The History of Infant and Maternal Public Health Care in the British Caribbean

Following the end of slavery in 1834, colonial governments in the British Caribbean unfolded a set of public health policies focused on women and children that were designed to “uplift the race,” including midwife training and baby-saving leagues.

McMaster Researcher


De Barros, J. (2014). Reproducing the British Caribbean: Sex, Gender, and Population Politics after Slavery. Chapel Hill: The University of North Carolina Press.

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What is this research about?

This research explores the first social welfare and health education programs that appeared in Jamaica, Barbados and Guyana from the early nineteenth century to the 1930s. This same period involved the transition from slavery to freedom in the colonies of the British Empire. Infant and maternal public health regimes were an important element of the colonial governments’ response to the perceived need to regulate population health and size in the aftermath of slavery. Dr. Juanita De Barros’ book Reproducing the British Caribbean: Sex, Gender, and Population Politics after Slavery carefully traces how biases regarding race and gender influenced these new public health policies, but were also partly challenged by the view that health education could counteract the ignorance of purportedly “uncivilized and immoral” mothers, the poor and mostly nonwhite women who were its prime target.

What did the researchers do?

De Barros documented unpublished history found in ten major archives in the Caribbean, the US and the UK as well as published government reports, research and newspaper articles. Using the historical record, De Barros reconstructed the perspectives and roles of many historical figures involved in the development of public health systems in Jamaica, Guyana and Barbados. Mapping the tensions that resulted when the varying agendas of different groups came into contact, De Barros accounts for how both individual actors from diverse backgrounds as well as powerful decision-makers in Britain and the Caribbean helped shape and implement programs designed to promote the health and reproduction of Caribbean populations.

What did the researchers find?

Midwives were seen by public officials as one crucial element in the effort to resolve the infant mortality issue in the early twentieth century. Midwifery and home visitor training programs were introduced in British Caribbean countries, De Barros explains, as part of the effort to replace “traditional” midwives blamed for infant deaths with “respectable” native midwives. This meant that white, British women were recruited to train and supervise local midwives and health visitors, who were given the task of instructing largely nonwhite, poor mothers on modern, “hygienic” methods of parenting. Middle-class women of African descent and members of the social elite dominated the volunteer-run “baby-saving leagues” that also emerged in this period to offer parenting advice to poor, mostly nonwhite women. These initiatives served the interests of the colonial state, but they also offered Caribbean women opportunities to achieve some of their own personal and professional goals (see Introduction, p. 15). In Chapter 4, De Barros focuses attention on the rising social prominence of female health practitioners, administrators and advocates associated with these programs, noting the historical significance of women such as Ethel Minett, one of the first female medical officers who was able to work while being married, and Princess Maud Kendall, an advocate for black middle-class women’s involvement in social welfare. 

How can you use this research?

Health practitioners and policymakers will benefit from knowledge about the historical contexts in which current concepts and practices of maternal and infant health and medicine emerged. Deeper awareness of how attitudes toward gender and race affect health care practices as well as cultural variation and adaptation in response to general health policies, historically and presently, can help us provide better health care today. In addition to historians of medicine and Caribbean and British imperial history, De Barros’ highly accessible work can be appreciated by all readers for showing us how social change and its impacts are the results of the historical efforts of many individuals who cared to make a difference.

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