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In the early twentieth century, shifting attitudes and new public health standards brought an unprecedented interest in and effort to regulate issues affecting reproduction and maternity. Maternal and infant health, nutrition, and medical care came under scrutiny, as did the issue of birth control. While the prior gained public support, the latter remained controversial. Though some reformers saw birth control as an important part of maternal welfare, others sought to separate it from more popular reforms. The careers of the four prominent but usually neglected reformers (Elizabeth Lowell Putnam, Ethel Sturges Dummer, Mary Ware Dennett, and Blanche Ames) examined in this book embody the struggle to define and resolve these tensions.

The study of these reformers offers a new perspective on more recognized leaders in the arena of reproductive health and rights, especially the U.S. Children's Bureau and Margaret Sanger. Putnam's elitism contextualizes the class politics of the Bureau, underscoring its sensitivity to the vulnerable and its innovative approach to public health. Dummer reminds us of roads not taken by policy makers in the Bureau, accentuating the differences between a child-centered and a woman-centered agenda. Dennett highlights the obstacles to women reformers in the formal political sphere, while Ames's penchant toward maternalism and compromise also led to difficulties. Together, they illustrate the complexities of formulating an effective approach to securing reproductive rights and health.