American psychiatry on the eve of Pearl Harbor was a small, stigmatised, and isolated specialty, for the most part confined as surely inside the high walls of its barrack-asylums as the patients over whom it exercised near-autocratic powers. The number of mentally ill patients incarcerated in state and county mental hospitals had grown sharply, from 150,000 at the turn of the century to 445,000 in 1940. The fiscal crisis of the states that accompanied the Great Depression had produced a steady deterioration of conditions in these institutions, a deterioration that would intensify as a result of the exigencies of total war. In the immediate aftermath of that prolonged conflict, conditions had degenerated to such a parlous state that a number of outside observers compared America's asylums to Nazi death camps.

Maternal mortality remains a cause of legitimate concern in developing parts of the world where rates often exceed 650 per 100,000 live births—at least twenty times higher than in the developed world, and appears impervious to all efforts to reduce it. Overwhelming poverty, insufficient health care, and the paucity of well-developed and thoroughly integrated programmes to reduce maternal mortality help ensure that these rates are comparable to, if not actually higher than, those found in some of the most unhealthy European cities and regions of the nineteenth century.

After the passing of the 1902 Midwives Act, a growing proportion of women were delivered by trained and supervised midwives. Standards of midwifery should therefore have improved over the first three decades of the twentieth century, yet nationally this was not reflected in the main outcome measures (stillbirths, early neonatal mortality and maternal death). This paper shows that there was a difference in the risks associated with delivery by the different attendants, with qualified midwives having the best outcome, then bona-fide (untrained) midwives and lastly doctors, even when account is taken of the fact that doctors were called in cases of medical need and may have been booked where a problematic delivery was expected. The paper argues that the lack of improvement in outcome measures could be consistent with improving standards of care among both trained and bona-fide midwives, because increased attention to the rules stipulating when midwives called for medical help meant that a doctor was called into an increasing number of deliveries (including less complicated ones), raising the chance of unnecessary and dangerous interventions.

This special issue uses Catholicism as a thread to bring together five contributions to the transnational history of contraception. The articles, which cover examples from Western and East-Central Europe, East Africa and Latin America, all explore the complex interplay between users and providers of birth control in contexts marked by prevalence of the Catholic religion and/or strong political position of the Catholic Church. In the countries examined here, Brazil, Belgium, Poland, Ireland and Rwanda, Catholicism was the majority religion during the different moments of the long twentieth century the authors of this special issue focus on. Using transnationalism as a perspective to examine the social history of the entanglements between Catholicism and contraception, this special issue seeks to underscore the ways in which individuals and organisations used, adapted and contested local and transnational ideas and debate around family planning. It also examines the role of experts and activist groups in the promotion of family planning, while paying attention to national nuances in Catholic understandings of birth control. The contributions shed light on the motivations behind involvement in birth control activism and expertise, its modus operandi, networking strategies and interactions with men and women demanding contraceptive information and technology. Moreover, through the use of oral history, as well as other print sources such as women’s magazines, this collection of articles seeks to illustrate ‘ordinary’ men and women’s practices in the realm of reproductive health.