Powers of life and death: aspects of maternal welfare in England and Wales between the wars.

A long series of official reports testifies to the importance of maternal mortality as a social problem for most of the inter-war period.' A number of historians have studied its significance, with some reference to the "medicalization" of childbirth: most exhaustively, Jane Lewis, in connection with the politics of maternity care, and Irvine Loudon, in his reconsiderations of causality.2 The first part of this paper deals with the dimensions of this social problem, reviews explanations of the maternal mortality rates and the general lines of debates surrounding them, and identifies different views about the quality of maternity services and their relationship to maternal mortality. The second part explains what services were available, paying special attention to home confinements and attendance on them by midwives and general practitioners; it takes up the details of arguments advanced about their work and reviews the development of relevant policy in the late 1930s. The paper argues that the credit due to scientific and public health medicine for improving women's chances of life can be greatly offset by evidence that medical power was exerted in ways which favoured professional interests when they came into conflict with clients' welfare.