Date of Award

January 2019

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)



First Advisor

Naomi Rogers


This thesis examines the development of prenatal care in the United States in the early 1900s by focusing on the life and career of Fred Lyman Adair who, as an obstetrician and eugenicist, played a significant role in shaping prenatal care into what it is today. Although prenatal care was a product of infant welfare activists and public health officials, obstetricians like Adair who struggled to establish obstetrics as a legitimate specialty, saw an opportunity in prenatal care to pathologize pregnancy and elevate their specialty. Adair, therefore, became one of the foremost champions of prenatal care, and helped to standardize prenatal care as a physician-centric service through his influence on medical education and public policy, thereby increasing medical control over pregnancy. However, an analysis of Adair’s professional writings demonstrated that, for Adair, medical control of pregnancy served a larger eugenic purpose. Eugenic notions of “race betterment” and prevention of “race suicide” for white Americans permeated his writings and motivated his vision for prenatal care as a eugenic tool. Historians have often cited eugenic control of reproduction as a cause of racial disparity in reproductive health today. Similarly, Adair’s eugenic vision of prenatal care perhaps had long-lasting consequences and may help explain why present-day maternal and infant mortality rates of African Americans exceed that of white Americans by two to three times.


This is an Open Access Thesis.

Open Access

This Article is Open Access