This book is the first comprehensive account of the triumphs and follies of the Sheppard-Towner Act of 1921-the first federal policy aimed at improving health outcomes for mothers and babies. Michelle Bezark insightfully weaves together the experiences of advocates and federal agents maneuvering around Congress to pass the law; state-level administrators' accounts of implementing its programs at the local level; and individual mothers' and children's experiences of the programs on the ground. This approach reveals the political, technical, and legal challenges of passing and administering early federal social welfare policy, and what this policy provided for-and required of-citizens. In reconstructing the full lifecycle of the law, Bezark tells the untold history of an important federal policy and provides a critical case study for how one group of reformers built out administrative capacity at every level of governance from scratch.

‘Congress passed the Sheppard-Towner Act in 1921 in hopes of reducing the United States’ horrific infant mortality rate. In her brilliant new book, Michelle Bezark illuminates the Act’s complex consequences for the women and children it served and the welfare state it helped to create.’

Kevin Boyle - author of Arc of Justice: A Saga of Race, Civil Rights, and Murder in the Jazz Age

‘Bezark’s superb history of landmark federal legislation is, in fact, so much more: a reckoning with the prospects and parameters of modern US state-building, and a case study of how social policy can profoundly alter the citizen-government equation.’

Sarah E. Igo - author of The Known Citizen: A History of Privacy in Modern America

‘In Making Babies Count, Michelle Bezark documents an important moment in the history of maternal and child health and allows us to witness the difference public policies can make. The lessons from this historic journey should encourage us all to continue to speak up to support the health and development of all young children and families.’

Joan Lombardi - Former Deputy Assistant Secretary for Early Childhood Development, United States Department of Health and Human Services (2009-11)

‘Michelle Bezark’s Making Babies Count is by far the best book yet written exploring and explaining the complicated political struggle around saving the lives and health of babies in Progressive-era America.’

Richard Rhodes - Pulitzer Prize-winning author of The Making of the Atomic Bomb

‘In this top-to-bottom history of the enactment, administration, and demise of the Sheppard-Towner Act, Making Babies Count makes a persuasive case for the far-reaching consequences of a short-lived statute. Deeply researched, crisply narrated, and brimming with human stories, this book will appeal to the generalist reader, as well as to experts in American politics, gender and women’s history, modern governance, social welfare, and the administrative state.’

Karen Tani - author of States of Dependency: Welfare, Rights, and American Governance, 1935-1972