The Role of Women as Agents and Beneficiaries in the Hungarian Family Planning System (1914–1944)

“Why should hundreds of thousands of women die each year during forbidden and secret surgery and why should hundreds of thousands of children be born into the world without their parents rejoicing in their coming, to be seen as a nuisance, a burden for parents who did not have the courage to help themselves or the knowledge to prevent conception. Is it not the most basic right of a woman to be a mother of her own free will and not the most basic right of a child to rejoice in their coming.” ¹

In the 1932 birth control conference of the Hungarian Social Democratic Party (HSDP), the secretary of the Feminist Association, Melanie Vámbéry, raised inevitable, yet provoking questions on artificial birth control and pregnancy termination. In the pro-natalist public discourse of interwar Hungary, motherhood and childbirth were considered national issues, as the government hoped for prosperity from the growth of the nation. Still, the state showed negligible interest in settling the economic conditions of essential workers connected to pregnancy, childbirth, and infant care. The article outlines the developments in the national concept of family planning with particular reference to the female agents of healthcare and social policy measures from the turn of the century up to 1944. After the lost war and the shattering Treaty of Trianon in 1920, Hungary found itself in a deepening demographic crisis. High infant mortality and criminal abortion rates, the deficiency of graduate midwives, and the one-child system in the south-western part of the country concerned both politicians and intellectuals. The paper aims at connecting the medical, political, and social discourses based on archival and press sources on family planning by analyzing the role and agency of different women's organizations. Furthermore, it highlights the role of medical professionals (doctors, midwives, nurses) intersecting with the role of women as active agents in the execution of social policy measures. By integrating documents on family planning such as journal articles, political speeches, and criminal abortion data into the national and political discourses, the article claims that women have often played contradictory roles in the process of family planning. Midwives and nurses who served as gatekeepers either helped women by providing access to birth control and abortion or complied with the regulations of the pro-natalist state, depriving women of choice.

Agents and Discourses

Until its dissolution in 1918, Hungary was part of the Austro-Hungarian Monarchy, and therefore adapted to the Austrian policies, however, the country adhered to different paths with regard to internal affairs. In the multiethnic Carpathian Basin, the Hungarian state followed the policy of Magyarization: the assimilation of ethnic minorities into the Hungarian nation was part of the nation-building process and represented the national hegemony in the 19^th and early 20^th centuries. And the idea of a prosperous nation required the quantitative growth of the population. At the turn of the century, flourishing civil life characterized the two capitals of the Monarchy: numerous associations and organizations came into being in Budapest, based on the structure of those of Vienna. Women's associations of that time were either profession-based (midwives and nurses) or ideology-based (conservative or feminist) organizations. ² The article will elaborate on the role and agency of three profession-based Hungarian women's organization: the Hungarian Midwife Association (Magyar Bába-Egyesület; 1894–1944), the National Stefánia Association (Országos Stefánia Szövetség; 1915–1940), and the Green Cross Health Protection Service (Zöldkeresztes Egészségvédelmi Szolgálat; 1927–1945). Furthermore, it aims at displaying the process of the disintegration of traditional midwifery by examining the expansion of the nurse system and its connections to the political elite of the Horthy regime. The gradual extension of medicalization and the hegemony of the hygiene discourse during the first half of the century, on the one hand, included the repression of home births, therefore more and more midwives became employees of medical institutions, while on the other hand, certain tasks, which were associated with traditional midwifery (healing, postpartum care), became the state-supported responsibilities of the newly introduced nurse system.

The general mobilization of women can be traced back, on the one hand, to the first wave of feminism and the professionalization of specific female occupations and, on the other hand, to Christian charity and social work. The complex social and healthcare crisis of the turn of the century considered both the situation of rural Hungary and the conditions on the outskirts of Budapest. Added to this, the overwhelming consequences of WWI strengthened the two main discursive frames in which motherhood and family planning had been characterized: the maternal framework and the national hygiene discourse. From the 1920s on, the medical and political discourses intersected with racial hygiene, population, and public health policy. Childbirth and mother and child protection became targets of political aspirations concerning the idea of the healthy marriage and the productive Hungarian family. The fight against infant mortality, venereal diseases, and criminal abortions were framed in the political discourse as national and ideological issues. ³ Midwives and nurses found themselves at the forefront of the medical discourse on national prosperity as the most important state-employed figures of pregnancy and childbirth. The eugenic and hygienic national discourses built on their role and labor, which were depicted as essential and patriotic efforts.

Eugenics emerged as a public health issue at the beginning of the century, and was popular among both Social Democrats and Conservatives, but even among feminists, as it intertwined with the improvement of the social order, and thus the liberation of workers and the emancipation of women. ⁴ Hygiene as a concept led, on the one hand, to the expansion of the public health system, and therefore the improvement of people's physical well-being, but, on the other hand, became a tool for biopolitical and racial exclusion. Medicalization and the tightening control over female reproduction also had controversial effects. Many women actually benefited from the institutionalization of childbirth, the provision of social services, and also from the partial decriminalization of abortion and the neo-Malthusian ideas of birth control. ⁵ At the same time, these developments had different effects on midwives and nurses, depending on their workplace and level of qualification.

Triggering Mother and Child Protection: The “Midwife-Case”

To understand the changes in the Hungarian family planning system, we need to underline the social factors that had shaped rural society from the middle of the nineteenth century. In traditional peasant communities, children had been regarded as a labor force: the well-being and prosperity of a family depended on the number of children. This social order was challenged by the transformation of rural areas: the large estate system did not allow peasant families to extend their land and, consequently, families started to become impoverished, thus children were no longer considered a sign of prosperity, but rather as a burden. Accordingly, birth control emerged as a solution to existential problems. ⁶

The Austro-Hungarian Monarchy was a multi-ethnic, multi-language state, where the Hungarian political aspirations regarding nation-building intersected with the efforts of medical professionals to save the nation from its own annihilation. Midwifery has become the focus of controversy: the lack of university-trained midwives invoked a crisis, based on which physicians were given the power to take control over female reproduction. By the last decades of the nineteenth century, high infant and maternal mortality emerged as a severe problem in the country, primarily due to the backwardness of rural areas. Therefore, the demographic situation became a focus of the national discourse. The issue was connected to the lack of qualified midwives; the situation of illegitimate children, unmarried mothers, and orphans; the problems of wet-nurses; illegal abortion and the one-child system. These social, political, and healthcare concerns were framed in the political discourse as the “midwife-case.” The case itself dates back to the 1876 Public Health Act, which ordered mostly illiterate, unqualified practicing midwives to acquire a university degree. ⁷ However, this was far from manageable, and ignored the realities of rural public health conditions. ⁸

Vilmos Tauffer (1851–1934), a renowned obstetrician of the time, started to investigate the causes of maternal and infant mortality and systematically collected data based on midwife diaries and gynecologist reports in the 1880s. According to his findings, the greatest challenge appeared to be the presence of peasant midwives (mostly elderly women without any qualification or license) in the countryside, many of whom were illiterate and had never heard of antiseptic measures. ⁹ These older women were identified with quacks and “angel-makers” in the press, making their living from illegal abortions. Tauffer thus proposed the introduction of second-rate midwife training (6 weeks), where elementary anatomic and antiseptic facts were taught as an immediate step to reduce the terrific death rates. ¹⁰ Gynecologists debated the issue, which was a turning point in the “midwife-case” considering state-provided education. The main opponent of second-rate training was Gusztáv Dirner (1855–1912), another highly recognized gynecologist and women's rights advocate, who wished to turn midwifery into a prestigious profession and perceived the low-level qualification as an offence towards intelligent midwives. ¹¹ The government favored Tauffer's solution and, in 1900, entrusted him with the task of developing midwifery training, assigning him the authority of a government commissioner. ¹²

The “midwife-case” interconnected with the one-child system (egyke) in the public discourse. Families with only one child lived in the south-western part of Hungary (Baranya, Somogy, and Tolna County), primarily in Ormánság and Sárköz, where the majority of the population was of German origin and belonged to the Protestant church. Consequently, the question had ethnic and denominational aspects as well, however, the main reasons for egyke were to be found not only in Protestant visions on reproduction but in the deprived economic status of the population and the aspirations for a higher standard of living. As having only one child became widespread in certain communities, families (especially women) who did not follow this reproductive model were considered immoral. ¹³ Midwives were perceived as sources of the problem in the public for selling contraceptives (condoms, discs or rags soaked in alum, camphor, or vinegar) and offering criminal abortions as a solution to women. ¹⁴

As for the unresolved situation of midwives, the protection of their interests was needed. In June 1894, Gusztáv Dirner the head of the Budapest Midwife Training Centre established the Hungarian Midwife Association as the second profession-based women's association in Hungary. Its main aim was to unite the university-trained midwives to protect their interests, fight for better wages and state-guaranteed pensions, and also to allow for the exchange of experiences. As midwives were the employees of the county, salaries were determined by the county administrations, who offered different levels of pay. Consequently, they were not entitled to retirement, though civil and religious charity organizations offered help for elderly midwives. ¹⁵ The Association was organized based on German and Austrian models, therefore the Hungarian journal Midwife-Guide (Bába-Kalauz; 1894–1938) also followed the structure of the Austrian Hebamme Zeitung and the German Allgemeinen Deutsche Hebamme Zeitung. The journal also functioned as a forum, where graduate midwives could exchange their experiences: short case studies from their praxes were presented to help each other with possible solutions in cases of problematic deliveries. ¹⁶ Although midwives and later nurses had their own journal, which opened up a forum for exchanging ideas, it can be assumed that their relative influence could have been negligible in the public discourse and, consequently, their political agency is questionable. Editorials and key articles had been written by male gynecologists, leaving the “trivialities” for women. Notwithstanding, at local levels, midwives undoubtedly had an impact on mothers and their family planning choices—leaving very few sources behind. A possible explanation for this may be that, due to the nature of the profession (constant readiness, physical exhaustion), midwives could not be engaged in intellectual lobbying work. Even highly qualified midwives, who could have a greater impact on the policy-making processes simply did not have the time or space to participate in the debates en masse.

The “midwife-case” underlined the deprived conditions of Hungarian rural areas and was pictured as a clash between the East and the West. ¹⁷ Still, the demand for high standard education similar to that of Western-Europe could not be realized given Eastern-European circumstances. Even well-trained, leading gynecologists failed to understand that people's mentality could not be fundamentally changed by a six-month-long university course. Elderly midwives insisted on their beliefs and customs, and the village community expected them to follow the traditions, including dangerous or unhygienic practices during childbirth or ineffective birth control devices. ¹⁸

The Struggle for Control Over Reproduction: The Expansion of the Nurse System

With the advancement of university midwife education, professionalization was accompanied by the fragmentation of traditional midwife tasks. This Janus-faced progress made it possible to isolate the responsibilities of midwives, mother and infant visiting nurses and healthcare nurses, and thus the development of independent vocational training. During the early stages of differentiation, separate training was given to professional, general health and specialized nurses. The disciplines were merged or separated according to the state-defined role of nurses: the emphasis shifted from social care to healthcare. The transition and exclusion from certain duties led to conflicts not only between the state and nurses, but also between nurses and midwives.

The appearance of nurse associations is habitually linked exclusively to WWI, however, as argued above, several factors contributed to maternal protection as a national issue. Nonetheless, the war did generate unprecedented conditions: women's work in the hinterland became essential, thus widening their scope of socially accepted roles. József Madzsar (1876–1940), a leftist physician, published a transnational report on infant mortality and maternity protection work, in which he claimed that the Hungarian infant mortality rate (21.2%) was the third highest in Europe, hence, to “prevent the gradual destruction of the nation's body” effective work should be completed. ¹⁹ As a consequence, the National Stefánia Association (Országos Stefánia Szövetség) was established in June 1915, with the aim of organizing and providing maternal and infant protection throughout the country. Although the leadership was made up of men, numerous women were appointed co-directors, like Mrs. Sándor Teleki (née. Júlia Kende), a famous feminist writer known as “Szikra.” The Association operated maternity homes and milk outlets, and set up regional centers to organize maternal and infant protection. ²⁰ In war-time public discourse their efforts have been considered a national service, as safety of women as mothers became a national cause. Thus, several female aristocrats joined the Association to provide charity to mothers in need as a patriotic act equated to men's military sacrifices. The most famous of them was countess Franciska Apponyi (Mrs. László Károlyi) the founder of the Municipal Assistance and Welfare Committee in Fót (Pest County), where she established the first maternal and child welfare institution. ²¹

As fears of national obliteration were fueled by war losses and lowering birth rates, the government realized it had to take action. With the 135.840/1917 circular decree, the Ministry of the Interior declared the organization of maternal and infant protection a national responsibility and placed it under the authority of the Stefánia Association. ²² Their office network was expanded, with the aim for it to be present in larger cities and towns countrywide. Furthermore, Stefánia also had extensive publishing activity: as the coordinator of specific nurse trainings, they issued the first official nurse textbook, The Leading Thread of Maternal and Infant Protection Nurses (1917). ²³ Information sheets, facsimile guides, and postcards were also distributed, as well as an annual booklet entitled Hungarian Mothers’ Calendar (Magyar Anyák Naptára; 1922–1941). Their journal Maternal and Infant Protection (Anya- és Csecsemővédelem) was published monthly between 1928 and 1941. Illustrations and narratives were framed within the nationalist and maternal discourse: children were pictured as gifts, saviors of the deprived nation. The symbol of the Association was a breastfeeding woman and an infant, with the slogan: “Hungarian mothers, you can make Hungary great!”

In the public discourse the questions of child protection intersected with feminist aspirations on women's right to vote. Irma Szirmai (née. Reinitz; 1867–1958) head of the Feminist Association's Child Protection Board claimed that emancipation of women is inseparable from the well-being of mothers, and thus the better living conditions of children. She imagined a country:

in which the child will be the most valuable treasure of the nation, and in which the woman will count as a person, who no longer drudges like a slave nor idles as a puppet, but works as a maintainer of herself and her children; who no longer earns her living only in the worst paid trajectories, but, developed in her individuality and economically independently, needs the help of society and the state only – but then with full right – when her breadwinner work is paused to do more productive state-maintaining work, when she upholds the nation with the blood sacrifice of motherhood. ²⁴

Feminists spoke up against child labor, prostitution, and war, reinforced by pacifist and equalitarian ideas. Szirmai also claimed that exploitation of children is possible for women are deprived of their rights and are therefore unable to protect their children. The pacifist, anti-war concepts were also framed as part of the maternal discourse, stating that women should not bear children to be slaughtered in a war. The Child Protection Board also raised a question that the demographic discourse failed to answer: what kind of life would children have after being born? It shed light on the rarely debated issue of the quality of life and the well-being of women and families. ²⁵

With the appearance of trained home visiting nurses (védőnő), traditional midwifery as a profession began to disintegrate. The Stefánia nurses took over the prenatal and postnatal care tasks, and midwives started to be identified only with childbirth and hospital work. As a consequence, pregnant women had to face dual control: in case of a wanted pregnancy, they gained stronger support and had better access to medical remedies, but, on the other hand, birth control and abortion became harder to access. Meanwhile, family protection, the encouragement of marriage and anti-birth control aspirations were shaped as social-medical (hygienic, eugenic) issues in the national discourse.

Women With New Identities: Working Women and Social Motherhood

The political situation changed after the lost war and its consequences. The Horthy regime was characterized by conservativism, nationalism, and racial protectionism, where the idea of territorial revisionism strengthened the discourse on reproduction as well. However, besides the dominant picture of women as mothers of the nation, the topic of birth control appeared in public discourse. Discussion on reproductive rights intensified with the advancement of gynecology and advancements in women's rights. Apart from public and political disputes, professional debates shaped the birth control discourse, and in many cases firmly connected to them, supported political argumentations. Permissible arguments included the autonomy of women, eugenic reasons, the criminality of rape, and the fear of overpopulation rooted in Neo-Malthusianism. These were mainly echoed by the Social Democrats, who framed birth control and the abortion question as a social issue connected to the unsustainable situation of the working class. ²⁶ Opponents, mainly conservatives, emphasized the protection of the fetus, the criminality of abortion, demographic reasons, and motherhood as the primary role for women. ²⁷ However, the position taken in the abortion issue became a permanent signifier of one's political position only after WWI, when, in the considerably decreased country, the demography discourse was used as a frame for discussing the future of the nation.

In Hungary, during the time of the Great Depression, between 1927 and 1933, several changes concerning birth control contributed to the reorganization of the family planning system. On the one hand, the one-child debate reappeared due to the sociographies published on the demographic situation in rural areas, while the abortion legalization process reached the point of decriminalization. Parallel with these developments, political debates over the structure of the nurse system and the introduction of the renewed large-scale obstetric data collection, the New Obstetric Ordinance took place. ²⁸ While interwar political aspirations, as a response to the overwhelming consequences of WWI, supported the concept of the “traditional family,” professional nurses, university-trained midwives, and gynecologists—together with conservative women's organizations—tried to find answers to evolving questions around birth control.

The control of female reproduction was a political issue, not only a legal and gynecological one. In January 1932, an assembly on birth control was held by the Medical Organization of the HSDP, where physicians, lawyers, writers, and sociologists presented their opinion. The permissive views were based on social arguments such as the deterioration of the family's health, worsening life conditions due to a child's illegitimate status, eugenic arguments, and fear of overpopulation. Several women, both connected to the feminist movement and the Social Democrats, took part in the congress, indicating their political agencies. ²⁹ Dr. Sári Schwarcz, a hospital chief physician declared the capitalist economy and tight state control over reproduction to be the foundation of demographic problems. She also argued for the fundamental right of the feminist agenda, namely women's right to choose: “The legislature deprives a woman of her most basic right, the right to freely make decisions regarding her own body.” ³⁰ This circumstance also proves that women's physical and mental well-being and corporal integrity cannot be exclusively associated with the second wave of feminism. Melanie Vámbéry (1882–1944), secretary of the Feminist Association, was an advocate of birth control. Her speech emphasized unemployment and extreme poverty as severe social problems, and that the introduction of effective and legal birth control would therefore result in a healthier society. Vámbéry unmistakably opposed the criminalization of abortion, however the question divided feminists and politicians as well. ³¹ As for Anna Kéthly (1889–1976), the second female Member of Parliament, the three ideologies obstructing artificial birth control were capitalism, militarism, and chauvinist nationalism. Kéthly stressed the economic vulnerability of women and children, and also the importance of sexual education and prevention. ³²

Education, conscientious medical advice accessible to all women, explanation of the use of birth control tools in appropriate institutions and hospitals: this is needed. The intervention [abortion] – if the necessary measures have been taken to describe the prevention procedure – should be carried out only in cases where social and hygienic indications can be well justified. ³³

Accordingly, besides women employed in the public health system, intellectuals (politicians, doctors, activists) also influenced the birth control discourse, on a different level. However, in the post-Trianon period, the agency of feminists connected to the liberal elite of the pre-war era weakened, therefore that of conservative women's organizations intensified. They nominally rejected feminism and opposed birth control, as they interpreted female roles primarily within the maternal context, but also fought for certain forms of female emancipation. The National Association of Hungarian Women, the most influential women's organization of interwar Hungary, conducted child protection activities based on their concept of “social motherhood.” ³⁴ According to the non-normative approach, contemporary women's organizations discussed women's responsibilities in the national and the maternal frameworks: motherhood and related public participation (such as social care work) were seen as a political issue that shaped their agency on a discursive level and equipped women with a new identity. ³⁵

Motherhood being determined as a primary, patriotic role for women raised inevitable questions concerning the material conditions of childbirth. From the late 1920s the Midwife Association was managed by Mrs. Ferenc Wimmer and Dr. Frigyes Wiesinger. Wimmer, who was a midwife with a university degree, advocated for state-guaranteed salaries and pensions as midwives’ financial difficulties still had not been resolved.

But what do we achieve with all this if these women with a higher level of education cannot go where they are most needed: the countryside, the villages. They don’t even mind working there, because they are offered a salary of 60 pengős a year, plus 10 kilos of wheat or 4 pengős per birth. If a boy is born, moreover, they receive a loaf of bread. And for this shameful wage, they have to walk 10 to 20 kilometers, even in winter. (…) And of course, there is no question of a pension. A decent apartment in many villages cannot even be given to doctors, let alone to midwives. ³⁶

Her article highlights the unsustainable situation of midwives in the countryside, where the birthrate was highest, and from where the pro-natalist government hoped for prosperity and renewal of the nation. The ambiguity lies in the differences between the family propaganda of interwar Hungary and the governmental actions taken to improve the life-conditions of essential workers for childbirth and infant protection: midwives and nurses. ³⁷

In the meantime, the Midwife Association's office network had been extended throughout the country, mostly in cities, facilitating midwives to fight for their interests. The organization also contributed to the statistics of the new Obstetric Ordinance (új Szülészeti Rendtartás), an initiative of Dr. Tauffer, who had been investigating the causes of infant mortality and the conditions of midwives since 1880. For this novel type of statics, demographic data from the Central Statistical Office, the Stefánia Association and the Midwife Association were collected. Between 1928 and 1930 more than 65,000 midwives’ diaries were inspected so that an overall picture of the obstetric situation in the country could be determined. ³⁸ In 1932, it became mandatory practice to collect well-constructed, comprehensive statistical data on obstetric events. These figures on miscarriage and induced abortion from 1928 to 1956 are more reliable and nuanced than the data of the Hungarian Statistical Office. ³⁹

It can be noted that contradictory political interests framed the abortion and birth control questions in interwar Hungary. While the propaganda encouraged people to have children, midwives continued to suffer from poor working conditions due to a lack of significant state intervention. Midwives at that time had restricted agency, as in the political and public discourses nurses were seen as the main agents of childcare and health protection. The ambitions for a healthy nation intertwined with the idea of “social motherhood,” whereby the reproductive and care work of mothers determined the future of children, and hence the future of the nation.

Soldiers of the Inner Front

In the late 1920s, new figures emerged in the public health administration, who determined its progress up to 1944. Béla Johan (1889–1983), a chief public health expert—also a controversial figure of interwar history, who had connections with the anti-Jewish measures of the 1940s—established the Green Cross Health Protection Service (Zöldkeresztes Egészségvédelmi Szolgálat) in 1927 to provide healthcare and family protection in the villages. ⁴⁰ The activities of the Green Cross nurses focused on complex healthcare, in the spirit of which the new nurse training system was organized, based on the American healthcare model of sample districts. ⁴¹

Due to the expansion of its courses and its centralization efforts, the Green Cross came into conflict with the Stefánia Association, which had enjoyed a state monopoly on nurse training since 1925. ⁴² The main issue appears to have been the two organizations’ different views on social and health policy. Stefánia primarily focused on prevention and social assistance in the infant protection system. In their memorandum of 1930, the leaders of Stefánia Association argued that major causes of death should be eliminated, hence infant mortality required exceptional attention. In contrast, the Green Cross saw the family as the foundation of the protection system, sought to provide general health care, and identified it as a priority for nurses. During the debate, the question of whether those working in care professions should have a medical role or not came to the forefront again. Thus, the social policy concept of the capital-based, liberal elite of the Monarchy clashed with the conservative, centralizing ideas of the Horthy Era. Also, the mother and infant protection system of the Stefánia was identified as a particularly Hungarian one, while that of the Green Cross was built on an American model imported by Béla Johan with the financial support of the Rockefeller Foundation. ⁴³

In 1940, the Stefánia Association became financially unmanageable due to the economic crisis and funding withdrawals, hence it was forced to hand over its network to the Green Cross. As Secretary of State, Béla Johan nationalized public health on January 1, 1941, and reorganized maternal and infant protection by placing it within the remit of the National Institute of Public Health. As part of these measures, the Green Cross nurses acquired state employee status and the National Stefánia Association was abolished in December 1940. The lately formed National Health Protection Association was built on Stefánia's network system, its presidency was taken over by Béla Johan, and the chief patron became the governor Miklós Horthy. The foremost task of the Health Protection Association was the provision of social work: with the help of a girl scouts household service, baby clothing and equipment were offered and distributed to mothers in need. ⁴⁴

Dr. Johan published his comprehensive public health policy program in 1939, which placed special emphasis on village communities. He declared the duties and responsibilities of public health personnel, including the Green Cross nurses and county midwives and also their means of education. Extensive healthcare propaganda was also conducted through radio shows (Healthcare Calendar), information boards, brochures, lectures, and travelling exhibitions. ⁴⁵ Their journal Green Cross (Zöld Kereszt) was published between 1930 and 1944, edited by László Kontra and Margit Mezey. Besides articles, the journal contained practical information, reports, and opened space for discussion: nurses could publish their experiences or ideas to improve the Service. For instance, Margit Halmos discussed the contribution of the Women's Defense Service in the Green Cross milk actions, ⁴⁶ while Mrs. István Matits and Ilona Tomanóczy emphasized the importance of the involvement of girl scouts in maternal and infant protection. ⁴⁷ That is, in the publications of nurse associations the concept of the military and motherhood is entwined, as the work of mothers was seen as a “battle” in the hinterland.

Following an assessment of the situation in rural areas, maternity cradles were made available to mothers of newborns in need. Since peasant women were often not comfortable with nurses and their regulatory activities, from 1935 on, sugar and milk were distributed to those in need as part of the Green Cross actions. If expectant women recurrently participated in examinations and counselling from the third month of the pregnancy, they received half a liter of milk a day and 1 kg of sugar a month. As an expansion of medical control over poor women, the Green Cross Service also offered a fee to breastfeeding women who had extra milk, and distributed breast milk to medically deprived babies. ⁴⁸ It is significant to note that charity in the 1940s was made at the expense of the “Jewish property” (from special food taxes, service obligations, and nationalized sources), which is an example of the intertwining of contemporary social policy with Jewish economic deprivation and racial exclusion. ⁴⁹ For the prevention of hereditary diseases, and for racial and eugenic reasons, compulsory marriage counselling was introduced, where information and advice on birth control could be acquired. ⁵⁰

By the 1930s eugenic views were linked to racism, particularly anti-Semitism. Social policy measures were introduced in the spirit of productivity and the “Judeo-Christian change of guard.” ⁵¹ In the writings of several physicians, the issues of maternal and infant protection slipped into racial protection, a trend that intensified, especially in the 1940s. ⁵² The antecedents of these social policy measures based on racial protection are to be found in Nazi Germany, as Hungarian biopolitical measures and discourses had been connected to the German ones since the Habsburg period. ⁵³ The racial protection measures of the third Jewish law, the Marriage Law of 1941, included a compulsory pre-marital medical examination, a marriage loan, and the prohibition of marriage between Jews and non-Jews. ⁵⁴ The medical part of the law was developed by Béla Johan, Secretary of State for Public Health, to whom the dismissal of doctors and pharmacists of Jewish origin can be linked. ⁵⁵ We must therefore consider that women benefited from racial exclusionary policies in several ways: by making obstetrics, thus reproductive services more accessible, women were able to negotiate on pregnancy terminations and by excluding Jews from certain occupations, they were also able to gain employment. ⁵⁶ However, the lack of medical professionals in the countryside and increased need for birth control made women turn to quacks and unqualified midwives.

Racial protection affected the Roma population as well. Assimilation policies and severe regulatory measures had been applied against the Roma people for centuries, but in the 1940s, as ideas on racial protection dominated the public discourse, the “Gypsy-case” came to the fore of medical debates. ⁵⁷ Irén Beleznay reported her experiences as a home-visiting nurse in the journal Green Cross. In addition to the main accusations considering cleanliness and the great number of children, the following quote clarifies that charity donations were not free at all: the state expected mothers to adopt the official doctrines on hygiene and a healthy way of life, passed on by nurses.

In their crowded, airless, dirty flats, shaggy, sleepy-eyed women and an unwashed, buzzing child-squad welcomes the visitor. The gypsy woman brings her children to the counselling office only to receive free sugar, milk, powder, and infant formula, which she then sells. She refuses to give something in return for donations, grasping the thing she receives, she deserves it, as she has acquired the right to it because of having many children. (…) In terms of their sense of cleanliness, the constant official control has not led to any improvement, various infectious diseases are prevalent among them, and they pose a permanent threat to the population from a moral, health and economic point of view. ⁵⁸

Based on the activity of nurses, we can conclude that their agency was restricted. Both Stefánia and Green Cross nurses were representatives of the state's family protection policy, and therefore officially opposed birth control and promoted the maternal discourse in their journals. While in the Stefánia Association men dominated the public sphere, the Green Cross nurses had more publicity. The opposition between midwives and nurses originated from the division of labor—who could have control over pregnancy, childbirth, and infant care—however, the attitude towards birth control can also be seen as a factor. While midwives had stronger relations with the obstetrician-gynecologist community, nurses were supported by the public health administration.

Conclusion

As argued above, state social policy measures and aid actions of the church and civic organizations and associations principally assigned two types of roles to women. On the one hand, they were active participants and agents, on the other hand, they were passive subjects and beneficiaries of social assistance activities. The division of labor in official bodies was characterized by the fact that, while the management consisted mostly of men, the actions were already carried out by women. This is well exemplified by the structure of the National Social Supervision Authority, which managed the ONCSA, where at the middle management level, among the social supervisors, we can find only three women (Emília Bronts [née. Dominich], Baroness Erzsébet Diószeghy, Dr. Mária Steller), while at the executive level the rate of women was close to 90%. ⁷⁴

Care work was exclusively connected to women as the required capabilities were connected to maternal instinct, derived from the “female principle.” The concept of biological femininity was often shared by women themselves, so motherhood as a primary female role and the idea of ​​a modern, educated, working woman did not appear antagonistic. ⁷⁵ Social care as a concept of female labor thus appears in the practical work of nurses. That is, they conveyed the central authorities’ ideas about women's roles, but they also had their own, albeit limited, room to maneuver in terms of passing on their personal beliefs. However, the disruption of the traditional hierarchy based on marital status was a source of conflict, as most social workers were single, while those cared for were married women. ⁷⁶ These women consequently became instruments of social policy, as the state tried to influence the lives of families through them.

In the 1940s, as war rhetoric intensified, nurses, midwives, social workers, and ultimately mothers began to be depicted as soldiers on the “inner front” with the extension of militarism to the hinterland. ⁷⁷ Since the maternal discourse suggested that the feminine nature of social care can be associated with motherhood, women's alleged or genuine characteristics (e.g., maternal instinct) explained their prominent role at the executive levels of social professions. In the “social motherhood” discourse, women appeared simultaneously in the maternal and national frameworks. ⁷⁸ Nonetheless, we must also note that the general mobilization of women was just the reverse of the rhetoric based on traditional female roles. ⁷⁹ Consequently, while nurses became part of the national discourse and propaganda, we must also note that their role was crucial in the efforts to protect rural families.