Sheppard-Towner Act Summary

  • Last updated on November 10, 2022

The first federal social welfare legislation in the United States authorized matching funds to the states for programs related to maternal and child hygiene. The act, which was passed largely as a result of the efforts of women’s groups, also set a new precedent by providing financial aid to mothers regardless of their ability to pay for services.

Summary of Event

The Public Protection of Maternity and Infancy Act of 1921, commonly known as the Sheppard-Towner Act, linked a chain of ideas and actions about the proper role of government in the economy and society from the presidency of Theodore Roosevelt to that of Franklin D. Roosevelt. The link began with the White House Conference on Child Welfare Standards in 1909 and ended with the Social Security Act of 1935. The Children’s Bureau, Children’s Bureau[Childrens Bureau] the establishment of which developed out of the White House Conference of 1909, was the first organization to investigate the causes of infant and maternal mortality in the United States. Children’s Bureau studies revealed that the United States had high rates, showing, for example, that the nation ranked seventeenth in maternal and eleventh in infant mortality among world nations in 1918. Studies also linked poverty and mortality rates, revealing that 80 percent of expectant mothers in the United States received no advice or trained care. To remedy this situation, Jeannette Rankin, the first woman to serve in Congress, introduced in 1918 a measure to provide public protection of maternity and infancy. Julia C. Lathrop, chief of the Children’s Bureau, sponsored the measure, and Senator Morris Sheppard of Texas and Representative Horace Towner of Iowa reintroduced the bill in the Sixty-sixth Congress. The bill made little progress until the full enfranchisement of women in 1920. Sheppard-Towner Act (1921)[Sheppard Towner Act] Public Protection of Maternity and Infancy Act (1921) Welfare programs;aid to mothers and children [kw]Sheppard-Towner Act (Nov. 23, 1921-June 30, 1929)[Sheppard Towner Act (Nov. 23, 1921 June 30, 1929)] [kw]Towner Act, Sheppard- (Nov. 23, 1921-June 30, 1929) [kw]Act, Sheppard-Towner (Nov. 23, 1921-June 30, 1929) Sheppard-Towner Act (1921)[Sheppard Towner Act] Public Protection of Maternity and Infancy Act (1921) Welfare programs;aid to mothers and children [g]United States;Nov. 23, 1921-June 30, 1929: Sheppard-Towner Act[05490] [c]Health and medicine;Nov. 23, 1921-June 30, 1929: Sheppard-Towner Act[05490] [c]Laws, acts, and legal history;Nov. 23, 1921-June 30, 1929: Sheppard-Towner Act[05490] [c]Social issues and reform;Nov. 23, 1921-June 30, 1929: Sheppard-Towner Act[05490] [c]Women’s issues;Nov. 23, 1921-June 30, 1929: Sheppard-Towner Act[05490] Kelley, Florence Lathrop, Julia C. Rankin, Jeannette Sheppard, Morris Towner, Horace

The League of Women Voters League of Women Voters;Sheppard-Towner Act[Sheppard Towner Act] urged the national parties to endorse the maternity bill in their 1920 platforms. The Democratic, Socialist, Prohibition, and Farmer-Labor Parties did, but the Republican Party ignored it. President Warren G. Harding, however, supported the bill in his Social Justice Day speech on October 1, 1920. Sheppard and Towner resubmitted the bill in April, 1921, and it passed the Senate on July 22 by a vote of 63 to 7. Samuel Winslow, Winslow, Samuel chair of the House Committee on Interstate and Foreign Commerce, which oversaw the bill, refused to hold hearings for months. President Harding prodded Winslow only after influential women such as Republican National Committee vice chair Harriet Upton warned him that the delay was alienating many women. The House finally passed the measure by a vote of 279 to 39; antisuffragist Alice Robertson, by then the only woman in Congress, voted against it. Harding signed the bill on November 23, 1921.

At the time of debate and passage, the inclinations of women voters were an unknown quantity. Suffragists had promised to clean house when they got the vote, and many politicians feared that women voters would vote en bloc or remain aloof from the main parties. Passage of the maternity bill was a goal of newly enfranchised women and took precedence over all other efforts. In 1920, the League of Women Voters helped to create the Women’s Joint Congressional Committee Women’s Joint Congressional Committee[Womens Joint Congressional Committee] (WJCC), which coordinated the lobbying efforts in Washington, D.C., for nearly two dozen women’s organizations. Florence Kelley, executive secretary of the National Consumers League, chaired the WJCC subcommittee responsible for enactment of the measure.

Kelley’s successful lobbying efforts overcame powerful opponents who assailed the measure as a threat to the moral foundation of the nation. Such organizations as the National Association Opposed to Woman Suffrage and the Woman Patriots equated feminism and woman suffrage with socialism and communism. Mary Kilbreth, a leading antisuffragist, wrote to Harding to tell him that many believed the bill was inspired by communism and backed by American radicals, and that it was a strike at the heart of American civilization. Organizations such as the Woman’s Municipal League of Boston, the American Constitutional League, the Constitutional Liberty League of Massachusetts, and the Massachusetts Public Interest League concurred.

Fearing the imposition of a nationalized health care system, the American Medical Association American Medical Association (AMA) also targeted the Sheppard-Towner Act. State medical societies in Massachusetts, New York, Illinois, Ohio, and Indiana spearheaded the opposition. The Illinois Medical Journal, official organ of the Illinois State Medical Society, attacked the act as a product of Bolshevist forces that sought to set up bureaucratic autocracy in the nation’s capital. The Journal of the American Medical Association campaigned against the Sheppard-Towner Act from February 5, 1921, until its repeal in June of 1929. In 1922, the AMA’s house of delegates condemned the legislation as a socialistic machination. Many women physicians, such as Josephine Baker, a constant ally of the National Consumers League and the League of Women Voters and president of the Medical Woman’s National Association in the early 1930’s, supported the Sheppard-Towner Act.

The act authorized an appropriation of $1.48 million for the fiscal year 1921-1922 and $1.24 million for the next five years (a period that ended on June 30, 1927). Of this sum, $5,000 would go to each state outright, $5,000 more would go to each state if matching funds were provided, and the remainder would be allocated on a population percentage and matching basis. The Children’s Bureau would channel the money through state child welfare or health divisions. States retained the right to reject aid.

The act provided for instruction in hygiene of maternity and infancy through public health nurses, visiting nurses, consultation centers, child-care conferences, and literature distribution. Forty-one states joined the program in 1922, whereas until the act’s repeal in 1929, only Connecticut, Illinois, and Massachusetts rejected Sheppard-Towner money.

The attorney general of Massachusetts issued an opinion that the act would misuse the state’s tax money and that it was unconstitutional because it violated the rights of the states. Massachusetts filed a suit with the U.S. Supreme Court on behalf of its taxpayers to enjoin the law. Harriet Frothingham, president of the Woman Patriots, filed another suit in the Supreme Court of the District of Columbia in the event that states were deemed ineligible to file a taxpayer’s suit. The District of Columbia court dismissed Frothingham’s case and the U.S. Court of Appeals concurred. She then appealed to the Supreme Court. In the interim, Solicitor General James Beck, who considered the Sheppard-Towner Act to be unconstitutional, encouraged Massachusetts to pursue its case. These suits threatened the range of federal programs that provided either direct aid or matching grants to states. On June 5, 1923, the Supreme Court dismissed both suits for want of jurisdiction; the Court did not rule on the constitutionality of the act.

Although the Sheppard-Towner Act was considered a permanent law, federal appropriations under the act’s provisions were scheduled to cease automatically on June 30, 1927. In 1926, proponents moved to have the authorization extended. The House of Representatives quickly approved a two-year extension by a vote of 218 to 44. The AMA, Woman Patriots, Daughters of the American Revolution, and other opponents, however, mobilized to stop the bill in the Senate. Opponents iterated many of the same themes that in 1921 had been less persuasive. Foremost among these was the notion that the Sheppard-Towner Act was part of a feminist-socialist-communist plot to Sovietize the United States. In the end, proponents accepted a compromise that extended the appropriations for two more years but repealed the law automatically on June 30, 1929. Restoration came, however, with the Social Security Act of 1935. Social Security Act (1935) Title V of the 1935 act authorized appropriations for the Children’s Bureau of $5.82 million for maternity and infancy protection, in addition to $3.87 million for crippled children and $34.75 million for aid to dependent children.


The Sheppard-Towner Act was in many ways the first federal welfare legislation. It authorized matching funds to the states for programs in maternal and child hygiene. The act also broke with the legacy of mothers’ aid by providing assistance regardless of the applicant’s financial status, although it allowed for the continuation of certain now-controversial trends: for example, visiting nurses offered advice and help according to the Children’s Bureau’s norms of good child care (which counseled against breast-feeding and cuddling babies on demand), even if these norms went against a client’s customs. The Sheppard-Towner Act also represented the first major dividend of women’s national enfranchisement.

The act’s passage was at least partially attributable to the efforts of the newly enfranchised suffragists. Women’s groups united and formed persuasive congressional lobbying groups, although their work was made more difficult by the vocal antisuffragist groups that equated Sheppard-Towner Act supporters with extreme leftism. Still, the act passed, and most states participated in its programs. The initial attempt to extend the act succeeded, but it was eventually doomed by the anticommunist and antisocialist sentiments that prevailed at the time. Although progressive women lobbied hard for the bill, President Herbert Hoover refused to press the matter and allowed the first federal social security law to lapse. The Great Depression precluded any revival of national provisions in the early 1930’s, and the loss of federal funds severely restricted many of the forty-five state programs that had continued to provide maternity and infancy aid on their own. As a result, the act was resurrected by the Social Security Act of 1935. Sheppard-Towner Act (1921)[Sheppard Towner Act] Public Protection of Maternity and Infancy Act (1921) Welfare programs;aid to mothers and children

Further Reading
  • citation-type="booksimple"

    xlink:type="simple">Bremner, Robert H., ed. 1866-1932. Vol. 2 in Children and Youth in America: A Documentary History. Cambridge, Mass.: Harvard University Press, 1971. Contains excerpts from original source material including provisions of the Sheppard-Towner Act, congressional debates, published opposition, and the 1923 Supreme Court decision upholding the constitutionality of the act. Chronology of significant child-related legislation; topical bibliography; index.
  • citation-type="booksimple"

    xlink:type="simple">Caputo, Richard K., ed. Federal Responses to People in Need. Vol. 1 in Welfare and Freedom American Style I: The Role of the Federal Government, 1900-1940. Lanham, Md.: University Press of America, 1991. Discusses the legislative history of the Sheppard-Towner Act of 1921 in the context of the federal government’s role in promoting social welfare. Notes, bibliography, index.
  • citation-type="booksimple"

    xlink:type="simple">Gordon, Linda. Pitied but Not Entitled: Single Mothers and the History of Welfare, 1890-1935. New York: Free Press, 1994. Shows the influence of women on the development of social welfare legislation. Gathered notes, appendix, index.
  • citation-type="booksimple"

    xlink:type="simple">Graetz, Michael, and Jerry Mashaw. True Security: Rethinking American Social Insurance. New Haven, Conn.: Yale University Press, 1999. The authors, professors at Yale Law School, discuss the overlapping roles that Social Security, various forms of insurance, and the child welfare system play. Unsurprisingly, they find many flaws, but several of the solutions they propose are interesting.
  • citation-type="booksimple"

    xlink:type="simple">Harvey, Anna L., and Randall Calvert. Votes Without Leverage: Women in American Electoral Politics, 1920-1970. New York: Cambridge University Press, 1998. Carefully researched volume begins with the Sheppard-Towner Act and other legislation of the 1920’s in order to analyze the success and failures of women’s lobbying groups.
  • citation-type="booksimple"

    xlink:type="simple">Lemons, J. Stanley. “The Sheppard-Towner Act: Progressivism in the 1920’s.” Journal of American History 55 (March, 1969): 776-786. A definitive history of the act as seen in the context of the Progressive Era in the United States. Includes extensive notes documenting original source material.

Children’s Bureau Is Founded

National Birth Control League Forms

International Congress of Women

First Woman Is Elected to the U.S. Congress

National Woman’s Party Is Founded

League of Women Voters Is Founded

U.S. Women Gain the Right to Vote

Proposal of the Equal Rights Amendment

Categories: History