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PROTECTION OF MATERNITY. 
STATEMENT OF ELIZABETH G. FOX, VICE PRESIDENT NA 
TIONAL ORGANIZATION FOR PUBLIC HEALTH NURSING. 
Miss Fox. I am speaking from a knowledge of public health nursing 
gained from eight years’ experience as a public health nurse and from 
three years’ experience as executive officer in charge of 1,300 public 
health nurses and as vice president of the National Organization for 
Public Health Nursing, which has a membership of between four and 
five thousand public health nurses. 
As much of the field work provided in the Sheppard-Towner bill 
will be performed by public health nurses, it is fair to suppose that 
it will be done according to the high standards and in the thorough 
manner now prevailing among public health nurses, some of whom 
are engaged in just the kind of work which is anticipated in this bill. 
There are now something like 10,000 public health nurses at work in 
the United States. Probably 75 per cent, if not more, of these 
nurses are working in cities and towns. Not over 25 per cent are 
working in the counties and rural districts. Some of them are 
employed through State and municipal funds; many of them are 
employed from private funds. Many of them are carrying on some 
measure of prenatal, maternity, and postnatal nursing. In those 
cities where this service is adequately cared for by well-established 
staffs, it will not be necessary to draw upon State and Federal funds. 
There are hundreds of towns and more than two-thirds of our counties, 
however, which have no such service at present, largely because of 
lack of funds. 
Careful studies indicate that the majority of the mothers in such 
towns and counties are without supervision during their pregnancy, 
have only one or two visits from a physician during the lying-in 
period, and are again without medical supervision during the first year 
or two of the baby’s life. Shortage of doctors, economic conditions, 
and lack of realization of the importance of supervision on the part 
of the mother partly account for this situation. 
It has been said by some of the opponents of this bill that maternal 
instinct and general intelligence are sufficient to guide a mother safely 
through pregnancy and in the care of her babies. Those who are 
familiar with the modern science of medicine and hygiene realize the 
fallacy of such an argument. The mothers themselves throughout 
the land are the first to say that they do not know how to care for 
themselves or their babies scientifically, and need and desire help from 
those who have been scientificlaly trained. Unless the Sheppard- 
Towner bill goes through the mothers in great areas of our country 
will have to remain without professional guidance and supervision 
for some time to come. 
It has been said that this bill will send large numbers of untrained 
individuals into private homes. Public-health nurses can not be 
called untrained individuals. They are highly trained in the allevia 
tion and prevention of sickness, the teaching of hygiene, and the 
preservation of health. The Children’s Bureau will undoubtedly 
establish high standards of qualification and of supervision for these 
workers. Dr. Livingston Farrand has said, ‘‘The entire modern 
health movement depends upon the adequate development of the 
visiting nurse.”