18 
PROTECTION OF MATERNITY. 
that the Bureau, after consultation with many authorities, medical 
and social experts, has endeavored to find a plan for better care, and 
this measure is the result. 
In the United States the rates of maternal mortality have been 
for some years among the highest shown by progressive countries. 
The infant mortality rate is also notably high. With your per 
mission tables of rates for the United States and foreign countries 
will be attached, showing not only the present rates but the tendency. 
I think I ought to say that the bureau has, since the first few 
years of its existence, had on its staff physicians specially trained in 
the field of the protection of maternity and infancy. 
It also has an advisory committee of distinguished pediatricians. 
They are in favor of this measure, because they have realized— I 
think more so than we have—the administration in the States, as at 
present organized. They realize that they are no more able to cope 
with the question than we have been to cope with the question of 
exportation in regard to foreign products, or with the other questions 
which Congress has seen fit to aid the States by such donations as 
would be carefully guarded in the expenditure of the money and 
which would ultimately produce greater activity on the part of the 
States. 
My judgment is that this measure will stimulate far larger appro 
priations on the part of the State than those which have been con 
templated that the Federal Government will give. Every scientific 
bureau in the Government is of necessity educational, and 
The Chairman. Can you give us, Miss Lathrop, the number of 
women who have died and the number of children who have died in 
this country 
Miss Lathrop. We have an incomplete birth registration, but 
probably for the year 1920 it was between 200,000 and 250,000 
children who died in the first year of life—before they had lived 12 
months. 
The adoption of this law undoubtedly will at once give added 
urgency to birth registration, which the bureau has stimulated by 
publications showing the importance of birth registration and by 
furnishing methods for tests of birth registration by volunteer organ 
izations. Such efforts by the bureau would be increased with the 
aim of bringing the whole country within the registration area as 
promptly as possible, and thus making possible prompter service to 
mothers and babies as a measure of lessening infant mortality. 
Study and stimulus of the best methods of improving birth registra 
tion are the duty of the bureau under its general law and would be 
especially timely and important in making the maternity and infancy 
law effective. 
The Chairman. And how many mothers have died in childbirth? 
Miss Lathrop. In the flu year it raised to 23,000 and last year it 
was 17,800. These, perhaps, might seem normal figures to those 
not familiar with the well-known medical facts that all of the deaths 
are preventable if you have the proper facilities. It is my impression 
that our complacency about this matter has come from the fact that 
in the circles in which most of us move there is competent nursing and 
medical care, and are not acquainted with those less fortunate. 
The Chairman. How about the rural life?