Already a coherent topic of importance in national and international politics by the outbreak of World War II in 1939, reproduction moved centre stage as science and medicine claimed ever larger roles in and after the conflict. We can identify two contrasting phases of change. During the postwar (baby) boom in the west, childbirth and contraception were further medicalized, and the United States, locked in Cold War with the Soviet Union, began to lead industrialized countries in exporting population control to the now increasingly decolonized ‘Third World’. From the late 1960s, social movements, especially feminism, challenged medical authority and produced a new politics of reproduction, which was then reconfigured during economic restructuring and the rise of neoliberalism. Part V analyses these changes, revisiting those innovations that historians have studied most, including hospital birth and the oral contraceptive pill, and exploring other major novelties, such as contraceptives that were more widely used and technologies of assisted conception.
Postwar governments established more comprehensive welfare and health-care systems and funded large-scale research. Especially in Europe, communitarianism and state action defined the era; medical authority rose to a peak. The term ‘biomedicine’ describes the regime, based on wartime models, which combined biological research, medical care, industry and state regulation in a variety of feedback loops. In obstetrics, where the aim had been to provide a safety-net to catch the few cases that needed intervention, antenatal monitoring and surveillance of every pregnancy became the ideal. Childbirth, in the 1930s still mostly at home in Europe and even the United States, entered the hospital to varying degrees around the world, but globalization relied on adaptation to local conditions (Salim Al-Gailani, ‘Hospital Birth’, Chapter 37). Maternal mortality finally declined in industrialized countries, but as women invested more in fewer pregnancies, they were taught new fears, including of age as a risk factor for Down syndrome (Ilana Löwy, ‘Prenatal Diagnosis, Surveillance and Risk’, Chapter 38).
While the war and the postwar decade reinforced pronatalism and marriage, which enjoyed unmatched popularity in Europe and North America, contraception was generally accepted as a means of ensuring that children were wanted, healthy and legitimate. Physicians overcame their reluctance to prescribe birth control, now reframed as a moral duty, and installed themselves as gatekeepers to medical technologies.