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Sara Josephine Baker

Sara Josephine Baker

Sara Josephine Baker (1873-1945) was a physician working toward improving the public health care and reducing infant mortality rates substantially in New York City.

Sara Josephine Baker was a pioneer in the field of public health and an activist in the women's movement. She was the first woman to receive a doctorate in public health. As the head of the Department of Health's newly created division of child hygiene, she reduced New York City's infant mortality rate to the lowest of all major cities worldwide. From 1922 to 1924 she represented the United States on the health committee of the League of Nations.

Born on November 15, 1873, in Poughkeepsie, New York, Baker was the daughter of affluent parents. Her Quaker father, Orlando Daniel Mosser Baker, was a lawyer and her mother was one of the first women to attend Vassar College. Baker's Quaker Aunt Abby stimulated her intellectually and instilled in her the courage to be a nonconformist. This background influenced her decision to enter medicine and establish innovative programs in preventive health, particularly in obstetrics (childbirth) and pediatrics (treatment of children).

Becomes a doctor

When Baker was 16 years old both her father and brother died in a typhoid epidemic. Devastated, she abandoned plans for attending Vassar and decided to go directly to New York Women's Medical College. She was determined to become a doctor in order to help support her mother and sister. In 1898, after four years of intensive study, Baker graduated second in a class of 18. She interned, or gained practical experience in medicine, at the New England Hospital for Women and Children, an outpatient clinic serving residents in one of the worst slums in Boston, Massachusetts. Later she moved to New York City with her roommate and fellow intern, where they set up a practice near Central Park West. Unable to make ends meet, Baker took a job as a medical inspector for the New York City Department of Health. She examined sick children in schools and worked toward controlling the spread of contagious disease.

Becomes first woman health official

In 1902 Baker was given the job of searching for sick infants in Hell's Kitchen. Located near the docks of Manhattan's West Side, Hell's Kitchen was a slum area where 1,500 children were dying each week of dysentery (a disease that causes severe diarrhea and dehydration). In 1908 the Department of Health established a division of child hygiene, with Baker as its director. She was the first woman in the United States to hold an executive position in a health department. There she shaped policies for innovative health reform and made preventive medicine and health education the responsibility of government. As Baker's program saved the lives of countless infants, she revolutionized pediatric health care in the United States and in other nations as well.

Starts innovative projects

One of Baker's projects was establishing "milk stations" throughout the city, where nurses examined babies, dispensed low-cost, high-quality milk, and scheduled checkups. In 1911 alone 15 milk stations prevented more than 1,000 deaths, and the next year 40 more stations were opened. Another of Baker's programs was the training and licensing of midwives, or persons who assist women in childbirth. Since many immigrant women were used to midwifery, they were reluctant to allow their babies to be delivered by male doctors in hospitals. Midwives were often unqualified, however, and infant death rates were high. Baker instituted a mandatory licensing program with results so successful that she was able to demonstrate that rates of infection for home deliveries were lower than those for hospitals.

Baker also started a program called the Little Mothers League to train young girls in the care of babies, since many girls were put in charge of their younger siblings while their mothers worked. Through this program nurses instructed schoolgirls in the feeding, exercising, dressing, and general care of infants. An even more significant method of reducing infant mortality was a foster care system Baker founded to give orphaned babies a better environment than that available in institutions. Her efforts helped reduce death rates from one-half to one-third of infants born in a year. She also introduced the concept of prenatal care to prevent infant mortality during and following childbirth.

Contributes to nation's public health system

Among Baker's other accomplishments were a school inspection system and the organization and streamlining of record-keeping procedures for health departments, which was adopted nationwide. She opened specialized clinics and instituted parent training by public health nurses. In 1912 she established the Federal Children's Bureau and made plans for creating a division of child hygiene in every state. Besides being a leader in the medical field, Baker was in the forefront of the fledgling women's movement. In 1915 she was invited by officials at the New York University (NYU) Medical School to lecture on child hygiene for a new course leading to a degree of doctor of public health. Since she did not have an actual degree in the field of public health herself, she offered to teach in return for the opportunity to earn the diploma. When Dean William Park turned down her request on the grounds that the medical school did not admit women, Baker refused the appointment.

Park searched in vain for a year for another instructor, finally giving up and admitting Baker and other women to the program. Baker's reception by some of the male students was hostile, but she continued teaching at NYU for 15 years. Along with five other women Baker founded the College Equal Suffrage League, an organization that campaigned for women's voting rights, and she marched in the first annual Fifth Avenue suffrage parade.

Appointed League of Nations representative

During her term as U.S. representative on the health committee of the League of Nations from 1922 to 1924, Baker was appointed consulting director in maternity and child hygiene of the U.S. Children's Bureau. After retirement she participated in more than 25 committees devoted to improving children's health care. She also served a term as president of the American Medical Women's Association. Baker died of cancer on February 22, 1945, in New York City. Her work laid the foundation for preventive health procedures that saved the lives of hundreds of thousands of babies, resulting in an improvement in mortality rates from one in six in 1907 to one in 20 by 1943.

Further Reading

Peavy, Linda, and Ursula Smith, Women Who Changed Things, Charles Scribner's Sons, 1983, p. 122.

Morantz-Sanchez, Regina Markell, Sympathy and Science: Women Physicians in American Medicine, Oxford University Press, 1985.

Morantz, Regina Markell, Cynthia Stodola Pomerleau, and Carol Fenichel, eds., In Her Own Words: Oral Histories of Women Physicians, Yale University Press, 1982, p. 30. □

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