In an attempt to address the high rates of infant mortality, the Sheppard-Towner Act is passed after lobbying from physicians who claim that midwives, a majority of whom are Black, are the cause of the high death rate. Black and Indigenous midwives are framed as "dirty, ignorant," and "backwards," while white male physicians are presented as the "safest" option for helping women through the "pathology" of pregnancy and childbirth.

Funding is given to states to remove birth from the home setting and create a white perinatal workforce, thereby medicalizing the pregnancy and birth process. This will lead to all but ten states passing restrictive midwifery laws.

The act is seen as progressive at the time, and white women suffragettes strongly support it. However, the act is ultimately used to delegitimize Black and Indigenous midwives and birth workers based on their illiteracy and lack of formal certification. As a result, the infrastructure of these birth workers as being central to community care is dismantled.