North Carolina Nursing History

In all times and across all cultures people have sought to limit the size of their families with varying degrees of success.  In ancient Egypt condoms were made from animal intestines and spermicides were prepared by combining crocodile dung and fermented dough.  In 19^th century America, women used a variety of homemade teas, douches, and ointments to prevent and/or terminate unwanted pregnancies. These remedies included butters and oils mixed with quinine or Lysol inserted in the vagina before sex.  Despite these measures, unplanned pregnancies occurred.  Deaths and disabilities resulted from unsafe contraceptive practices, unsanitary home deliveries and numerous pregnancies too close together to give the mother a chance to sufficiently recover her health. In the early 20^th century, appalled by high maternal mortality rates, birth control advocates led by nurses Emma Goldman and Margaret Sanger brought family planning into the modern era. 

 Their efforts came to North Carolina with the assistance of Dr. Clarence Gamble, the medical director of Sanger’s Planned Parenthood organization.  An heir of the Proctor and Gamble company fortune, he wanted to create a simple, reliable, inexpensive, and easily available means of contraception which would become a profitable new product for his company.

Gamble approached the North Carolina State Board of Health with an offer too good to refuse.  He proposed to cover the costs of contraceptives (condoms, and spermicidal foams and jellies) and the salary of a “consultant nurse” if the state instituted a family planning program through its local health departments. He insisted the nurse would be Frances Pratt, RN, whose job would be “to canvass North Carolina in the interest of poor, prolific mothers and babies destined to be born in poverty and disease”. (The News and Observer Tue, Jan 18, 1938 ·Page 4).

Frances Roberta Pratt was born on May 18, 1890, the 8^th of eleven children.  After graduating from the NC College for Women now (now UNC-G) she taught school to save enough money to realize her dream of becoming a nurse.  In 1923 she graduated from the Roosevelt and Sloan Hospital School of Nursing in New York City and returned to Raleigh for advanced training in public health nursing with the State Department of Health.  After several years specializing in maternal/child health programs, the State Board of Health reported in 1937:

On March 15, 1937, Miss Frances R. Pratt, a specially trained nurse under the auspices of the State Maternal health league, joined the sub staff of the Division of Preventive Medicine. Miss Pratt’s work was financed by an individual contribution from an outside agency. Her work has been to organize through the medical profession and the local health officers on a voluntary basis, a system of contraceptive control work when based on medical needs. Her work has been successful and has been a welcome and needed addition to the staff work.

When the program was launched, there were three private birth control clinics in the state; within 5 years, there were 56, almost all publicly funded. By mid-1939 the number of birth control clinics in North Carolina had risen to 62, second only to New York.  In the early 1940s, with less than 3% of the country’s population, North Carolina had 13% of the nation’s birth control clinics.  Pratt worked tirelessly from Murphy to Manteo, spreading the gospel of healthier mothers and babies through family planning. She spoke to local, state and national audiences about her work and authored and co-authored articles in the American Journal of Public Health in 1940 and 1941 detailing the contraceptive program in North Carolina.

Over the last 90 years, state family planning programs have grown from one nurse and 9 clinics in 1937, to every health department in the state offering multiple methods of family planning and serving hundred of thousands of people.  Frances Pratt led the family planning nursing program until her retirement.  She died in Kinston in 1975.