In February 1924, Mamie Hodges of San Antonio, Texas, addressed a letter to the US Children’s Bureau. In the letter, she described an all too typical set of circumstances. Hodges was a young mother teetering on the brink of poverty. At the time she wrote to the Bureau, she and her husband had nearly paid off their home. However, a new discovery made Hodges fear for her family’s future: she was pregnant. Again.Footnote ¹

Hodges was careful to explain to the federal agents that she was happy to fulfill the duties of a wife and mother. When she was first married, she wrote, she told her husband that she “loved children above all things and thought the highest position to which a woman could attain was that of wife and mother.” But when her husband lost his business, he threatened to leave her and would regularly abuse her until she “would cry and cry.” When she became pregnant a third time, he blamed her and told her to “‘knock’ it before it had life.” She refused, but did not think she had enough money saved to pay the doctor and nurse’s bill for the upcoming pregnancy and birth.Footnote ²

Desperate, Hodges asked her family doctor if the new federal law she had heard about gave him the authority to tell her “how to not to get in that condition so often.” She wanted time to regain strength between babies and to save money to care for the ones she had. But her doctor just laughed and said women were “supposed to be smart enough to find out those things themselves.”Footnote ³

Unable to rely on her husband or doctor, Hodges wrote directly to the federal agents at the US Children’s Bureau. She begged them, “please do not think for one minute that I would commit murder; I would not.” But, she implored, “I would like to have enough time between times to make enough to carry me through the next. And it is very hard to bring them into the world without wither [sic] the funds to buy the little clothes and pay the doctor bill.” Hodges hoped the new law might bring her relief and that the federal agents themselves could provide her with the advice she needed. She also wanted her own “copy of this famous bill” to read for herself.Footnote ⁴

The “famous bill” Hodges referred to was the Sheppard-Towner Act of 1921. Colloquially known as the “Better Baby Bill,” it provided federal funding to match state spending on infant and maternal health and welfare programs. Sheppard-Towner programs aimed to reduce the nation’s exceptionally high infant and maternal mortality rates by funding free and accessible preventative prenatal, postnatal, and pediatric care, as well as home visiting programs, birth registration campaigns, midwife training and regulation, and child-rearing instructions for all interested women and girls. The law was Congress’s first “explicit” social welfare legislation and was one of the earliest federal matching grant programs.Footnote ⁵

The US Children’s Bureau – under the Department of Labor – administered federal matching grants to the states, which then ran the programs according to their perceived population needs. Sheppard-Towner programs were available to all, not just those deemed “needy and deserving,” as later federal maternal and child welfare programs would be.Footnote ⁶ It was also the first attempt to incorporate “women’s issues” into national policy after the states ratified the Nineteenth Amendment, granting women the franchise. Though the law was short-lived – Congress allowed it to lapse only seven years after its programs began – its effects were far-reaching. According to the US Children’s Bureau, half of all babies born in the United States between 1921 and 1929 benefited in some way from this legislation.Footnote ⁷

Mamie Hodges was no aberration. More than a hundred thousand American women from every region, class, and educational background wrote to the US Children’s Bureau every year during the first two decades of the twentieth century.Footnote ⁸ In an era before New Deal reforms – often seen as the first time federal policy became visible in ordinary people’s lives – women like Hodges wrote directly to federal agents to seek help and advice about their most intimate troubles.

Many, like Hodges, wanted a copy of the law to interpret for themselves. Women read the law, shared it with friends and neighbors, and even asked the Children’s Bureau to send dozens of copies so they could share it with book clubs and civic associations. Like Hodges, many also wrote of deeply personal matters. They described abusive husbands, requested information about family planning, asked for child-rearing advice, and detailed their fears that another pregnancy might lead to physical or financial ruin. Notably, the Children’s Bureau used these opportunities not to sympathize but to educate. They wrote to women like Hodges about the administrative workings of federal and state health and welfare agencies and ignored the intimate details the women divulged.

Mothers’ letters to the Children’s Bureau reveal more than the desperate conditions so many early twentieth-century women found themselves in. They also show how deeply engaged women were with the state and federal agencies they believed could provide them with the services they needed. Like Hodges, Mrs. J.W. Pruitt of West Virginia was an expectant mother. She was, as she described it, “unable to provide necessary clothing for [her]self and baby, much less medical aid.”Footnote ⁹ She wrote to ask the federal bureau to send her their published literature on child-rearing. Moreover, she had read that “at least 43 states and the Federal government co-operate in providing medical aid and nursing” to families like hers. She wanted to know if her state, West Virginia, was among them.Footnote ¹⁰ By writing for information and counsel, Pruitt did exactly what the staff at the Children’s Bureau hoped: she sought out child-rearing advice from the federal agency and asked about the specific Sheppard-Towner programs run by her state bureau.

Not all mothers writing to the Children’s Bureau did so in desperation. In fact, most women who wrote to the federal agency just wanted clear and uniform instruction for child-rearing. One Sheppard-Towner beneficiary typified many mothers in the 1920s when she boasted about how carefully she had followed the Children’s Bureau’s advice. She wrote, “When people stop me on the street and ask the whys and wherefores of my so obviously healthy baby, I always say ‘He’s a Government baby.’”Footnote ¹¹ For Hodges, Pruitt, and many women of their generation, the Children’s Bureau provided hope for a trustworthy and knowledgeable, if distant, ally in their efforts to raise healthy babies and remain healthy themselves.Footnote ¹²

The Children’s Bureau, through its Sheppard-Towner programs, embarked on an educational campaign to teach all American mothers the “government way” to raise children and how to engage with their governments.Footnote ¹³ When Mrs. J.B. Howell of Nashville, Tennessee, asked the Children’s Bureau to send copies of the law so that she could read and discuss it with her book club, she noted that she had first written to her state’s department of public health. Only once she had been directed to the federal bureau did she forward her request to the Children’s Bureau.Footnote ¹⁴ Just as the Children’s Bureau hoped, women like Howell learned to engage with both state and federal agencies in their efforts to share and promote the law to their friends and neighbors.

Indeed, state agents fielded so many requests for copies of the law that they ran out. The Children’s Bureau staff received so many requests that they nearly ran out, too. When a Vermont state agent asked the Bureau to send more copies, a federal agent replied, “Our supply of copies of the Sheppard-Towner Act is almost exhausted … If you need more copies later, write to us again, and we will send them if possible.”Footnote ¹⁵

The law was historic, and this fact alone must have piqued the interest of many. However, as correspondence between Children’s Bureau agents and private citizens like Hodges and Howell shows, creating a citizenry that understood and engaged directly with government agencies was crucial to the Children’s Bureau’s vision of governance. Along with providing services to support their needs, it was one of the primary objectives and outcomes of Sheppard-Towner’s short tenure. In this context, nearly running out of copies of the law was a signal measure of success.

Making Babies Count reconstructs the Sheppard-Towner Act’s passage, implementation, defunding, and legacy. To this end, it makes three key arguments. First, it shows that collecting and collating vital statistics – in other words, counting babies – was critical to both the law’s success and its failure. Second, it reconstructs the law’s administration at the state and local levels to show that administrators used federal funds to expand state administrative capacity and that Sheppard-Towner programs taught individual women and children how to see and engage with government health and welfare agencies. Third, it ties Sheppard-Towner directly to Title V of the Social Security Act, demonstrating that the Children’s Bureau learned from their political failure and implemented much stricter federal oversight over subsequent legislation – especially in data collection and accounting. In reconstructing the full life cycle of the law, Making Babies Count tells the untold administrative history of the rise and fall 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.

Making Babies Count narrates the story of the Sheppard-Towner Act from multiple perspectives and across multiple scales. It weaves together the experiences of advocates and federal agents maneuvering within and around Congress to pass the law, state-level administrators’ accounts of implementing Sheppard-Towner programs at the local level, and individual mothers’ and children’s experiences of the programs on the ground. This comprehensive approach – which is both top down and bottom up – shows the multifaceted political, technical, and legal challenges of passing and administering early federal social welfare policy, as well as what this policy provided for – and required of – citizens.

As an early matching grant program, the law provided federal dollars to match state funding for infant and maternal welfare programs. By focusing on how the law operated at the federal, state, and local levels, Making Babies Count reveals precisely how the law worked in practice while uncovering the consequences of decisions made in Washington and in statehouses for the programs’ beneficiaries. Moreover, it sheds new light on the significance of the Sheppard-Towner Act itself in the evolution of state capacity at both the federal and state levels in the early twentieth century. Previous studies of the law have concentrated on the female-led Children’s Bureau’s gendered political conflicts with the American Medical Association, the Public Health Service, and anti-suffrage organizations. Through this lens, scholars have used Sheppard-Towner to explain the rise and fall of women’s political influence at the federal level in the 1910s and 1920s.Footnote ¹⁶ However, these analyses focus primarily on the politics of the law’s passage and subsequent demise in Washington, DC. They do not follow the law’s funds from the nation’s capital to the state and local levels. Doing so, however, sharpens the law’s effects and significance to American political development.

Much of the work state agents did under Sheppard-Towner made citizens more legible to state governments. By visiting homes, registering births, and logging the health and illness of mothers and children, state health agents gained greater access to and a more nuanced understanding of their citizenry. Likewise, as mothers’ letters to the Children’s Bureau demonstrate, much of the work that Sheppard-Towner agents did advertised state and federal bureau capacity. They taught women and children what to expect from state and federal agencies and what these agencies expected from them in return. It was the beginning of what I call “bidirectional legibility” between women, children, and the state.

Though Sheppard-Towner itself was short-lived, the governmental reach that federal and state agents built with the law’s programs was long-lasting. As Montana’s state director proudly reflected in 1925, “It is significant to compare the well organized state machinery existing today with the casual, chaotic activities operating before the enactment of the Sheppard-Towner Law.”Footnote ¹⁷ With Sheppard-Towner funds, states established their own bureaus dedicated to maternal and child health and welfare, and they trained parents to recognize and expect services from them. As a result, when lawmakers passed the Social Security Act in 1935, the Children’s Bureau was quickly able to rehabilitate many Sheppard-Towner programs (and the state bureaus that administered them) with agency infrastructure – and local buy-in – already in place.

In addition to highlighting the state capacity that federal and state agents and their volunteers built with Sheppard-Towner funds, Making Babies Count uncovers the structural and political reasons the popular and effective law was defunded shortly after it passed. By focusing on political discourse in Washington, scholars have overlooked the significant role that state administrators unwittingly played in Sheppard-Towner’s ultimate demise. My policy-focused approach uncovers how central the politics of federalism were to the law’s successes and failures. Granting states administrative autonomy over their programs was key to allowing the sweeping and progressive bill to pass through a conservative Congress, while administrative flexibility was critical to getting Sheppard-Towner programs up and running quickly at the state and local levels. However, allowing states near total control of Sheppard-Towner gave state administrators wide latitude to decide which populations they served and how.

Additionally, it made collecting and collating program data at the federal level nearly impossible. This emphasis on state authority in administration meant that each state director documented their Sheppard-Towner work differently – if they did so at all. When it came time to renew federal appropriations in Congress, the Bureau staff found itself unable to create and present national statistics on the workings of state programs. Without the reliable national data on which the Children’s Bureau rested its political claims to expertise, the Bureau had little ability to defend its use of federal dollars when the political winds shifted in Washington and its policies came under attack. Lawmakers, therefore, allowed Sheppard-Towner’s funding to lapse in 1929.

Reconstructing the politics, administration, and legacy of the Sheppard-Towner Act illustrates how and why the modern American administrative state evolved as it did.

Making Babies Count exposes lawmakers’ trouble administering the programs and working within the constraints of the law. Moreover, it brings to light the consequences of the law’s failure for the federal social welfare programs that followed. Through their frustrating experience administering Sheppard-Towner, the Children’s Bureau staff learned to be more stringent with federal oversight – especially in state data collection. In a political climate much more friendly to federal intervention, the Bureau staff was able to implement this oversight in their administration of Title V of the Social Security Act.

Yet, even as they succeeded in reshaping federal and state administrative apparatuses, other agencies and organizations – namely the Public Health Service (PHS) and the American Medical Association (AMA) – chipped away at the Children’s Bureau’s claims to expertise and political hegemony over America’s children. After the New Deal, the Children’s Bureau’s political and cultural sovereignty over child welfare policy was syphoned off to numerous other agencies within the federal bureaucracy. With the Children’s Bureau’s “dismemberment,” Americans lost the public face of maternal and child health and welfare policy.Footnote ¹⁸

Early Twentieth-Century State-Building and the Sheppard-Towner Act

Historians of women and gender have long taken interest in the US Children’s Bureau – the first female-run federal agency in the United States – and its legislative agenda. Motivated to uncover the history of women interacting with and shaping the federal government, scholars have uncovered a rich political history of Progressive-era women’s associational networks, which wielded significant political pressure in Washington and in state houses in the early twentieth century. With such scholarship, we have come to understand the gendered political conflict over the passage and defunding of the Sheppard-Towner Act. Significantly, these scholars have described the end of Sheppard-Towner as a political failure, and the policy itself is treated as an aberration in the otherwise laissez-faire political landscape of the 1920s.Footnote ¹⁹

Scholars have focused on the gendered history of the Sheppard-Towner Act for good reason. The law was the product of a watershed moment for American women in politics. It was the brainchild of Julia Lathrop, the first woman to run a federal agency. The nation’s first congresswoman, Jeannette Rankin (R-Montana), proposed Lathrop’s bill to Congress in 1918. Moreover, Congress passed the final version of the bill just one year after the states ratified the Nineteenth Amendment, which extended the franchise to women. Scholars’ focus on the gendered aspects of the passage and defunding of Sheppard-Towner in Washington has distracted from its role in both building and constraining federal and state administrative capacity. When we examine the legacy of the Sheppard-Towner Act through the analytical lens of American political development and state-building – alongside gender – Sheppard-Towner can answer important questions about the evolution of the administrative state at every level of governance.Footnote ²⁰ As the largest-scale federal social welfare program of its time, the Sheppard-Towner Act is critical to understanding the expansion of the federal bureaucracy and the shifting political weight of state and federal administrative power in the early twentieth century.Footnote ²¹

Indeed, viewing the Sheppard-Towner Act through scholarship on the structure and function of the administrative state offers additional insight into the centralization of the federal government in the early twentieth century. Historians and theorists of the nineteenth- and early twentieth-century state have argued that its strength lay in its complexity and obscurity.Footnote ²² Sociologist Elisabeth Clemens describes the American government as a “Rube Goldberg State,” insisting that “the modern American state is a mess.” She argues that this mess obscures the role of the federal government to both lawmakers and taxpayers.Footnote ²³ Reconstructing the implementation of an early social welfare policy like the Sheppard-Towner Act demonstrates how that mess actually operated.

By looking to the first instances of federal social welfare spending in the Sheppard-Towner Act, we see that it was during the early decades of the twentieth century – not during the New Deal – that this form of state power through multiplicity took concrete form.Footnote ²⁴ As scholars of New Deal programs have shown, federal matching grants empowered states by providing resources and creating standards (on which those resources depended) to centralize, bureaucratize, and more strictly govern.Footnote ²⁵ However, the legacy of the Sheppard-Towner Act demonstrates that matching grants before the New Deal could both strengthen and diminish federal authority – and they had the potential to fall victim to changing politics.

Much of the existing scholarship contends that the federal matching grant programs that proliferated in the 1910s and 1920s are key to understanding how the American state gained strength through opacity.Footnote ²⁶ Federal programs expanded through these grants, such scholarship argues, but did so in ways that were unclear to citizens and politicians alike. However, the administrative history of Sheppard-Towner shows that while the implementation of the law’s programs was undoubtedly messy – involving multiple levels of governance, relying on both professional and volunteer labor, and offering cross-cutting incentives to all – Sheppard-Towner was certainly not opaque to either lawmakers or citizens. In fact, Sheppard-Towner’s state and federal programs (and the state and federal bureaus that ran them) were highly visible and intentionally discernable to everyday Americans like Mamie Hodges.

While scholarship on the complexity and obscurity of the state has illuminated much of what is unique in American statecraft, it risks defining the state out of existence; if the state is everywhere, then it is nowhere. Recently, sociologists have called upon scholars to more creatively identify the “many hands” of the state.Footnote ²⁷ These scholars hope to theorize the state and define its boundaries while also recognizing the multiplicity of state and non-state actors and institutions prevalent in American statecraft.Footnote ²⁸ Centering a specific federal policy like Sheppard-Towner offers one way forward. By focusing on policy, we can more clearly define state priorities even as these agendas were carried out in a “Rube Goldberg” fashion with federal, state, and private administrators.Footnote ²⁹

When viewed through the lens of American political development, the history of the Sheppard-Towner Act bears out Michel Foucault’s theory that collecting and collating vital statistics is a significant aspect of modern state-building, or what he called “bio-politics.”Footnote ³⁰ Collecting and collating national and state-level infant and maternal mortality rates was the centerpiece of the Children’s Bureau’s legislative aims in the 1910s and 1920s. They believed that counting these births and deaths, would make them count politically. More recently, James Scott has argued that states have a vested interest in making citizens “legible” – visible in tidy numbers to their governments. Legibility was certainly one of the Children’s Bureau’s primary goals with Sheppard-Towner programs.Footnote ³¹ By visiting homes, registering births, and logging the health and illness of mothers and children, state health bureaus gained a more nuanced understanding of their citizenry.

Historians have begun to reconstruct exactly how this process of state-building through registering, licensing, and collecting vital statistics worked. Recent scholarship has demonstrated how critical federal and state policies enforcing marriage licensure, birth registration, and immigration quotas were to building a stronger bureaucratized state that reinforced white supremacy, patriarchy, and age categories in the twentieth century.Footnote ³² Scholars have also shown how the federal government invested more heavily in “numbering” American citizens through New Deal programs and opinion polling.Footnote ³³ Sheppard-Towner is certainly part of this history. State agents taught parents to provide state agencies with data and documentation about the children that they bore. Moreover, the legacy of the Sheppard-Towner Act can help explain how and why the federal government learned to prize vital statistics and the significant political consequences when a federal agency was unable to collect them.

Of course, legibility is a two-way street. As the administration of the Sheppard-Towner Act shows, citizens learned to see states as states learned to see citizens. This is the phenomenon I identify as bidirectional legibility. Sheppard-Towner agents did a great deal of work to advertise state and federal bureau capacity and to teach women and children what to expect from state and federal agencies. As letters like Hodges’ and others demonstrate, many women took those lessons to heart.

Still, little has been written about the implementation of Sheppard-Towner programs at the state and local levels or how this legislation shaped the relationship between everyday citizens and their government or between federal and state agents.Footnote ³⁴ The history of the Sheppard-Towner Act reveals not only that the federal government’s administrative capacity expanded during the early twentieth century, but how it expanded and why. When we examine the evolving relationship between the Children’s Bureau and state bureau directors, we see exactly how the politics of federalism constrained federal authority – through data collection. By understanding the particular role that vital statistics played in changing the power dynamic between federal and state bureaus, we can begin to understand how one federal agency refined its ability to “see like a state.”Footnote ³⁵ Additionally, when we investigate the educational programs that the Children’s Bureau undertook with Sheppard-Towner funding, it becomes clear that Children’s Bureau agents not only learned to “see like a state” but taught citizens to see the state in return. Moreover, they taught citizens to see themselves the way the state did – in documentation and numbers.

As political theorists have demonstrated, matching grants were a politically expedient – and therefore popular – way for Progressive-era Congress to assert some federal control over state spending without appearing to compel state cooperation in federal programs.Footnote ³⁶ While this funding mechanism allowed a degree of federal pressure on state programs, few lawmakers complained about it as “overreach” before Sheppard-Towner’s passage.Footnote ³⁷ Because of the sweeping and ambitious nature of Sheppard-Towner programs, and because it was largely administered for and by women, the law became both the political and legal test case for all federal matching grant programs.Footnote ³⁸

Though the Sheppard-Towner Act was one of a number of federal matching grants to the states in the 1920s, it is uniquely instructive. Unlike other contemporaneous matching grant programs, Sheppard-Towner was not administered by the US Department of Agriculture. By the time the Sheppard-Towner Act passed, the (USDA) had developed deep institutional roots through the Land Grant Universities and the extension programs they had administered for decades. By contrast, as political scientist Kimberly Johnson has argued, the Children’s Bureau was particularly hemmed in by the political constraints of federalism because it lacked the institutional and political clout the USDA had built both within Washington and outside it.Footnote ³⁹ Despite Sheppard-Towner’s popularity on the ground, the Children’s Bureau’s dearth of political support in Washington made Sheppard-Towner particularly susceptible to political and legal attacks.

Without political support in Wahington, the Children’s Bureau relied heavily on volunteer networks to support and implement Sheppard-Towner programs. A robust literature now exists on the more invisible forms of state-building that took place in the early twentieth century, much of it done with voluntary labor and associational networks.Footnote ⁴⁰ The administrative history of the Sheppard-Towner Act is certainly part of that story. However, the history of Sheppard-Towner programs also deepens our understanding of how volunteers actually expanded the reach of the state. Much of the work those volunteers did advertised and made visible state and federal programs and administration. Sheppard-Towner volunteers brought government into sight for their friends and neighbors.

Scholars have correctly pointed out that a great deal of Progressive-era state-building specifically centered on changing children’s relationship to the state. Such scholarship argues that by changing legal codes, requiring children to attend school, and mandating age documentation for work, Progressive-era lawmakers made children wards of the state alongside their parents and guardians.Footnote ⁴¹ The administrative history of Sheppard-Towner programs bear this thesis out. In fact, the history of Sheppard-Towner programs builds on such arguments because Sheppard-Towner agents frequently trained children to act as agents of the state. With Sheppard-Towner funding, state agents not only taught children, particularly young girls, state-sanctioned methods of child-rearing and structuring family life, they also enlisted children directly to help run and promote state programs.

Making Babies Count is structured roughly chronologically to demonstrate how these lessons in state-building evolved over time. Chapter 1, “‘More Fatal than the Trench’: Infant Mortality and the Rise of Statistical Politics,” begins the story by outlining the conditions of infant and maternal health work in the United States before the passage of the Sheppard-Towner Act. It connects the rise of statistical politics to infant mortality in order to explain how and why a multifaceted and non-communicable health crisis became a metric for the health of the nation in the 1910s. The chapter traces the formation of the American Association for the Study and Prevention of Infant Mortality (AASPIM), whose founders hoped to publicize and address the issue of infant mortality, alongside the founding and early initiatives of the US Children’s Bureau. The chapter outlines how baby-saving advocates within and outside the government taught Americans to count babies and make babies count politically. The chapter focuses on the competing ideas and interests that intersected within the baby-saving movement of the 1910s while illuminating why some advocated for federal intervention and others opposed it. Ultimately, the divisions that emerged within a diverse coalition split its leadership over the passage of Sheppard-Towner. Some leaders went on to work for the Children’s Bureau and support Sheppard-Towner programs, while others spent years lobbying against the law and played a significant role in its defunding. As this chapter shows, the political currents that undid Sheppard-Towner were there from the very beginning.

Chapter 2, “A Bill for ‘Better Babies’: Passing and Administering the Law,” documents the politics of passing the Sheppard-Towner Act through Congress and the concessions the Children’s Bureau made in order to do so. These concessions had significant implications for how the law was administered at the federal and state levels. Dodging legal and political challenges to their administrative authority, the Children’s Bureau agents ceded significant control to the states and therefore struggled to oversee state programming – and critically state documentation. Within this dynamic, the Children’s Bureau and state directors alike showed a great deal of ambivalence about federal oversight in state programming. By focusing on the administrative tensions characterizing Sheppard-Towner’s implementation, this chapter demonstrates the contingent process of state-building in the early twentieth century – much of which was done with voluntary labor. In the process, it exposes what the promise of Sheppard-Towner programs meant to ordinary mothers and public health workers across the nation and describes the disappointment some felt at the limits of what the law could offer.

Chapters 3 and 4 work together to show how Sheppard-Towner programs built out state capacity. Chapter 3, “‘The Hand of the Government’: Public Health on the Ground,” focuses on the medical and public health work that Sheppard-Towner agents did at the state and county levels. This work included traveling health clinics, better baby contests, home visiting, and midwife training and regulation. It shows how critical Sheppard-Towner state agents were to both making rural populations visible and legible to the state and to making state bureaus and programs more visible and legible to rural populations. As they went county to county and door to door, state public health doctors and nurses tried to adapt to the variable circumstances they encountered. Sometimes, they enticed rural families with entertaining spectacles. Other times, they relied on coercive methods, including threats and intimidation, especially with African American and Native American women. In both cases, they made themselves and their agencies known to rural Americans.

Chapter 4, “‘A Help One Another Club’: Teaching Motherhood and Citizenship,” focuses on the educational programs that the Children’s Bureau and state bureaus ran with Sheppard-Towner funding. Sheppard-Towner programs aimed to standardize American “mothercraft” and to teach citizenship through educational initiatives: little mothers’ leagues, mothers’ courses, educational films, and instructional material mailed to mothers. Much of this educational information came directly from the Children’s Bureau and reflected federal and state agents’ beliefs that there was one “correct” method of child-rearing that could and should be taught to all American mothers. Their educational efforts often sought to circumvent actual mothers and focused instead on shaping the next generation of “potential mothers” – young girls. Through these educational programs, both state and national bureaus gained greater access to the intimate lives of their constituents and tried to shape familial relations nationwide. Critically, they also taught mothers and children how to see and engage with state and federal agencies – as well as how to exchange personal data for state services.

Chapter 5, “‘Our Arithmetic Was Unique’: Trouble with Accounting and Defunding Sheppard-Towner,” returns to discussions of the law at the federal level. It reconstructs debates over defunding the law in Congress and in the federal agencies, arguing that the Children’s Bureau leadership learned from their trouble administering Sheppard-Towner programs through the states. Giving states ultimate authority over programming had meant that each state director documented their Sheppard-Towner work differently – if they did so at all. When it came time to renew federal appropriations in Congress, the Bureau staff found itself unable to create and present national statistics on the workings of state programs. Children’s Bureau leaders recognized that they would have to take more control over state-level accounting in subsequent legislation if they hoped to maintain their claim to expertise through accurate reporting. In the meantime, without reliable national data, the Bureau had little ability to defend its use of federal dollars when conservatives swept Washington in the 1926 election and the law came under attack. A few years later, in a political climate much more friendly to federal intervention, the Bureau staff was able to implement the oversight they learned they needed in their administration of Title V of the Social Security Act. Yet by then it was too late: the Bureau had nearly lost its battle for singular authority over child health and welfare policy.

Historian Margot Canaday correctly asserts that states must “puzzle before they act.”Footnote ⁴² Making Babies Count shows how state and federal agencies learned to make their citizenry legible and learned to make themselves legible to their citizens. This was, of course, a contingent and muddled process. Through their troubled administration of the Sheppard-Towner Act and the programs’ subsequent rehabilitation under the Social Security Act, we see the process of state and federal bureaus puzzling, then acting with more precision. This transitional, yet impactful, piece of legislation helps explain how the nineteenth-century “government out of sight” became the vastly expanded system of federal social welfare programs that proliferated under the New Deal.Footnote ⁴³ In both its successes and its failures, then, Sheppard-Towner was (and is) instructive.