly on programs, sometimes serving in a consultative and advisory capacity.
Research programs that could not be justified as contributing to the war effort had to be dropped according to general policy affecting all Federal agencies. This affected the Bureau’s work profoundly–it did away with the balance between the fact finding and research program and the program of advisory services to the States and administration of the grants. (Never since its war years has the Bureau recovered its research program.)
Before Pearl Harbor the Children’s Bureau had undertaken studies of the effect on children of conditions in defense production areas, particularly lack of community health, welfare, education, and recreation services and facilities.
During the defense and war years the Bureau’s regional staff worked with State health and welfare officials and with the regional councils of the Office of Defense Health and Welfare Services to build up services and facilities for children in crowded areas.
Brief studies throughout the war period of hospitals and infirmaries, of day-care programs, of boys and girls working on farms, of places of detention for juveniles, of migrant youth kept the Bureau as close as was possible, under the restrictions imposed on research, to conditions adversely affecting children and youth.
The Bureau took part in the councils of the Office of Defense Health and Welfare Services.
In 1941 the Bureau called a conference on day care of children of working mothers and, on this base, issued its publication, Standards for Day Care of Children of Working Mothers. A year later, the Children’s Bureau in cooperation with the Women’s Bureau worked out a maternity policy for industry.
Later, when Federal aid for local day-care projects was supplied from Lanham Act funds for community facilities, the Office of Education and the Children’s Bureau certified need.
Between 1941 and 1943, the Bureau studied conditions around military camps to see what was happening to the wives and infants of men in the armed services, and the facilities available for their care. Beginning in 1941, State health agencies requested and the Children’s Bureau approved the use of Federal maternal and child health funds for maternity care of wives of enlisted men in the armed forces. In March 1943, Congress voted the first appropriation for emergency maternity and infant care for the wives and babies of men in the lowest four pay grades of the armed forces.
As industrial production mounted, the Children’s Bureau intensified enforcement of the child-labor provisions of the Fair Labor Standards Act.
As the number of boys and girls under 18, and even under 16, who had left school to go to work rose to approximately 3 million the Children’s Bureau and the Office of Education undertook to stem the tide through back-to-school drives in 1943 and 1944, with support throughout the country.
The Children’s Bureau in 1940 shared in the forming of the United States Committee for the Care of European Children, to coordinate United States resources for the care in this country of child victims of the war in Europe.
Early in 1941, the associate chief visited England as a member of the United States Civilian Defense Mission. When the Office of Civilian Defense and the Office of Defense Health and Welfare Services appointed a joint Committee on Health and Welfare Aspects of the Evacuation Plan, the Children’s Bureau was a member and did much to organize health and welfare procedures for evacuation of cities and preparation of reception centers.
Beginning in 1943, the Bureau at the suggestion of an advisory group undertook a comprehensive study of guardianship, its laws and procedures as they affect children, circumstances under which guardianship is desirable and the supervision that should be provided to serve the best interest of children. The study was published under the title: Guardianship: A Way of Fulfilling Public Responsibility for Children.
The Children’s Bureau early in 1942 called together a National Commission on Children in Wartime composed of some 60 professional and lay citizens. Meeting annually during the war, this Commission adopted the Children’s Charter in Wartime and made recommendations to guide the Bureau in its work.
Grant-in-Aid Programs
Fortunately, grants to States for maternal and child health and crippled children services had been increased somewhat in 1939. This helped States hold the line in the face of wartime shortage of medical and nursing service.
Maternal and Child Health
Because of the withdrawal of doctors and nurses from communities to go into the Armed Forces, the main problem faced by the States was to replace personnel as they left, when possible, and through reorganization of these programs to enable the limited personnel remaining to serve larger numbers of mothers and children.
Maternal and child health programs beginning in 1942 and 1943 showed decreases.
Medical services rose slightly during the early years of the war and then by 1945 fell to levels below those of 1940. Nursing services rose during the early war years and then turned downward. Immunizations against smallpox and diphtheria followed this downward trend.
Crippled Children
The effects of the war were keenly felt in the field of services for crippled children through spiraling costs, the withdrawal of hundreds of surgeons, nurses, and physical therapists for service in the Armed Forces; shortages in hospital facilities and services; difficulty in arranging transportation to clinics, hospitals, and convalescent homes; and restrictions on the manufacture of metal appliances.
As a result of all these difficulties, decreases in crippled children’s services occurred each year. Fewer crippled children received care in clinics, hospitals, and convalescent or foster homes, and public-health-nursing and physical-therapy services declined. Although towards the end of the war, these services were increasing, they still had not reached the high point of 1940-41.
Care for children with rheumatic fever and resulting heart disease moved forward in many States.
Child Welfare
Many social problems affecting the lives of children were created or intensified by the dislocations of family and community life growing out of wartime conditions. The absence of millions of fathers in military service and the increased employment of mothers outside the home were the greatest causes of family dislocation. Children in migrating families were exposed to abnormal family and community life in war-congested areas. Adolescents were restless and under tension and many left home to seek employment. Juvenile delinquency was on the increase everywhere.
In addition to the provision of child welfare workers in local areas to help communities meet problems such as these, State public welfare departments used child welfare services funds to provide special staffs to deal with wartime child welfare problems. For example a number of States developed special projects for the study and prevention of juvenile delinquency, including special consultants on the State staff, workers assigned to State training schools, and to local areas to work on the control of juvenile delinquency.
To meet demands for consultation service on the development of community day-care service for children of working mothers, over half the States added workers to the staff of State and local public welfare departments. The problem of securing personnel was serious throughout the defense and war years. To meet the problem of staff shortages and turnover, State public welfare agencies increased their staff development programs both through in-service training and through educational leave for professional training.
The widespread need to extend and adapt child welfare programs to meet the problems of children and youth growing out of situations such as these brought increased requests to the Bureau from State public welfare departments, law enforcement agencies, national and local private agencies, defense-council committees on children, and citizens’ groups for advice, and consultation.
The Bureau’s regional child welfare staff was called on by the State agencies to aid them in planning child-welfare services for congested war areas, to assist in developing State and local programs for services for children of working mothers, to expand the service for licensing day nurseries and foster-family day-care services, and to develop protective services for boys and girls in danger of becoming delinquent or needing social service to overcome behavior problems.
Juvenile Courts and Juvenile Delinquency
Wartime conditions increased juvenile delinquency. The general trend in delinquency cases during the period beginning in 1940 was upward to a peak in 1945.
In 1942, the Bureau cooperated with the Bureau of Public Assistance in studying needs for children’s services in Newport News and Pulaski, Va., and assisting in the development of plans for a coordinated community program for the treatment and prevention of juvenile delinquency. In an effort to learn what was happening to children, the Children’s Bureau studied the detention of children under 16 years of age in jail in Georgia, North Carolina, and South Carolina. Other studies during this period included a study of juvenile delinquency in 9 cities greatly affected by the development of war industries, army camps or navy bases; a study of curfew ordinances and their social implications; a study of four training schools for socially maladjusted children in West Virginia.
In February 1943, a meeting of the National Commission on Children and Youth held at the White House dealt with juvenile delinquency and the community’s responsibility for providing services. In accordance with the Commission’s recommendations the Bureau issued Controlling Juvenile Delinquency, a bulletin designed to help communities think and act constructively in meeting the problems of children in trouble, and a bulletin Understanding Juvenile Delinquency written for parents and civic leaders.
The Children’s Bureau sponsored conferences on the training for police work with juveniles in November 1943 and May 1944. In the summer of 1944, studies were undertaken in 5 cities to observe the work of police with juveniles.
Children of Working Mothers
Shortly after the country entered the defense period, reports began to trickle into the Bureau from various defense centers of children being left at home alone or locked in parked cars all day while their mothers worked; of children being left with the neighbors, with an older sister or brother or grandparents or with relatives; of children being allowed to shift for themselves.
Perhaps even such situations–as bad as they were–would not have been cause for undue alarm if it were not for the fact that communities were short-handed with respect to services for children; that the day-care, recreational, guidance, and other facilities which the Bureau had learned through long years of experience were needed for the adequate care of children were curtailed or were lacking.
The first step-the only step the Bureau could take with the resources it had–was to mobilize the experts who knew how to work out ways of meeting such situations. So it was that the Bureau on July 31-August 1, 1941, called a conference of outstanding representatives in the field of child care to discuss the need and the best methods of meeting the need.
The Conference on Day Care of Working Mothers stated: “In this period when the work of women is needed as an essential part of the defense program it is more than ever a public responsibility to provide appropriate care of children while mothers are at work…”Nursery schools, nursery centers, and cooperative nursery groups should be developed as community services, under the auspices of public or parochial schools, welfare departments, or other community agencies. They should not be located in industrial plants or limited to children of mothers employed in particular establishments. Infants should be given individual care, preferably in their own homes and by their own mothers.”
In August 1942, the War Manpower Commission recognized the gravity of the situation by issuing a statement of Policy on Employment in Industry of Women with Young Children. In part, this statement read as follows: “The first responsibility of women with young children, in war as in peace, is to give suitable care in their own homes to their children….In order that established family life may not be unnecessarily disrupted, special efforts to secure in industry women with young children should be deferred until full use has been made of all other sources of labor supply.”
The War Manpower Commission in the summer of 1942 directed the Office of Defense, Health, and Welfare Services, in consultation with other departments and agencies of the Federal Government, to develop a coordinated program of Federal assistance in providing care for children of working mothers. To carry out these purposes $400,000 was transferred from the President’s Emergency Fund for the necessary Federal services and for grants to States for State and local advisory services. No part of these funds could be used for the actual operation of child-care centers.
Under this program 28 plans administered by State departments of public welfare and 33 plans administered by State departments of education were approved, on recommendations of the Children’s Bureau, for welfare plans and the Office of Education, for education plans.
Unfortunately these funds were not available after June 30, 1943. A number of State departments kept workers on with their own funds or with Federal-State funds for child welfare services.
The WPA and later the Federal Works Administration under the Lanham Act converted some relief nursery school projects into war-time projects and made funds available for other nursery schools and before-and after-school programs in war areas.
At the peak, July 1945, approximately 1,600,000 children were enrolled in nursery schools and day-care centers receiving Federal funds. Under this program, most of the projects were sponsored by schools and school people; a small minority were under the auspices of welfare departments or community agencies other than schools.
The Office of Education and the Children’s Bureau were asked to certify to the need for centers under educational or welfare auspices, respectively. They relied largely on the recommendations of State education or welfare departments.
Through the Lanham Act communities were able to obtain about 50 percent of the cost of group-care facilities for children. No funds were made available for other types of care-types of care that were just as crucial from the point of view of the welfare of children.
One of the major issues was the need for care for children under two–babies who needed individual care. The Bureau tried unsuccessfully to have the Federal Works Agency make funds available for this type of care for these children. Group care for infants developed in several congested areas.
The Children’s Bureau on July 10, 1944, called a conference on the care of children under 2 years, which was attended by authorities from the fields of psychiatry, nursery school education, child welfare, child health, and child development. The purpose of the conference was to have the members advise the Children’s Bureau on the needs of babies and the ways in which these needs could best be met under war conditions. The group agreed on the following principles:
1. Decisions as to the care of young children must be made in the light of the child’s needs.
2. Every effort must be made to preserve for the baby his right to have care from his mother.
3. Advisory and counseling service should be a part of every program of child care.
4. Foster-family day care, which more nearly met the baby’s needs than group care, should be developed for children under 2 or 3 years of age.
5. Group care was not a satisfactory method of caring for children under 2 years of age.
6. Whenever possible the age of admission to group care should be fixed at 2′/2 to 3 years.
The withdrawal of Federal support for day-care centers in 1946 made things difficult for many families. The Children’s Bureau, in a release dated March 1, 1946, urged communities and States to set up representative planning bodies on which parents would be represented, along with schools, social agencies, and other groups to deal with “this question of day care on long-range, not emergency terms.”
Twice as a country we have done something about day care, but never in terms of what children need. In the depression years centers were maintained with Federal assistance in order to provide employment for adults. In the war years they were maintained in order to get women on the job. Perhaps sometime in the future the problem will be considered in terms of the welfare of children.
Employment of Children and Youth
Child labor returned in full force with the advent of World War II. The depression thirties reared a wall of unemployment around America’s young people ready for and needing work. But the war forties plunged children and youth, dangerously unprepared, into adult jobs, many of them taken at the sacrifice of schooling. Even before Pearl Harbor with the development of defense industries, many children found employment and, as the war progressed their numbers skyrocketed.
During World War II, America had a transient youth problem as serious as that experienced in the depression years of 1932 and 1933. These war migrants were on the whole younger than their depression counterparts and the incentives, the work opportunities, and the modes of travel were different. But, for many, living conditions were as bad, the dangers of new companionships were as great, and the effect on the young people of complete release from parental authority and supervision of any kind was the same.
Many of the large war industries sent their agents out through the country to recruit new workers, and a large number of young people under 18 years of age responded eagerly. Boys and, to a lesser extent, girls, 16 and 17 years of age and some 14 and 15, migrated for work in war centers where they were separated from their families.
Local prejudice, which was so strong against the migrant in the depression era continued, though the reasons for it were somewhat different. The needs of these young people were seldom considered in the course of community planning.
Though some relaxations were permitted under Federal and State child-labor laws, the Bureau in general intensified its enforcement of the child-labor provisions of the Fair Labor Standards Act. Failures to observe such laws increased as the number of young workers rose. Thirteen Advisory Standards for the employment of young people under 18 in hazardous occupations were issued by the Bureau.
In spite of pressure from many sources, the framework of child-labor laws and the employment certification for young workers previously built up held. In large measure they prevented manufacturers from employing youngsters too immature for wartime industry. The following are illustrations of cooperative activities with other agencies during the war in this area.
After consideration with the Children’s Bureau and the Office of Education, the War Manpower Commission in January 1943 issued a Statement of Policy on the Employment of Youth Under 18 Years of Age which declared that these young people could best contribute to the war effort by remaining in school and, when their work was needed, by accepting vacation and part-time employment. This was followed by a statement of policies for part-time employment of in-school youth agreed upon by the Bureau, the Office of Education, and War Manpower Commission.
The onset of World War II found oppressive child labor still a pattern on the land. Young workers in the fields had little legal protection from employment. Hard work, long hours, and low wages and little schooling were the rule. Two Federal acts applied to the work of these children but to a limited extent only. Under the Sugar Act of 1937, producers were eligible for full payments only if they employed no children under 14 years on the crops and children of 14 and 15 no longer than 8 hours a day. These restrictions did not apply to growers.
The Fair Labor Standards Act applied to child labor in agriculture only on the days and during the hours when children were legally required to attend school. School attendance laws differed widely in different States as to the ages at which children must attend school, how many days a year, the reasons for permitting release from school, and a period for planting and harvesting crops.
A survey of the employment of youth on farms in 1942 by the Children’s Bureau and the Office of Education was used as a base for recommendations by the Bureau’s Advisory Subcommittee on Young Workers in Wartime Agriculture and incorporated in a pamphlet issued in 1943, Guides to Successful Employment of Non-Farm Youth in Agriculture. The Bureau cooperated in maintaining standards for the employment of youth in agriculture, with youth-serving agencies, with the War Food Administration, and the Extension Service of the Department of Agriculture throughout the war period.
The Children’s Bureau publication The Work and Welfare of Children of Agricultural Laborers in Hidalgo County tells the story of life lived by the children of farm laborers who harvested winter vegetables in one important agricultural area in America in 1941. The information for this study was obtained in interviews with 342 families of farm laborers who lived in the southern part of Hidalgo County. The study revealed that there were thousands of children, some as young as 6 years, who followed the crops with their families, who did hard grueling work for long hours, who lived in squalid shacks, who had little opportunity for school.
Maternal and Infant Mortality
Despite the disruptions of the war years, steady progress was made in the period 1940-45 in safeguarding mothers and children from fatal risks in child bearing and in infancy. The maternal mortality rate for the year 1945, 20.7 deaths per 10,000 live births, was the lowest ever recorded in this country prior to that time–a decrease from 37.6 in 1940. Likewise, the infant mortality rate declined from 47.0 deaths under 1 year per 1,000 live births in the period from 1940 to 38.3 in 1945.
Despite the encouraging reduction in national rates beginning in the mid-thirties, maternal mortality in some States, particularly among nonwhite mothers, was still disproportionately high. An analysis of maternal and infant mortality rates for 1944 showed that reduction in maternal mortality among nonwhite mothers lagged 15 years behind that for the rest of the population.
A study of neonatal deaths reemphasized for the Bureau the importance of concentrating attention on risks in the first month of life if the infant mortality rate was to be lowered significantly in coming years. While death rates for the first year of life dropped 29 percent from 1935 to 1944, rates for the first month declined only 24 percent in the same period. Sixty-two percent of all infant deaths in 1944 occurred when the infant was less than a month old.
In 1948 the Bureau published a manual for physicians on care of premature infants.
The Story of Emergency Maternity and Infant Care (EMIC)
The State of Washington was the proving ground for the emergency program for the care of the wives and babies of servicemen. At Fort Lewis, as around all training posts, in late 1940 and early 1941, families of many of the men had come to live. The Commanding Officer of the Fort, concerned with the well-being of his men, began observing some of the difficulties that these families–far from home–were encountering. He found a group of wives who were in need of maternity care but unable to get it. They were girls, most of them young, who had followed their men to camp with the hope that they might be with their husbands for a little while before they were sent overseas. Most of them were having their first babies. Frequently their husbands went overseas before their babies came. These girls had no fixed residence.
In peacetime, the fort hospital like all Army and Navy hospitals, provided medical and hospital care for dependents of enlisted men, without regard to financial need. But now the number of soldiers at the fort had swelled so that this service could no longer be given without jeopardizing the health of the soldiers.
County funds could not be drawn upon because the soldiers’ wives were not residents of the county. They came from all over the country, some as far away as New Jersey. Red Cross chapters couldn’t begin to handle the load.
So the Commanding Officer took the problem to the State health officer. Could he help? When the Commanding Officer appealed to the State health officer for help in this emergency, he, in turn, asked the Children’s Bureau to give him permission to use maternal and child health funds available under the Social Security Act for the care of these women.
The Children’s Bureau agreed that maternal and child health funds could be used to do this. In August 1941, the program got underway. Soon, other State health officers, encountering similar problems, sought additional grants from the Children’s Bureau. During the last half of 1942, the Children’s Bureau set aside all unallotted maternal and child health funds, about $200,000, for this program and 28 States set up operating plans for these services. But by this time, it was obvious that the requests from State health agencies to care for the needs of wives of enlisted men would quickly outstrip the funds available.
The Children’s Bureau appealed to the Bureau of the Budget in August and September 1942 for funds for emergency maternity and infant care, to be administered by the State health agencies under the provisions of the maternal and child health program (Title V, Part 1 of the Social Security Act). The Bureau of the Budget agreed to include this item in the first deficiency bill when Congress reconvened in 1943.
Many citizen’s organizations, including the General Federation of Women’s Clubs, the WCTU, the National Congress of Parents and Teachers, the American Legion, the YMCA, the American Red Cross, and others, supported the proposal throughout its consideration by Congress.
Congress unanimously approved the measure. On March 18, 1943, the deficiency bill was signed by the President and became a law. The money appropriated was to cover the cost of medical, hospital, and nursing care for wives and babies of men in the four lowest pay grades of the armed forces. The program was called Emergency Maternity and Infant Care-EMIC for short.
The news of this first appropriation traveled fast. The press associations and the radio spread the news across the Nation. State health departments and the Bureau were swamped with letters from servicemen asking about care for their wives. Since the program was to be available to every man in the lowest four pay grades to reassure him as to the care that would be given his wife and baby and thus to help build high morale among the men in the Armed Forces, the Bureau decided to put “stuffers” in the Army and Navy pay envelopes. The first stuffer, approximately 5 million copies, was distributed in August 1943, and informed each of these men of the plan. In all, five stuffers were sent out.
Under the EMIC program wives of servicemen in the 4th, 5th, 6th, and 7th grades of all services and aviation cadets were provided, without cost to them, with medical, nursing, and hospital care throughout pregnancy, at childbirth and for 6 weeks thereafter. Hospital care was paid for at ward rates and the money could not be used to pay part of the cost of luxury accommodations.
The babies of these servicemen were also eligible for medical, nursing, and hospital care if sick any time during their first year of life. From the beginning of the program through the end, June 1949 about 1,500,000 maternity and infant cases were authorized for care. The year of peak load was 1945, when 485,000 cases were accepted. The mothers, by and large, were young and a high proportion of them were having their first babies. A large number of servicemen’s families had their second baby under the program; a few applications for care for a third were received.
By far the largest lot of these newcomers were born in New York and California, with Pennsylvania, Texas, and Illinois claiming the next largest numbers. All of the States had had a considerable number, and even Alaska, Puerto Rico, and Hawaii made a showing.
By direction of the Congress, the fiscal year 1947-48 saw the beginning of the end of this wartime program–the biggest public maternity program ever undertaken in the United States. Congress directed that liquidation of the program should start July 1, 1947, and be completed by the end of June 1949.
EMIC ran up a record for births in hospitals. For example, 92 out of 100 of the babies born under the EMIC program in 1945 were born in hospitals. (Of all the babies born in the United States that year, including the EMIC babies, only 79 out of 100 were born in hospitals, and even that proportion was high in comparison with a pre-war year.)
These figures reflected the tremendous effort made by State and local health officers, physicians, hospitals, and nurses to get good care to this particular group of wives and infants of servicemen. At the height of the program some 48,000 doctors and 5,000 hospitals cooperated. Great credit was due them for the service they rendered to the servicemen and their families.
The story of the EMIC program is in reality a composite of many stories. It is the story of young mothers left alone to have babies while their husbands went overseas to fight for their country. It is the story of young men in the Armed Forces whose morale was lifted by certainty that their wives and babies would receive the care they needed and with no worry about how the cost would be met.
It is the story of Congress and how it met the problem with open heart and open purse strings. It is the story of doctors and hospitals and nurses contributing skill and devotion to the needs of these mothers and babies.
It is the story of State health departments working long hours to plan the assistance needed.
It is the story of the most extensive single public medical care program ever undertaken in this country.
Care of European Children
In the spring and summer of 1940, Belgium, Holland, Norway, and France fell before the German hordes in rapid succession. After the nightmare of Dunkirk, Britain was threatened with invasion by air and sea. The lot of the war-stricken peoples-particularly the children-touched the hearts of the people of the United States. British parents wanted above everything else a safe refuge for their children. Many American families wanted to offer the welcome of their homes. Many did so through various religious, social, and professional agencies.
In 1940, the Children’s Bureau, recognizing the need to systematize the flow of children coming from Europe to the United States to live with friends or relatives for the duration of the war, became one of the prime movers in forming the United States Committee for the Care of European Children. The purpose of the committee was to coordinate all the resources available in the United States for the care of child victims of war in Europe.
Practical problems that would have discouraged any group of people less convinced of the importance of what they were doing beset the committee at every turn. Standards of care and the reviewing of the qualifications of child-caring agencies wishing to participate had to be set up. This the Children’s Bureau was asked to do.
Children Who Came During the War
The largest single group of children (5,000) who came during the war, 1940-45, were British evacuees. Most of the others were from Germany, Austria, and then the other countries in the order in which they were overrun by the Nazis. Many of the continental children who came had been uprooted not once or twice, but many times. They had become wary of counting too much on anyone or on any home.
They had seen people die. They had seen people killed. They had lived through bombings, many of them, and some had memories of machine gun strafings. They knew what it was to live with people huddled together in uncertainty. They had seen human beings at their best, if fortitude is the measure; they had also seen them at their worst. Many had endured anxiety, terror, grief, hunger, and fatigue-and they bore the scars of their experience. But by and large the placement of this group of children in American homes was remarkably successful.
The supervision of these children in their foster homes rested entirely with the child-caring agencies designated by the Children’s Bureau. The United States Committee provided consultative and advisory services to the agencies on problems of the individual children and foster homes. Periodic reports were made to the committee by the agencies on each child, giving information regarding his physical development, foster-home adjustment, and school progress.
Placing these children required the highest skill of child-welfare workers. They had to work in the dark, or near dark, on many matters that are of prime importance in a successful foster-family selection. Often they knew little or nothing of the child’s family, its customs, its traditions. Then, too, the experiences that many of these young people had been through-experiences far removed from and literally beyond even the imagination of the child-welfare workers and the foster-parents-made understanding even more difficult.
Whenever possible, the agencies attempted to place family groups together in one home or in the immediate neighborhood. After placement the agency continued to supervise the child in the foster home. This venture in human relationship turned out to be very human indeed. In most of the placements, the difficulties were met and over-come and the boy or girl was soon taking his place with other children in the family, the school, the church or synagogue, and the community generally. In many, many instances permanent ties, as close as in any family, were developed.
About 3,500 of the British children had returned to England by April 1945. By the summer of 1946 some of the continental children had been reunited with their families; others were well on their way to becoming United States citizens.
Children Who Came at War’s End
At the end of the war, the United States Committee was again faced with planning the care of European children in this country. The staff of the United National Relief and Rehabilitation Administration, reported in October 1945 that there were about 100,000 children under 14 years of age in the camps for displaced persons in Germany. Of these children a considerable percentage were Polish, Hungarian, and Roumanian Jews.
Many of the children were with relatives, but there were about 1,800 unaccompanied children under 16 in camps in the American zone and 2,000 in the British zone. Most of these children were adolescents. These facts were reported to the United States Committee for the Care of European Children. The committee immediately began making plans to bring up to 2,000 unaccompanied children into the United States under the corporate affidavit.
Then President Truman issued a directive on December 22, 1945, on the immigration from Europe to the United States of displaced persons and refugees. This directive facilitated the immigration of refugees, especially orphaned children, within the limits of existing immigration quotas. The United States Committee was named their sponsor.
Thus the children coming at the war’s end were children from the concentration camps–children who had lived for years without family ties, children who survived when their parents had not, children who had been surrounded by persecution and brutality. Most of them were older adolescents, beyond the age which fits easily into foster homes or at which children are usually adopted.
Fortunately, the United States Committee now had almost 10 years of experience upon which to base the finding of homes for these young people. This experience could be drawn upon to insure the success of the venture, not only from the point of view of their foster parents but also in terms of the security and well-being of these young candidates for American citizenship.
By March 31, 1948, 1,275 had arrived. Their new homes were in all parts of the Nation-in 30 of our 48 States. Eighty percent of the children were teen-aged youngsters.
With the creation of the Displaced Person’s Commission in 1948 and later with the passage of the Refugee Act (1953), the Bureau was once again asked to advise on the bringing of children to the United States for adoption.
The World’s Children
The Bureau had always been concerned with the health and welfare of children around the world as well as in the United States but not until 1941 did the Bureau have an operating program in this area. The Children’s Bureau started its work with other countries and with international organizations, during World War I with a study of material on the welfare of children in belligerent countries.
After the organization of the League of Nations, the Chiefs of the Children’s Bureau served in a consultant capacity as the American member to various commissions and committees of the League.
In 1920, the Chief of the Bureau went to Czechoslovakia at the invitation of the President of that Republic to advise on the development of a child-welfare program.
Representatives of the Children’s Bureau also were active in the Pan American Child Congresses, held at intervals since 1916. In 1928, the United States gave its formal adherence to the American International Institute for the Protection of Childhood. The Chief of the Bureau was for many years the representative of the United States on the Council of the Institute.
But in 1941, the Bureau for the first time had an operating program in the international field. It was at that time that the Bureau first received grants from the State Department for cooperation with the other American Republics in matters pertaining to maternal and child health and child welfare.
Under this program, the Bureau recruited and sent specialists to work in the other American Republics and provided for personnel from these countries to come to the United States for further training. In 1941, when the program started, the Bureau established a unit, later called the Division of International Cooperation, to handle this work.
During World War II, the Children’s Bureau was concerned with the problems faced by the Nation’s children and their families–and adapted its program to meet them in many ways, often on a stop-gap base. Then, almost suddenly the war was over. If ever the world needed to look to its children, now was the time.
Here in the United States, programs for children were spotty and scattered. Health services were unavailable to children in many counties and small towns. Child welfare services were even more limited. These represented unfinished business.
Chapter VI — THE DECADE, 1946-1956
For the Bureau the first years of this period were spent in shifting from intensive wartime activities to a program of on-going permanent activities. Once the changeover was completed the Bureau
concentrated on strengthening the Federal-State grant-in-aid programs and planning for further investigative work.
Throughout this decade all aspects of the Bureau’s program were colored by the great increase in the child population following the high birth rate during World War II and by the growing tensions among people, reflected so obviously in the lives of children-tensions arising from the Korean War and from the unknowns and uncertainties of the new atomic age.
Dr. Martha M. Eliot became the Bureau’s fourth chief on September 4, 1951.
The Bureau in a New Setting
As the general health and welfare activities of the Government expanded and with the creation of the Federal Security Agency, a variety of people and groups advanced many reasons for the closer association of the Children’s Bureau with agencies responsible for these activities and with educational services or programs closely related to the programs of the Bureau.
Finally, on July 16, 1946, the Bureau, minus its child-labor functions, was transferred to the Federal Security Agency. This transfer took place under Reorganization Plan No. 2 of 1946 which was accepted by the Congress. In his message to Congress accompanying this executive order, President Harry S. Truman said, “The child-labor program is the only permanent program of the Children’s Bureau that is properly a labor function. The other four-child welfare, crippled children, child and maternal health, and research in problems of child life-all fall within the scope of the Federal Security Agency. The transfer of the Children’s Bureau will not only close a serious gap, but it will strengthen the child-care programs by bringing them in closer association with the health, welfare, and educational activities with which they are inextricably bound up….The promotion of the education, health, welfare, and social security of the Nation is a vast cooperative undertaking of the Federal, State, and local governments. It involves numerous grant-in-aid programs and complex intergovernmental relations. The transfer of the Children’s Bureau will simplify these relations and make for better cooperation.”
On July 16, 1946, by administrative order of the Federal Security Administrator, the Bureau was placed in the Social Security Administration. On April 11, 1953, by Act of Congress, the Federal Security Agency became the Department of Health, Education, and Welfare.
Mid-century White House Conference
A notable event–the Mid-century White House Conference on Children and Youth–marked the midpoint in this decade and gave long overdue impetus to consideration of the emotional development of the child. Coming as it did at one of the most crucial times in the history of our Nation, the Mid-century Conference focused on what was known about healthy personality in children and what was being done to give every child a good chance to develop such a personality.
Nearly 6,000 people attended the Conference. Through work groups and discussions, the Conference arrived at 67 major recommendations-a platform for action for all concerned with the well-being of children.
Photo Sources:
Lenroot at desk: http://www.loc.gov/pictures/item/hec2009014583/
Eliot with Sen. Murray: http://www.loc.gov/pictures/item/hec2009013565/
1938 Conference: http://openlibrary.org/works/OL1588615W/Proceedings_of_Conference_on_Better_Care_for_Mothers_and_Babies_held_in_Washington_D._C._January_17-
EMIC: https://cb100.acf.hhs.gov/cb_eBrochure_EmergencyCare
European Refugees: http://www.theatlantic.com/infocus/2011/07/world-war-ii-axis-invasions-and-the-fall-of-france/100098/
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