For centuries London has been at the centre of the social and economic fabric of British life, and its empire. London has not only been renowned for its pivotal role in the world of finance and politics, but also for its acute problems of overcrowding and social and economic dislocation. Starting in 1902 and ending just before the outbreak of the Second World War, Metropolitan Maternity highlights the distinct role London played in these years within the debates and policies concerning the economic and military future and physical welfare of the nation. Focusing on the expansion of maternal and child health and welfare services in the early twentieth century, this book shows that London mothers and children tended to be better served than those in provincial cities or rural areas. Yet even in London some areas were better served than others. A central theme of the book is the complexity of socio-economic and political forces that determined the differing levels of provision and health standards within the city. The book also examines the increasing emphasis placed on state sponsorship of health services in the early twentieth century and the growing willingness to involve and listen to mothers and their needs in the planning and development of services.

The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

This book charts the journey of British General Practitioners (GPs) towards professional self-realisation through the development of a political consciousness manifested in a series of bruising encounters with government. GPs are an essential part of the social fabric of modern Britain but as a group have always felt undervalued, clashing with successive governments over the terms on which they offered their services to the public. Explaining the background to these disputes and the motives of GPs from a sociological perspective, this research casts new light on some defining moments in the creation of the modern British state, from National Health Insurance to the National Health Service, and the history of the British medical profession. It examines these events from the point of view of the professionals intimately involved in and affected by them, using both established sources, like Ministry of Health records, an in-depth analysis of rarely studied records of professional bodies, and previously unresearched archive material. The result is a fascinating account of conflict and cooperation, and of heroic, and less-than-heroic, defiance of political authority, involving interactions between complex personalities and competing ideologies. Scholarly yet readable, this book will be of interest to the general reader as much as to medical practitioners and historians.

The first half of the twentieth century witnessed a revolution in contraceptive behaviour as the large Victorian family disappeared. This book offers a new perspective on the gender relations, sexual attitudes, and contraceptive practices that accompanied the emergence of the smaller family in modern Britain. Kate Fisher draws on a range of first-hand evidence, including over 190 oral history interviews, in which individuals born between 1900 and 1930 described their marriages and sexual relationships. By using individual testimony she challenges many of the key conditions that have long been envisaged by demographic and historical scholars as necessary for any significant reduction in average family size to take place. Dr Fisher demonstrates that a massive expansion in birth control took place in a society in which sexual ignorance was widespread; that effective family limitation was achieved without the mass adoption of new contraceptive technologies; that traditional methods, such as withdrawal, abstinence, and abortion were often seen as preferable to modern appliances, such as condoms and caps; that communication between spouses was not key to the systematic adoption of contraception; and, above all, that women were not necessarily the driving force behind the attempt to avoid pregnancy. Women frequently avoided involvement in family planning decisions and practices, whereas the vast majority of men in Britain from the interwar period onward viewed the regular use of birth control as a masculine duty and obligation. By allowing this generation to speak for themselves, Kate Fisher produces a richer understanding of the often startling social attitudes and complex conjugal dynamics that lay behind the vast changes in contraceptive behaviour and family size in the twentieth century.