'Prevention and health: every mother's business', a comment on child health policies in the 1970s.

Abstract

Introduction OVER the past two years, a series of government reports, consultative documents and white papers have heralded a major change in government policy in the field of health.! This change is captured in these publications in the concept of prevention a concept which draws attention to the role that the individual and the community can play in promoting and safeguarding the nation's health. The concept of prevention has farreaching implications not only for the distribution of resources and responsibilities within the health service, but also for the organisation of roles and responsibilities within the family and community. While implications for the various sectors of the N.H.S. have been subject to scrutiny,2 its implications for everyday life, and particularly for everyday family life, have not. It is this neglected dimension of health policy that is explored in this paper. The paper focuses on one area where the philosophy of preventive health is well developed and where concrete proposals for implementing preventive strategies have been put forward: namely maternal and child health. 3 The first section of the paper outlines the background to the new health policy; the second examines the way the principles of prevention have been interpreted in the context of pregnancy and childcare. It suggests that the central concept in the formulation of policies in this area has been that of parental responsibility. However, in its translation from principle into policy, the concept appears to have undergone a subtle transformation, with 'parent' being equated with 'mother', and 'responsibility' becoming synonymous with 'sacrifice' ~nd 'culpability'. Underlying the new strategies of prevention it is thus possible to detect an ideology of the family very similar to the one which has traditionally underlain the formulation of social policy. This ideology promotes a vision of the conjugal two-parent unit in which the woman, with the economic support of her husband, performs the major childrearing tasks. The third section approaches preventive health from a rather different angle: focusing on its meaning within the everyday lives of women with young children. Looking at mothers' accounts of their childbearing and childrearing experiences, we find that the ideology of responsibility is one that is already deeply embedded in the fabric of their daily lives. These accounts suggest that it is not a lack of respon-