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Maternal Health Center Opens in Santa Fe-1937

By Michael Ann Sullivan

On October 27, 1937, the Santa Fe Maternal Health Center (SFMHC) opened under the auspices of Margaret Sanger and the New York Clinical Research Bureau. Florence Davenport, Faith Meem, and several other prominent Santa Fe women had invited Sanger to tea the previous summer to speak about the benefits of birth control. Plans quickly commenced to organize a free clinic for poor women and children and provide pre- and post-natal care, birth control, and venereal disease treatment. Sanger agreed to send fifty dollars' worth of birth control supplies and to pay the salary of a nurse for four months. Sanger told the Santa Fe group, “[t]here is always a bit of fireworks at first but it quiets down...” She concluded, “Best wishes and keep us informed. We shall all be keenly interested.”

Fireworks indeed greeted the clinic’s inception. Archbishop Rudolph Gerken denounced the Santa Fe Maternal Health Center during his 1937 Christmas Eve sermon. Gerken reminded his parishioners that birth control was a sin. “Practice self-control instead of this so called birth control,” he commanded. Gerken accused the Santa Fe Maternal Health Center of disguising birth control as maternity work and warned his flock to stay away from it.

The Santa Fe clinic proved popular with Catholic women despite the Archbishop’s condemnation. One hundred and seventy women, primarily Hispanic Catholics, visited the Santa Fe Maternal Health Center within the first three months. After seven months, more than 750 patients had been seen by clinic doctors at the Center, or in their own homes by visiting nurses. Fully one third of the women who used the Santa Fe Maternal Health Center accepted birth control although very few women went solely to get contraceptives.

In the early twentieth century, Sanger spearheaded a national movement to provide birth control to all women who wanted it. Contraceptives, even information about them, had been banned in the United States since the passage of the Comstock Law in 1873. The Comstock Law prevented obscene literature and immoral devices from being sent through the mail. In addition to pornography, this included birth control devices and information on contraceptives, abortion, and venereal disease. Sanger opened an illegal birth control clinic in Brooklyn, New York in 1916. Although well attended, city officials soon shut it down. Sanger then began making strategic alliances with doctors and other public health officials. She advocated birth control to improve the health and emotional quality of women’s lives. In her later years she joined forces with the American Eugenic Association, stressing birth control as a remedy for preventing biologically unsound reproduction.

In June of 1938, Florence Davenport, SFMHC board member, cited poverty and disease as the primary reasons for birth control work in Santa Fe. Davenport noted that in the first seven months of operation, "[h]ardly any one of the three hundred odd people who have come to us has enough food to eat, clothes to wear or even the decencies of living. Hardly one of them would need our ministrations nearly so much, if at all, were she not a victim of years of malnutrition and privation. Inadequate food, poor sanitation, overcrowded homes, too many children too close together, combine to make the mothers and the children, prey to almost all the ills that flesh is heir to."

In 1938, New Mexico still suffered from the effects of the Depression. Santa Fe County ranked the fifth highest in the nation for infant and maternal deaths. Causes of high mortality included poor sanitation, inadequate food, and inaccessibility of health care. A significant number of homes did not have running water, electricity, or indoor toilets. To make matters worse, few medical establishments treated indigent patients.

Health options in Santa Fe reflected statewide trends. The Catholic Church owned and operated St. Vincent’s Sanatorium, the largest hospital in town, and the Catholic Clinic. St. Vincent’s dated to the early nineteenth century but remained a small local charity hospital. It provided assistance to the poor in emergency situations but didn’t offer preventative health services like pre-natal care. Most poor women arrived in the emergency room at the time of their labor, if they used a hospital at all. The Catholic Clinic predated the Maternal Health Center by eight days, and provided little more than basic medical treatment. The only other hospital in Santa Fe, the federally owned Indian Hospital, served a small select population and had even fewer beds.

The entire state of New Mexico lagged behind the nation in medical facilities and public health practices. Although a Board of Medical Examiners existed in the Territorial Period, its services covered only rudimentary health measures like the recording of vital statistics. By the late nineteenth century, Boards of Health and Public Health Departments in other states improved sanitation, regulated food processing, and prevented the spread of infectious disease. New Mexico instituted a professional Department of Public Health in 1919, only after the disastrous influenza epidemic of 1918.

At the time of the SFMHC’s opening, medical care in Santa Fe included an underdeveloped Public Health Department and Catholic control of the few existing health facilities. Santa Fe, a city of 17,000, depended primarily on the private physicians and emergency treatment for its medical needs. The founders of the SFMHC hoped to rectify some of those deficiencies, supplement existing health care, and surreptitiously distribute birth control.

Although Sanger preferred an overt clash with the Catholic Church and birth control as the primary aim of the clinic, the women in Santa Fe felt that open war with the Catholic Church would prevent them from helping poor women. The Santa Fe Maternal Health Center hoped to address the problems of poverty and high infant and maternal mortality that plagued poor New Mexican mothers and their families. They believed birth control was crucial to this project, but recognized that poor women needed a complete health and social welfare agency to effect change.

Six months after the clinic opened, Cecil Damon, Sanger’s secretary at the Birth Control Clinical Research Bureau, wrote Florence Davenport to apprize her of Sanger’s intention to cancel funding. Damon explained that "[t]he general feeling seems to be that too little contraceptive work is being done in your clinic to warrant a large outlay, in proportion to the many other health activities indicated in your letter. The contributors that I approached all feel that there are many people who are willing to support general health activities, but that there are so few who can be found to assist with birth control projects, that their help should be reserved for birth control work exclusively."

Florence Davenport pleaded with Damon not to abandon them. She countered that the only way the SFMHC could reach contraceptive patients was through general medicine. When the Clinical Research Bureau refused to relent, Katherine Mayer, another SFMHC board member, expressed the general frustration: "Could you point out that we are trying to do work in the Capitol City of an almost completely Catholic State. That Santa Fe is the center of the Diocese and that all of our opposition doubles and triples in strength because of this fact. That 8 out of 9 members of the City Council are Catholic. That the State, County and City Health officials cannot help us as long as we have affiliations with Birth Control Group. That the Archbishop has come out against us."

Notwithstanding the special circumstances of Santa Fe, Sanger stopped sending supplies and money.

The Santa Fe Maternal Health Center continued to provide birth control “quietly and tactfully” along with more general health services to poor women and children despite Sanger’s withdrawal of support. From the first, the women of the SFMHC realized that even their original plans would not be sufficient to help mothers and children. By June of 1938, in addition to pre- and post- natal care, treatment for venereal disease, and birth control, the SFMHC had added clinics for eyes, teeth, circumcision, and operative diagnosis. They provided food, clothing, clean milk, and even found work for patients’ husbands. Over the years the Santa Fe Maternal Health Center provided whatever poor families needed. They resisted both eugenic birth control aims and the confrontational strategies that Sanger insisted upon.

This is not to say that non-eugenic birth control services were entirely free of middle class prejudice. Although the SFMHC made no attempt to use birth control as a way to regulate the fertility of poor women or reduce the Hispanic birth rate, they did assume middle class reproductive values as the norm. SFMHC doctors, nurses, and board members concluded that numerous pregnancies contributed to family poverty and maternal ill health. They believed that women who had fourteen or fifteen children would not do so if they had a choice. Some visiting nurses considered Hispanic healing traditions superstitious or even ignorant. Customs like swaddling or not bathing after birth seemed deleterious to health and hygiene. The nurses complained, “... you then have a slight insight into our obstacles, the frightful conditions we are aiming to eliminate, the staggering work that yet faces us, all hidden behind our adobe walls.”

The Santa Fe Maternal Health Center certainly imposed middle class standards of child rearing, reproductive norms, and sexuality on poor families. Yet, unlike Sanger, the SFMHC did not promote the eugenic benefits of birth control or maternal and infant health reform. The SFMHC treated eighteen percent of the population in Santa Fe, primarily poor Hispanic Catholics, who could not afford medical treatment elsewhere. Many women desired the medical services, including birth control, that the Center provided. Poor women hoped to obtain treatment for sick children, prevent infant deaths, ensure healthy pregnancies, improve their own health, and control their fertility. The women that organized and ran the Santa Fe Maternal Health Center demonstrated that birth control did not have to be about controlling and regulating poor women and instead quietly provided non-eugenic birth control along with more comprehensive medical and social services.

At the twenty-fifth anniversary meeting Katherine Mayer, one of the original founders, described the SFMHC impact. “In 1938…Santa Fe County had the highest infant mortality rate in the nation…with 166.7 deaths per thousand births. Today, 1961 Department of Public Health figures show 33.4 deaths per 1000 births.” Mayer acknowledged that the SFMHC made “no claim to anything but a small local factor in these dramatic changes,” yet she stressed that the SFMHC “played its part in bettering conditions in Santa Fe.”

Sources Used:

“Archbishop Takes Rap at Maternity Center,” The Santa Fe New Mexican, December 27, 1937.

Deutsch, Sarah. No Separate Refuge: Culture, Class, and Gender on an Anglo-Hispanic Frontier in the American Southwest, 1880-1940. New York: Oxford University Press, 1987.

Kennedy, David. Birth Control in America: The Career of Margaret Sanger. New Haven: Yale University Press, 1978.

Gordon, Linda. Women’s Body, Women’s Right: Birth Control in America. New York: Penguin, 1990.

Griswold del Castillo, Richard. La Familia: Chicano Families in the Urban Southwest 1848 to the Present. Notre Dame, Indiana: University of Notre Dame Press, 1984.

New Mexico State Plan for Hospital and Health Facility Survey and Construction: 1955-1974. Department of Public Health, March 1962. State Records Department, Santa Fe, New Mexico.

Roberts, Dorothy. Killing the Black Body: Race, Reproduction, and the Meaning of Liberty. New York: Vintage Books, 1997.

Schackel, Sandra. Social Housekeepers: Women Shaping Public Policy in New Mexico. Albuquerque: University of New Mexico,1992.

Sullivan, Michael Anne. Walking the Line: Birth Control and Women’s Health at the Santa Fe Maternal Health Center, 1937-1970. MA Thesis, University of New Mexico, 1995.

______. Healing Bodies and Saving the Race: Women, Public Health, Eugenics and Sexuality, 1890-1950. Dissertation, University of New Mexico, 2001.

Walzer Leavitt, Judith. The Healthiest City: Milwaukee and the Politics of Health Reform. Princeton, New Jersey: Princeton University Press, 1982.

All quoted material from Santa Fe Maternal and Child Health Center Papers, Center for Southwest Research, General Library, University of New Mexico.