This special issue adopts a comparative approach to the politics of reproduction in twentieth-century France and Britain. The articles investigate the flow of information, practices and tools across national boundaries and between groups of experts, activists and laypeople. Empirically grounded in medical, news media and feminist sources, as well as ethnographic fieldwork, they reveal the practical similarities that existed between countries with officially different political regimes as well as local differences within the two countries. Taken as a whole, the special issue shows that the border between France and Britain was more porous than is typically apparent from nationally-focused studies: ideas, people and devices travelled in both directions; communication strategies were always able to evade the rule of law; contraceptive practices were surprisingly similar in both countries; and religion loomed large in debates on both sides of the channel.

Twentieth-century psychiatry was transformed in the 1950s and 1960s by the introduction of powerful psychopharmaceuticals, particularly Chlorpromazine (Thorazine). This paper examines the reception of Chlorpromazine in the Soviet Union and its effect on the Soviet practice of psychiatry. The drug, known in the USSR by the name Aminazine, was first used in Moscow in 1954 and was officially approved in 1955. I argue that Soviet psychiatrists initially embraced it because Aminazine enabled them to successfully challenge the Stalin-era dogma in their field (Ivan Pavlov’s ‘theory of higher nervous activity’). Unlike in the West, however, the new psychopharmaceuticals did not lead to deinstitutionalisation. I argue that the new drugs did not disrupt the existing Soviet system because, unlike the system in the West, the Soviets were already dedicated, at least in theory, to a model which paired psychiatric hospitals with community-based ‘neuropsychiatric dispensaries.’ Chlorpromazine gave this system a new lease on life, encouraging Soviet psychiatrists to more rapidly move patients from in-patient treatment to ‘supporting’ treatment in the community.

This article focuses on Britain’s 1917 National Baby Week and specifically how it played out in London. Pageantry and celebration were an important part of the event, and possibly a welcome distraction from the trials and horrors of war, and they were embraced by women of all social classes. But there was much more to it, as women who led the event seized the opportunity for political purposes, in what appeared to be an unthreatening environment of celebrating motherhood. Their goal was to promote the material wellbeing of, and state support for, women and children, and in this they were remarkably successful. Baby Week was also seized upon as an opportunity to showcase other welfare systems as a model for Britain, focusing in particular on New Zealand, with its free and comprehensive health service for infants. Rather than reflecting the eugenic and pronatalist concerns of the establishment, the event should be seen as a moment of politicisation of women arguing for cross-class social reform targeted at mothers.

The first major reorganisation of the National Health Service took place in 1974, twenty-six years after the service had been established. It has long been perceived as a failure. This article draws on archival records and a witness seminar held in November 2016 to provide a more nuanced assessment of the 1974 reorganisation and understand more fully why it took the form that it did. In particular it identifies the reorganisation as an important moment in the ongoing story of management consultants engaging with health policymakers, and explores the role of McKinsey and Co. in detail for the first time. Key explanatory factors for their involvement are identified, including the perceived lack of expertise and manpower inside the civil service and the NHS, and perceptions of their impact and effectiveness are discussed. Many debates about the use of management consultants today were directly foreshadowed during the early 1970s. Alongside this, the role of other groups of policy actors, including civil servants, politicians and medical professionals, are established and the extent to which British health policymakers have had to work within existing cultural, political, legislative and practical constraints when trying to initiate change is demonstrated. The fact that many of the ‘mistakes’ that were made have been repeated in the course of subsequent reforms, speaks to the poor institutional memory of Whitehall, and the Department of Health and Social Care in particular. In the run up to 1974 management consultants could make only a limited contribution to an imperfect compromise.

Over the twentieth century, the Lunacy Office (renamed the Court of Protection in 1947) was responsible for appointing ‘receivers’ to manage the property of adults in England who were found incapable of managing their own affairs. Tens of thousands of people were in this position by the 1920s, and numbers continued to grow until after Second World War. This article uses the archives of the Office to examine the evolution of the concept of mental incapacity over the first half of the twentieth century, offering a corrective to the popular impression that the time before the Mental Capacity Act of 2005 was an era of ignorance and bad practice. It examines the changing ways in which being ‘incapable’ was understood and described, with particular reference to shifting ideas of citizenship. I argue that incapacity was not always seen as absolute or permanent in the first half of the century, that models of incapacity began to include perceived vulnerability in the interwar period and that women in particular were seen in this way. From the 1940s, though, the profile of those found incapable was changing, and the growing welfare state and its principles of employment and universality saw the idea of incapacity narrowing and solidifying around knowledge deficits, especially among the elderly. This brings the history of the Lunacy Office into the twentieth century and connects it to current concerns around assessments of mental capacity today.

Though resulting from a long-term process, the need to manage pregnancies both medically and bureaucratically became a state concern, especially from the 1920s onwards. A woman’s official obligation to notify the state of her pregnancy (and therefore to know it on time) goes beyond a matter of biopolicies and poses a range of contradictions. ‘Pregnant or not?’ – as an issue of knowledge – is a powerful tool for apprehending the tensions between individual freedom, privacy, institutional requirements and professional powers.

In order to better understand the historical meaning of pregnancy diagnostics in mid-twentieth-century France, this paper combines three dimensions: uncertainty and its management; the informational asymmetry between institutional agents and women; and the diachronic dimension of gestation. Writing this history sheds more light on an apparent paradox: while knowing and notifying one’s own pregnancy became a duty, the tools that could help women eliminate some doubt right from the first months of their pregnancy – in particular the innovation of laboratory diagnosis – was seen as a danger. When, in 1938, private laboratories began publishing advertisements for the laboratory test in the most widely-read newspapers, tending to reframe it as a commercial service, the anti-abortion crusade was increasing its propaganda and its political pressure. This crusade’s legal victory proved incomplete, but for a long time some of the most conservative physicians recommended great parsimony in prescribing testing. Combined with reducing the legal time limit for notification, this conflict shows how the state injunctions towards women could look like a ‘double bind’.

This paper explores the influence of English female doctors on the creation of the International Planned Parenthood Federation (IPPF) and the production and circulation of contraceptive knowledge in England and, to a lesser extent in France, between 1930 and 1970. By drawing on the writings of female doctors and proceedings of international conferences as well as the archives of the British Medical Women’s Federation (MWF) and Family Planning Association (FPA), on the one hand, and Mouvement Français pour le Planning Familial (MFPF), on the other, this paper explores the agency of English female doctors at the national and transnational level. I recover their pioneering work and argue that they were pivotal in legitimising family planning within medical circles. I then turn to their influence on French doctors after World War II. Not only were English medical women active and experienced agents in the family planning movement in England; they also represented a conduit of information and training crucial for French doctors. Transfer of knowledge across the channel was thus a decisive tool for implementing family planning services in France.

Despite facing manifold social and educational barriers, British asylum nurses across the long nineteenth century articulated distinctive professional identities as a means of leveraging their position in the medical hierarchy. This article draws upon a corpus of previously unattributed contributions to the Asylum News (1897–1919) – one of the first journals produced for the edification of asylum workers – to illustrate the diversity of medical personae developed and disseminated by these employees in the Edwardian era. Through scientific and creative works, nurses engaged with the pressing social and medical debates of the day, in the process exposing a heterogeneous intellectual culture. Moreover, as their writings attest, for some ambitious nurses these pretensions to intellectual authority prompted claims for medical autonomy, driving agitation on the hospital wards. The article thus strengthens claims for the ‘cultural agency’ of asylum workers and offers new insights into the cultural antecedents of professionalisation and trade unionism.

This article explores the introduction of smallpox vaccination into Nepal in 1816 at the request of the Nepalese government; the king, however, was not vaccinated, contracted the disease and died. British hopes that vaccination would be extended throughout the country did not eventuate. The article examines the significance of this early appearance of vaccination in Nepal for both Nepalese and British, and relates it to the longer history of smallpox control and eventual eradication. When the Nepalese requested World Health Organization (WHO) assistance with communicable disease control in the mid-twentieth century little had changed for most Nepalese. We know about the events in 1816 through the letters of the newly imposed British Resident after Nepal’s military defeat in the Anglo-Nepal War (1814–16). By also drawing on other sources and foregrounding Nepal, it becomes possible to build up a more extensive picture of smallpox in Nepal that shows not only boundaries and limits to colonial authority and influence but also how governments may adopt and use technologies on their own terms and for their own purposes. Linking 1816 to the ultimately successful global eradication programme 150 years later reminds us of the need to think longer term as to why policies and programmes may or may not work as planned.

A tropology of moral injury and corruption long framed the plight of the sex crime victim. Nineteenth-century psychiatric acknowledgment of adverse sexual experience reflected general trends in etiological thought, especially on ‘epileptic’ and hysteric seizures, but on the whole remained descriptive, guarded and limited. Various experiential threats to the modern sexual self beyond assault and rape were granted etiological significance, however: illegitimate motherhood, masturbatory guilt, sexual enlightenment, ‘homosexual seduction’ and chance encounters leading to fetishistic fixation. These minor early appeals to medical psychology help us appreciate the multiple nuances of ‘sexual trauma’ advanced in Breuer and Freud’s Studies on Hysteria (1895) and Freud’s subsequent work.

Based on a wide range of historical sources, including published scientific literature and archives (Institut Mérieux, WHO and IMTSSA), this article examines the history of the development of the meningococcal A vaccine between 1969 and 1973. It explores the social factors of vaccine development including various collaborations, informal discussions, the circulation of products and materials, formal meetings, trials and setbacks to highlight the complex reality of the development, production and use of the vaccine. Inscribed in a ‘Golden Age’ of vaccine development and production, this episode not only adds to the scholarship on the history of vaccines, which has tended to focus on a narrative of progress, but also considers the sharing of knowledge through collaborations, and the risks involved in the development of a vaccine. Finally, this perspective reveals the uncertainties and difficulties underlying the production of an effective vaccine.

This paper examines racial science and its political uses in Southeast Asia. It follows several anthropologists who travelled to east Nusa Tenggara (the Timor Archipelago, including the islands of Timor, Flores and Sumba), where Alfred Russel Wallace had drawn a dividing line between the races of the east and the west of the archipelago. These medically trained anthropologists aimed to find out if the Wallace Line could be more precisely defined with measurements of the human body. The paper shows how anthropologists failed to find definite markers to quantify the difference between Malay and Papuan/Melanesian. This, however, did not diminish the conceptual power of the Wallace Line, as the idea of a boundary between Malays and Papuans was taken up in the political arena during the West New Guinea dispute and was employed as a political tool by all parties involved. It shows how colonial and racial concepts can be appropriated by local actors and dismissed or emphasised depending on political perspectives.

In 1920 in France, a law was passed prohibiting abortion, the sale of contraceptives and ‘anti-conception propaganda’. While contraception was legalised in 1967 and abortion in 1975, ‘anti-natalist propaganda’ remained forbidden. This article takes seriously the aim of the French state to prevent the circulation of information for demographic reasons. Drawing from government archives, social movement archives and media coverage, the article focuses on the way the propaganda ban contributed to shaping the public debate on contraception as well as lastingly impacting the ability of the state to communicate on the subject. It first shows how birth control activists challenged the legal interdiction against communicating about contraception (1956–67) without questioning the natalist obligation. It then shows how, after 1968, communication on contraception became a power struggle carried out by various actors (sexologists and feminist and leftist activists) and how the dissemination of information about contraception was thought of as a way to challenge moral and social values. Finally, the article describes the change of state communication policies in the mid-1970s, leading to the first national campaign on contraception launched in 1981, which defined information as a task that women should take on.

Historians tend to view public health as a quintessentially modern phenomenon, enabled by the emergence of representative democracies, centralised bureaucracies and advanced biomedicine. While social, urban and religious historians have begun chipping away at the entrenched dichotomy between pre/modernity that this view implies, evidence for community prophylactics in earlier eras also emerges from a group of somewhat unexpected sources, namely military manuals. Texts composed for (and often by) army leaders in medieval Latin Europe, East Rome (Byzantium) and other premodern civilisations reflect the topicality of population-level preventative healthcare well before the nineteenth century, thereby broadening the path for historicising public health from a transregional and even global perspective. Moreover, at least throughout the Mediterranean world, military manuals also attest the enduring appeal of Hippocratic and Galenic prophylactics and how that medical tradition continued for centuries to shape the routines and material culture of vulnerable communities such as armies.

The birth of Louise Brown, the world’s first ‘test-tube baby’, has come to signify the moment at which technologically assisted human reproduction became a re ality. This was a highly mediated and visible reality, as this article explores through the example of a British television documentary about Louise Brown broadcast when she was just six weeks old, ‘To Mrs Brown… A Daughter’ (Thames Television, 1978). In the article, I discuss the programme alongside data from an interview with its producer, Peter Williams. Williams sought to convince the public that IVF was morally acceptable and to cultivate sympathy for the infertile through this film. I will consider how he went about this by focusing on the programme’s visual presentation of Louise Brown, Peter Williams’ aims in making the film and his sympathetic relationship with the ‘pioneers’ of IVF, gynaecologist Patrick Steptoe and physiologist Robert Edwards. I will conclude with a discussion of the political implications of this film and how it contributed to the normalisation of IVF at a pivotal moment in its history.

In 1942, the British Minister of Health commissioned a report from the newly established Advisory Committee on Mothers and Young Children into ‘What can be done to intensify the effort to secure more breast feeding of infants?’. To make their case, the members of the sub-committee put in charge of the report sought expert testimony on the benefits of breastfeeding. They consulted medical officers of health, maternity and child-welfare officers, health visitors, midwives, obstetricians, paediatricians and a physician in private practice. They also consulted five ‘psychologists’ (a contemporary umbrella term for psychologists, psychoanalysts and psychiatrists). It is not surprising that the committee turned to medical professionals, as infant feeding had long been an area of their expertise. However, seeking the views of ‘psychologists’ when establishing the benefits of breastfeeding marked a more innovative development, one which suggested that a shift in conceptualising the significance of breastfeeding was gathering pace. In the interwar period, psychoanalysts and psychoanalytically oriented psychiatrists showed growing interest in early infancy. It led to an extensive psychoanalytic engagement with contemporary feeding advice disseminated by the medical profession. This article will explore the divergences and intersections of medical and psychoanalytic theories on breastfeeding in the first half of the twentieth century, concluding with a consideration of how medical ideas on breastfeeding had absorbed some of the contentions of ‘psy’-approaches to infant feeding by the post-war period.

The Czech Republic holds one of the highest numbers of men labelled as sexual delinquents worldwide who have undergone the irreversible process of surgical castration – a policy that has elicited strong international criticism. Nevertheless, Czech sexology has not changed its attitude towards ‘therapeutic castration’, which remains widely accepted and practised. In this paper, we analyse the negotiation of expertise supporting castration and demonstrate how the changes in institutional matrices and networks of experts (Eyal 2013) have impacted the categorisation of patients and the methods of treatment. Our research shows the great importance of historical development that tied Czech sexology with the state. Indeed, Czech sexology has been profoundly institutionalised since the early 1970s. In accordance with the state politics of that era, officially named Normalisation, sexology focused on sexual deviants and began creating a treatment programme that included therapeutic castration. This practice, the aim of which is to protect society from sex offenders, has changed little since. We argue that it is the expert–state alliance that enables Czech sexologists to preserve the status quo in the treatment of sexual delinquents despite international pressure. Our research underscores the continuity in medical practice despite the regime change in 1989. With regard to previous scholarship on state-socialist Czechoslovakia, we argue that it was the medical mainstream that developed and sustained disciplining and punitive features.

This paper analyses the shifting images of Chinese medicine and rural doctors in the narratives of literature and film from 1949 to 2009 in order to explore the persisting tensions within rural medicine and health issues in China. Popular anxiety about health services and the government’s concern that it be seen to be meeting the medical needs of China’s most vulnerable citizens – its rural dwellers – has led to the production of a continuous body of literary and film works discussing these issues, such as Medical Practice Incident, Spring Comes to the Withered Tree, Chunmiao, and Barefoot Doctor Wan Quanhe. The article moves chronologically from the early years of the Chinese Communist Party’s new rural health strategies through to the twenty-first century – over these decades, both health politics and arts policy underwent dramatic transformations. It argues that despite the huge political investment on the part of the Chinese Communist Party government in promoting the virtues of Chinese medicine and barefoot doctors, film and literature narratives reveal that this rustic nationalistic vision was a problematic ideological message. The article shows that two main tensions persisted prior to and during the Cultural Revolution, the economic reform era of the 1980s, and the medical marketisation era that began in the late 1990s. First, the tension between Chinese and Western medicine and, second, the tension between formally trained medical practitioners and paraprofessional practitioners like barefoot doctors. Each carried shifting ideological valences during the decades explored, and these shifts complicated their portrayal and shaped their specific styles in the creative works discussed. These reflected the main dilemmas around the solutions to rural medicine and health care, namely the integration of Chinese and Western medicines and blurring of boundaries between the work of medical paraprofessionals and professionals.