it to $392,000,000. That is a saving of $600,000,000 in one year on one thing. If we can get along without some of these unnecessary things, don't you think it would be very much better to do it and be able to put some money in great movements like this that would be of material benefit to the people of our country?

Mrs. WARD. Now, you are introducing a discussion upon which I do not want to enter. But I will say that one of my family sleeps in the Argonne, and nevertheless there is no one more interested in keeping down the expenses than I. But we have not reached the millennium. We have got to consider the people of the lowest standard in the world and not the people in the highest. At any time there may be a war. While I believe the surest way of preventing the war is to come to an understanding between England and America, I believe that we must reasonably prepare for it, and I think it would be a grave mistake if we did not appropriate

Senator MCKELLAR. May I ask the question whether it is your idea that we should continue to expend 90 per cent of all our revenues for war purposes and economize on the 10 per cent for the people of our country and for the good of our people?

The infant mortality

Mrs. WARD. I am not an expert on war. in one town in Pennsylvania is 19.1 per cent and I do not believe that all the instruction in the world would lower it. I do not believe there would be any reduction in the infant mortality. Of course it is a good bill, but is it an indispensable bill? I think only the indispensable bills should be passed now.

The CHAIRMAN. We are very glad to have heard from you.

Senator MCKELLAR. I do not think we took this economy feature into consideration so much when this Government appropriated $100,000,000 last year for the children and women of Europe.

The CHAIRMAN. And $25,000,000 the other day.
Senator MCKELLER. Yes.

STATEMENT OF MRS. LARUE BROWN, CHAIRMAN CHILD WELFARE COMMITTEE, NATIONAL LEAGUE OF WOMEN VOTERS.

Mrs. BROWN. Mr. Chairman, at the recent hearings upon the Sheppard-Towner bill the statement was repeatedly made by opponents of the measure that the indorsements of it by the women's organizations were not to be taken at face value, and this was true even of that of the League of Women Voters. These statements reflect upon the good faith of those who have presented these indorsements. It is desired, therefore, to present a brief supplementary statement setting forth the facts.

Mrs. Park has already told the committee how the League of Women Voters determines upon its legislative program. At the annual convention of the league, held this year at Cleveland, the following resolution was adopted on April 15, 1921:

The League of Women Voters again indorses the principle of Federal aid to the States for the protection of maternity and infancy and requests the immediate pasage of a bill designed to bring about this cooperation. It urges that the administration of its measures be by the United States Children's Bureau, and asks that the appropriation be adequate to carry out the purpose of the act.

47819-21-10

This resolution was submitted to the convention on one day and voted upon on another day. There was full opportunity for discus sion at each of these sessions. No changes were suggested to the convention or to the child-welfare conferences which preceded it except certain changes directed toward strengthening the language of the resolution. These were adopted and the resolution was passed in the form stated above without a single dissenting vote.

It would too greatly protract this statement to review in detail the action of the various State leagues, but since reference has been made to what took place in Maryland and in Minnesota the facts as to these States may be referred to.

One lady who appeared to oppose the bill quoted a Mrs. Kenyon as authority for the assertion that the action of the Minnesota league was "railroaded" through that body. I quote a telegram, which I have just received from Miss Marguerite Wells, of Minneapolis, chairman of the Minnesota League of Women Voters:

Sheppard-Towner indorsement made in convention of 215 delegates, at which eight persons spoke on bill, including Mrs. Kenyon, who was given privileges of the floor, though she was not a delegate.

As to the attitude of the women of Maryland, which has been particularly questioned, I submit herewith and ask to have inserted in the record telegrams from the Maryland League of Women Voters, the Woman's Christian Temperance Union, the Council of Jewish Women, the Women's Civic League, the Women's Trade Union League of Baltimore, the Service Star Legion, and the Maryland Federation of Women's Clubs. This last and very important organization was holding its annual convention while the hearing on this bill was going on. It was unanimously reindorsing the bill practically at the moment when the representative of the Maryland antisuffrage organization was attacking it before the Senate committee.

Coming back to the League of Women Voters, nothing else upon its program has received such united and enthusiastic support as this bill. It is not pretended that every single woman in an organization of over 2,000,000 members has affirmatively expressed her approval. But the indorsement by the National and State leagues has not been by vote of executive committees, as in the case of one of the antisuffrage organizations whose representative came here to oppose the bill. The matter has in each case been presented to and received the approval of a regular convention of our membership.

Turning for a moment to the contentions made to your committee by the opponents of the bill, it is apparent that in many cases they are based wither upon a failure to find out what the bill really provides or a failure to understand which in some cases is so extreme as to suggest wonder as to the good faith in which the criticism is made. It is said that the purpose of the bill is to permit the sending out from Washington of a large number of untrained old maids who are to snoop into the private affairs of mothers and force upon them undesired and unintelligent advice. It is said that in some way not clearly explained the bill will bring about the invasion of the rights of the States. It is said that there is not enough medical control in the bill in that it lets loose upon a helpless community the untrained amateurs mentioned above. It is said that there is too much medical control in the bill in that it will turn over a helpless community to the mercy of State supervised doctors.

The fact is that the Children's Bureau at Washington is only to examine and approve the plans made by the States, by whom all the active control of what is to be done under the bill is to be exercised; and to make the common effort as effective as possible by collating the experience of the various States and making the assembled material available to all. It will work through its hygiene division which is directed by trained physicians, who will be aided by its social service and other experts. Its function is to render the same valuable service constantly given to the States and to the people by other scientific bureaus of the Government the value of whose work is so generally recognized.

The work of the States is of course that which will involve direct contact with the people. It will be done by the child hygiene or child welfare divisions of State boards of health or by similar agencies which will be under the direction of trained and competent people.

Nothing in the bill looks to any compulsion of any sort. No State need accept the benefits of the bill unless it so chooses. No citizen need take advantage of the opportunities offered for advice or instruction against her will. That many women need and desire such help would, we are sure, be denied by no one. The difference of opinion on the part of the ladies who have spoken against the measure seems to be based upon an opinion that the matter should be made one of sporadic charity instead of being put upon the dignified plane of public instruction upon which other equally necessary public instruction has long been placed in the United States.

Indeed if this bill is a cloak for socialism, bolshevism, or any other of the "isms" which are so freely bandied about in these days by those who look at things through the spectacles worn by the principal opponents of this measure, then the sooner we get rid of the much more insidious and far-reaching menace of the public schools, the safer the country will be.

The talk about "free love" and "birth control" is an attack upon the good faith not only of those supporting this bill but of Federal and State administrative authorities which is not worth dignifying by discussion. I may, however, call to the attention of the committee the resolution of indorsement by the National Catholic Welfare Council as bearing upon the inherent probability of such a charge.

That a bill whose only purpose is the saving of life should be attacked as "destructive of the family" seems fantastic. Nothing so certainly destroys the family as death. This bill is meant to save the children of America, America's mothers, to save to America her children.

(Telegrams indorsing the Sheppard-Towner bill were submitted from the following persons: Mrs. Fran Sanderson, president Maryland State Federation of Women's Clubs; Mrs. T. Parkin Scott, president Maryland Division, Service Star Legion War Mothers of America; M. Lem Ellicott, president Maryland League of Women Voters; Hortense Powdermaker, secretary Baltimore Women's Trade Union League; Mary R. Halsup, president Woman's Christian Temperance Union of Maryland; Mrs. M. A. Toy, national president Service Star Legion; Bessie C. Cone, president Federation of Jewish Women's Organizations, and Mrs. Edward Shoemaker, president, and Mrs. Benjamin W. Corkran, chairman, of the legislative committee, Women's Civic League.)

STATEMENT OF ELIZABETH G. FOX, VICE PRESIDENT NATIONAL 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 SheppardTowner 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 alleviation 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."

It has been said that these workers will disrupt the homes and destroy family life. There are now 10,000 public-health nurses at work in this country. Can any of our opponents bring evidence to show that the work of these nurses has resulted in the destruction of family life? Quite to the contrary they are constantly protecting and preserving family life through the building up of family health. No public-health nurse working under a responsible agency is permitted to give advice concerning birth control to any patients. Publichealth nurses working under reputable agencies are not allowed to interfere with the political or religious opinions of their patients, nor to give any instruction contrary to law, such as instruction in matters concerning birth control. These regulations are part of the ethical code which all nurses observe.

The point has also been made by our opponents that agencies would be allowed by this bill to enter private homes. I should like again to describe the practice prevailing among public-health nurses. Their work lies entirely in homes. Sometimes they are called to these homes by members of the family, sometimes by relatives and friends, sometimes by doctors or social workers, and sometimes by other agencies. When making a first call upon a family, they always explain who they are and why they have come.

The family is at liberty to refuse them admittance if it chooses. Occasionally a family does refuse admittance to a public health nurse. The nurse never tries to force her admittance. If she can not find her way into the home by gaining the confidence of the family, she feels that it is useless to enter the home by means of coercion. If she is refused admission the first time, she may call again, but never at any time does she enter a home against the wishes of the family. Exception to this statement should be made when a nurse is employed by a municipal department of health for the control of communicable diseases. It is a fact that only in a very small percentage of cases are public health nurses unable to win the confidence of the people they would serve. It is often the experience that families who are reluctant to admit the nurse on her first visit, come to consider her one of their most valuable friends and helpers. Public health nurses are not looked upon as nuisances by the people of this country. On the contrary, they are so sought after that they can not begin to accomplish all the work which they are called upon to do.

It is entirely within the province of any individual to refuse to be advised or helped by the agents provided by this bill. It is also within the possibility of any State to refuse to put the bill into practice. There is no note of compulsion anywhere in the bill.

Some of the opponents have said that the bill provides nothing useful since it does not offer hospital or dispensary facilities. These opponents seem to think that the only care needed is that during the lying-in period. They do not appreciate the vast importance of advice in the hygiene of pregnancy and child hygiene. Quite as many lives are lost through neglect during the period of pregnancy and during the early period of the child's life as through the lack of hospital facilities at the time of confinement.