October 2012Vol. 13, No. 9Centennial Series: The Children's Bureau and Family Planning

This is the sixth article in our second Centennial Series, CB Decade-by-Decade. These articles will examine highlights from each decade of the Children's Bureau's first 100 years. The first Centennial Series addressed some of the social issues, practices, and policies that laid the groundwork for the creation of the Children's Bureau.

"In my first message to Congress on domestic affairs, I called for a national commitment to provide a healthful and stimulating environment for all children during their first five years of life. One of the ways in which we can promote that goal is to provide assistance for more parents in effectively planning their families…We know that involuntary childbearing often results in poor physical and emotional health for all members of the family. Unwanted or untimely childbearing is one of several forces which are driving many families into poverty or keeping them in that condition…[I]t needlessly adds to the burdens placed on all our resources by increasing population."
—President Richard Nixon, Special Message to Congress on Problems of Population Growth, 1969

During the 1960s, the Children’s Bureau began efforts to address family planning, reflecting rising concerns over population growth and the burden of large families on the poor. Several trends and events changed the landscape and set the stage for increased government involvement in family planning. One significant event was the baby boom that followed World War II, which contributed to growing concerns about a global population explosion. Family planning and population control were viewed as essential for preserving economic well-being in the face of limited world resources (Aries, 1987).

Support for family planning also was framed in social, health, and welfare issues. Research linked unintended pregnancies to health difficulties for mothers and children, an increased risk of poverty, and the need for public assistance (Alan Guttmacher Institute, 2000). According to the 1969 publication, The Children’s Bureau's Job Today (p.6), family planning efforts were largely driven by the growing recognition that:

Large families can place a high economic burden on families.
Closely spaced child births increase the chance that an infant will be born with a low birth weight and be at greater risk for health problems.
Parents have the right to "plan for the number of children they can raise in social and economic security."

During the 1960s, national groups representing medical professionals and social workers called for more widespread support of family planning efforts (Oettinger, 1965). Katherine B. Oettinger, then Chief of the Children's Bureau, took a strong interest in the Federal Government's role in meeting what she called "this most profound challenge to the future of the world" (Oettinger, 1965, p.212).

The 1967 Social Security Amendments, for the first time, established family planning services as a maternal and child health function and earmarked 6 percent of maternal and child health funding for family planning. The Amendments also specified that family planning services be made available to families receiving public assistance, if they desired such services.

The Children's Bureau, through its maternal and child health programs, took on a key role in early Federal family planning initiatives. The Bureau administered Federal matching funds for State health services connected with family planning under the Social Security Act public assistance titles. In 1968, it was estimated that State programs assisted more than 420,000 women (Children's Bureau, 1969). Over the course of the decade, the Bureau directed research and demonstration grants on various aspects of family planning. Research explored individual motivation for accepting or rejecting family planning, attitudes related to fertility, and the impact of birth rates on the needs for maternal and health services. In addition, the Bureau supported training of physicians, nurses, and other health care professionals in family planning strategies. Family planning services related both to spacing of children and helping families address infertility (Oettinger, 1965).

In 1970, Federal funding for family planning services expanded through passage of the Family Planning Services and Population Research Act (P.L. 91-572), which created Title X of the Public Health Services Act. This act authorized $382 million for family planning programs, State formula grants, population research, training grants, and informational and educational efforts for 3 years (Children's Bureau, 1971). The Act responded to President Nixon's appeal to establish as a national goal "the provision of adequate family planning services to all who want them but cannot afford them" (see http://www.presidency.ucsb.edu/ws/?pid=2132). The Act also established the Office of Population Affairs within the Department of Health, Education, and Welfare to administer and coordinate family planning and population research activities.

References

Alan Guttmacher Institute. (2000). Fulfilling the promise. Public policy and U.S. family planning clinics. New York: Author. Retrieved from http://www.guttmacher.org/pubs/fulfill.pdf

Aries, N. (1987). Fragmentation and reproductive freedom: Federally subsidized family planning services, 1960–80. American Journal of Public Health, 77(11), pp. 1465–1471. doi:10.2105/AJPH.77.11.1465

Children’s Bureau. (1971). Here and there. Children, 18(2), p.75.

Children’s Bureau, Social & Rehabilitation Service, U.S. Department of Health, Education, and Welfare. (1969). The Children's Bureau's job today. Washington, DC: U.S. Government Printing Office. Retrieved from the Maternal and Child Health Library: http://www.mchlibrary.info/history/chbu/20318.pdf

Oettinger, K.B. (1965). This most profound challenge. Children, 12(6), p. 211–14, Retrieved from: http://hearth.library.cornell.edu/cgi/t/text/text-idx?c=hearth;idno=4761305_138_006