The Complicated Birth of Midwifery

By Abby Norman on September 13, 2015

Around 353,000 babies are born every day. Some of them will be born in hospitals, others at home with the assistance of a midwife or doula, while others will make their grand entrance in the back of a car or ambulance somewhere in between home and hospital.

The history of childbirth, and in particular of midwifery, is a complicated and often cyclical one. Throughout 19th century America, midwives attended the majority of births, especially in the American South. Improved medicine and accompanying technologies meant that by the early 20th century, midwifery was highly discouraged, only to come around again when the natural birth movement was born in the 1960s.

In other words, the natural act of childbirth reflected the technological, social and medical beliefs and practices of the time. You can learn a lot about what life was like in a particular time period by examining societal attitudes toward childbirth.

16th Century
Midwives have been around since the beginning of human history. No doubt our caveman ancestors had other female tribe members help hold them up or stagger into a cave long enough to give birth. Even prior to modern language, some human acts require no verbal communication: coitus and childbirth among them.

If we start by looking at a period in history when midwifery became a specified community role, we’d start around 1522. At this point, elder females in communities worldwide ruled the roost when it came to helping younger women deliver babies. Having been licensed and educated in childbirth, midwives were highly respected community members. So much so that when they arrived to aid a laboring woman, it was the mom-to-be’s task to make the midwife feel at home and appreciated, offering her “groaning beer” or special cakes.

Midwife History Medieval
Thus childbirth became a very social event, where women close to the new mom would join the midwife in the home to cluck around, eat cake, drink and maybe lend a hand as the woman struggled. These women had a cute nickname, too: God sibs. Over time, the name morphed into a term you’re probably more familiar with: gossips.

Towards the middle of the century, and after hearing horror stories of childbirth fatalities, a family known as the Chamberlens created a tool that they believed would change the birthing game forever. They created the obstetric tool commonly known as forceps, and they guarded their invention ferociously.

They would often attend births with the tool hidden under their cloaks, blindfolding the mother so that she wouldn’t see it, and bang pots and pans to disguise the sound of the tool (which they feared, if heard, could give away the key to its design). It would be another two hundred years before forceps became widely used, in part because the original prototype would be discovered in the floorboards of the Chamberlens’ house long after the inventors had died.

Midwife History Experiments
The next major renaissance in midwifery and obstetrics came from the Antebellum South. Young doctors practiced suturing techniques on female slaves and often bought slaves specifically with that purpose in mind. Subsequently many common gynecological procedures were developed during this time, most notably the treatment of fistulas, tears that can occur during childbirth and lead to complicated infections if they aren’t repaired.

Victorian England
Across the pond, London’s destitute women were dying in droves of something called “childbed fever”, or puerperal fever. “Lying-in” hospitals, which were also cropping up in many U.S. cities during this time, were almost entirely dedicated to delivering the poorest women’s babies. It’s an interesting corollary to modern times, when giving birth to a baby in the hospital can cost up to $32,000.

As women came into the hospital to give birth—only to die within a week—young doctors were scurrying back and forth between the birthing room and the morgue to suss out why these women had died. Unfortunately, they weren’t washing their hands after conducting the autopsies, and continued to spread the very bacteria that had killed the women on whom they were performing autopsies to the otherwise healthy women in the ward.

Midwife History Crib
Luckily for the women of London, “germ theory” (what we would call bacteriology today) began to take hold in city hospitals, and new medical students were being taught proper hand washing and sterilization techniques. Not surprisingly, as soon as these simple innovations were added to lying-in protocols, the occurrence of childbed fever dropped dramatically.

PR damage had already been done, however, and most upper class Victorian women wouldn’t be caught dead in a hospital to give birth. Queen Victoria herself gave birth at Buckingham Palace—though, not without help. It was she who blew the next winds of change into midwifery in the form of ether.

Twilight Sleep

Midwife History Victoria
Word got out that the Queen herself had made use of ether to ease the pain of childbirth, and many religious figureheads were strongly opposed to it. Pain was the point of birth, because it was the punishment women endured on Eve’s behalf (eating the apple and all that). Queen Victoria thought that was hogwash, and many women followed suit. They began to regularly request not just the use of ether, but cocaine, marijuana and opium.

Obstetricians and occasionally midwives attended births at the homes of middle and upper class women, bringing along their drugs and tools. Given these women’s perceived delicate nature, many worried that if they were not relieved of childbirth pain, their babies would suffer because they would be too exhausted to parent. Thus, it was not the poor, inner city women of the lying-in hospitals who got the ether, but the countesses, duchesses and baronesses.

Midwife History Nurse
The decades wore on and women’s rights—particularly their reproductive rights—became a social focus in a way that they hadn’t been before. In the decades that would follow, women would essentially surrender themselves entirely to the childbirth process. They would kiss their husband goodbye, go into the hospital, be knocked out with a drug cocktail (called scopolamine) and wake up several hours later cleaned up with a pink, sleepy baby in their arms. This was Twilight Sleep.

What the women weren’t aware of, however, was that while they were in this “sleep” they were often strapped to the bed to keep from injuring themselves—or nurses—as they writhed about in agony. It wasn’t uncommon for them to be put in padded pens so that they couldn’t escape during the birth, which was often a problem considering the drug cocktail was known to cause vivid hallucinations. But since women woke up from Twilight Sleep with no memory of the birth, they had no complaints and hailed it as a revolution.

Natural Birth Movement and Lamaze

Natural Birth Figures
Childbirth became largely medicalized during the early to mid 20th century. Women went into the hospital, had their Twilight Sleep, and woke up fresh-faced with a baby in their arms. The baby went home and a woman had the wise words of Dr. Benjamin Spock to guide them in child-rearing. The supportive, female-empowering and maternal community of midwives had been somewhat forgotten—along with the entire childbirth experience, thanks to scopolamine.

As the Gestalt theory of psychology, being more in touch with one’s inner experience, became more prevalent, the idea that a woman should be an active and aware participant in the birth of her child soon followed. This was the basis for Dr. Lamaze’s work, which followed in the footsteps of Russian psychologist, Ivan Pavlov. Remembered largely for his studies with salivating dogs, Pavlovian psychology had one key offering to laboring mothers: the art of mental preparation.

Dr. Lamaze was convinced by the idea of “psychoprophalaxis”: if a woman could convince herself that she was ready to give birth, then she would be. By psychologically conditioning herself for the reality of giving birth, she could manage her pain without drugs. This idea was further ingrained into the minds of women everywhere when Dr. Grantly Dick-Read published his formidable tome, Natural Childbirth, in the 1970s. Dr. Dick-Read promoted the idea that childbirth itself wasn’t painful, women just made it painful by worrying about it.

Yoga Moms
This was the foundation for the Lamaze classes of the ‘80s, which have by contemporary standards almost become a trope: a room full of heavily pregnant women, their birth partners, and a lot of “hee hee hoo hoo” going on. The co-founder of Lamaze, Elizabeth Bing, also taught many of the courses and lauded the technique.

That is, of course, until she had her own children.

In an interview many decades later, Bing admits that she not just requested—but demanded—an epidural and drug relief when she gave birth to her son. Despite decades of debunking the necessity of either to thousands of women, she wasn’t even a little bit sorry.

Modern Times

In today’s world, women have more options than ever before when it comes to having babies on their own terms—at least when it comes to delivery (abortion restrictions in the U.S. continue to abound) and, assuming a woman has health insurance to pay for the costly services. They can choose home births, hospital births, hospital births with a midwife, doulas, water births, planned cesarean sections or, if they’ve had a c-section before, they can opt for a “VBAC” —a vaginal birth after cesarean.

Regardless of what the mother has in her birth plan, one thing has been true about childbirth since the dawn of time: the baby is the one that decides when it’s time to be born.

Abby Norman is an author based in New England. Her memoir FLARE has been acquired by Nation Books (Hachette). Her work has been featured on The Rumpus, Medium, Hippocampus Magazine, The Atlantic, The Mary Sue and The Huffington Post.

From: all-that-is-interesting.com

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Born Southern: Childbirth, Motherhood, and Social Networks in the Old South

By V. Lynn Kennedy

In "Born Southern", V. Lynn Kennedy addresses the pivotal roles of birth and motherhood in slaveholding families and communities in the Old South. She assesses the power structures of race, gender, and class—both in the household and in the public sphere—and how they functioned to construct a distinct antebellum southern society.

Kennedy’s unique approach links the experiences of black and white women, examining how childbirth and motherhood created strong ties to family, community, and region for both. She also moves beyond a simple exploration of birth as a physiological event, examining the social and cultural circumstances surrounding it: family and community support networks, the beliefs and practices of local midwives, and the roles of men as fathers and professionals. The southern household—and the relationships among its members—is the focus of the first part of the book.

Integrating the experiences of all women, black and white, rich and poor, free and enslaved, these narratives suggest the complexities of shared experiences that united women in a common purpose but also divided them according to status. The second part moves the discussion from the private household into the public sphere, exploring how southerners used birth and motherhood to negotiate public, professional, and political identities. Kennedy’s systematic and thoughtful study distinguishes southern approaches to childbirth and motherhood from northern ones, showing how slavery and rural living contributed to a particularly southern experience.

Published by: The Johns Hopkins University Press

From: muse.jhu.edu

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Cesarean Sections

From: historyengine.richmond.edu

On January 29th, 1822, Dr. Ebenezer Basset who was the town physician of Nassau, New York was abruptly interrupted by his medical assistant Jacob Kipp, who notified the doctor of their servant girl who was terribly ill. Braving the cold, Dr. Basset attended to the black servant girl who was lying in the snow with an unusually large cut on her abdomen and right next to her was a razor blade that was covered in blood. Upon further examining the youth of fourteen, Dr. Basset noticed and began to uncover a fetus hidden underneath the snow. Dr. Basset was in complete shock at what he had just witnessed. To his amazement, the youth of fourteen had just conducted a cesarean section on herself. After Dr. Basset recovered from his shock he sent Jacob Kipp to a neighboring town to retrieve Doctors Francis and Beck to help assess the situation.

Upon their arrival to the city of Nassau, Dr. Basset explained to his colleagues what had occurred. The three physicians began to treat the African American servant girl while making detailed notes of the procedure. The physician’s amazement is understandable given that cesarean sections were known about, but not widely used. Even more amazing, the procedure was a self-administered one. How could a black youth of fourteen perform such a complicated procedure on herself?

Historians have always claimed that cesarean sections had been performed by slaves who came from Africa to America. In fact, the first recorded successful cesarean section was performed in Colonial America. There is an account of a doctor in Virginia by the name of Dr. Jesse Bennett who on January 14th, 1794 performed the first cesarean section on his wife with the help and guidance of their slave who was well versed in the procedure of cesarean section. According to author Herbert M. Morais who wrote, The history of the Negro in medicine, African Americans had prior knowledge and used cesarean sections in Africa and brought that knowledge with them to the early colonies of America. Although the procedure was amazing to these white doctors, it would have not been foreign to black females in this era.

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Midwives and the Civil War – Specktown’s Becky Rickert

By Norman Gasbarro, 3-10-11

For a 19th century farmer, having many children was considered a blessing, and boys especially were expected to start working the farm along with their father as soon as they were able.  So, Martin and Betsy set out to have a large family.  Unfortunately for them, their two sons Samuel Rickert (1850-1858) and Henry Rickert (1835-1837) died young – leaving only seven daughters who survived into adulthood.

At the time of the Civil War, five of those daughters had married and several of the husbands were serving in the war.  During the war, four of the daughters gave birth to a total of eight children.  The special responsibility that Betsy had to her daughters was to make sure that they learned the ways and methods of childbirth and that they assumed the responsibility of assisting each other when needed.

The youngest daughter of Martin and Betsy, Hannah Rickert, was born in 1847.  Undoubtedly, her oldest sister Elizabeth Rickert, who was about 18 at the time, was present when her mother gave birth for the last time – as was probably also Susannah Rickert who was 14, and Rebecca “Becky” Rickert, who was only 10.

Rebecca “Becky” Rickert (1837-1918), as previously mentioned, was probably present at the birth of her youngest sister Hannah and was able to assist in some ways at that birth.  During Becky’s early years of life, she suffered from scarlet fever, which left her with some mental incapacity, but not enough that she couldn't continue to assist in the births of her sister’s children and perform tasks in the home that all women were expected to perform.

During the Civil War, she undoubtedly performed the role of midwife or midwife’s assistant at the births of her eight nieces and nephews who were born during the war.

When the mother Betsy Rickert died in 1877, Becky moved in with her sister Hannah and assisted Hannah in the births of her later children.  She became especially attached to Hannah’s oldest daughter Elizabeth “Lizzie” Riegle (1872-1942) to whom she passed on her skills.  It was Lizzie who made midwifery her profession and family oral history confirms that she actually used the title and got paid for her services.

As the 19th century closed, Becky was no longer capable of taking charge in childbirth situations nor was she able to do much more than perform simple household task.  Friends and family members visited her and brought her picture post cards, which she collected, and conversed with her in “Dutch.”  She sat on her rocker, smoked a corn cob pipe, and played with her grand nieces and nephews and other children who came by.  Hannah expressed concern that she would die before Becky and that there would be no one to take care of her.  But that was not true, for if that had happened, Lizzie surely would have kept her and nursed her in her last days.  Becky died about a year before Hannah.

Thus it was that the skills of midwifery were passed down through the generations in Specktown, Lykens Township, Dauphin County, Pennsylvania.  Betsy Rickert and her daughters, especially Becky Rickert, performed this invaluable service during the Civil War.  Lizzie Riegle, who learned the skills from her “Aunt Becky,” made her living by charging families $25 for one months service – two weeks before birth, birth, and two weeks after birth.

Although there were country doctors in the late 19th century and early 20th century in the Lykens valley area, and some women chose to rely on their services, the record will show that there was sufficient demand for women who specialized in assisting with childbirth.  The only training they had received was as “apprentices” to elder sisters or to their mothers who also performed the same services.

Today, midwifery is a specialty branch of medicine and is available for those who choose to not have a medical doctor assist in the birthing process.  According to information found on Wikipedia, use of the term “midwife”, common in ancient times, took a long time to return to common usage and that could explain why the Civil War era women did not use it.  In the 18th century and into the 19th century in America, midwifery was associated with witchcraft, particularly because women who practiced it were seen more as “population controllers” because they disseminated birth control information and also performed abortions.  This was the era when it was important to have as many children as possible and anyone who tinkered with that idea was seen as devilish or as a witch.

Excerpted from: civilwar.gratzpa.org

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19th Century Midwifery

Call The Midwife – An Historical PerspectiveLabels

February 14, 2012 by Come Step Back In Time

The hit tv series,"Call The Midwife", is a real gem in the BBC’s Sunday night viewing schedule and its popularity is supported by viewing figures topping nearly nine million. I am not at all surprised that a second series has just been commissioned.  The series finale is on Sunday 19th February, BBC 1 at 8.30pm. Based on the books by Jennifer Worth (formerly Lee) about her own real life experiences as a newly qualified midwife in London’s East End during the 1950s.  I am currently reading Call The Midwife and will then move on to In The Midst of Life.  There are two further books, Shadows of the Workhouse and Farewell to the East End.  These books are well-written, fascinating, at times heartbreaking and a must-read for anyone with an interest in the history of medicine.  Worth decided to write down her memoirs after reading an article ‘Impressions of a Midwife in Literature’ that appeared in the January edition of Midwives Journal, 1998. The article struck a chord with her, why were, as Coates concluded, midwives virtually non-existent in literature? Worth immediately decided to rectify this and thus her wonderful books and the subsequent television series was born.

The history of midwifery is a complex subject and when conducting research for this article, I discovered that there is definitely a shortage of academic books on this highly skilled branch of nursing.

During the 17th century, City of London midwives had to serve a seven-year apprenticeship before delivering a baby on their own.  Historically, midwives have had a strained relationship with physicians, who would often viewed their practices with suspicion.   Debates surrounding the creation of strict guidelines for the practice of midwifery are often found in contemporary newspapers and medical journals.  In a number of the examples that I found, it struck me just how vulnerable the midwife was at the hands of the law if a delivery went tragically wrong or simply that the midwife was poorly trained in the first place.

In one such example, from an 1845 edition of Provincial Medical and Surgical Journal, a thirty-five year old carpenter’s wife had died soon after giving birth and an inquest was launched into the circumstances surrounding her death.  Her medical history indicated that in two previous pregnancies she had suffered from retention of the after-birth and in her current pregnancy the scenario had occurred once more.  She was attended by a legally qualified practitioner who was an admitted licentiate of the Apothecaries’ Company since 1822.  This was a home birth that took place in a tiny rural English village. Following the woman’s death, the body was examined and found to be missing the entire uterus together with several feet of the large intestine, both of which had been forcibly extracted.  A verdict of manslaughter was put forward by the coroner and the midwife practitioner committed for trial at the next assizes.  This case had highlighted, once again, the need for a regulatory body to be established for all practitioners engaged in midwifery procedures.  A Petition was subsequently put forward to parliament.  The Petition read:

‘That your Petitioners, in the pursuit of their professional duties, have frequently witnessed and deplored the evil consequences ensuing from the indiscriminate practice of Midwifery, not only to themselves, but to society in general, for the want of some adequate legal protection or recognised body to test the competency and qualifications of those who practice in that peculiar department of the medical profession, the existing medical candidates for their diploma as to their obstetric knowledge; and your Petitioners are of opinion that the practice of Midwifery has not hitherto received that degree of attention from the Legislature, or protection from the Government, which is commensurate with its importance.’

In the UK today practicing midwives are governed by strict legislation and guidelines set-out by The Nursing and Midwifery Council which was established in 2002.

Historically, a majority of working class women gave birth at home, if this wasn’t possible then they would be admitted to a ‘Lying-in’ hospital.  The reason for this was often social rather than medical and the most common type of lying-in hospital would have been found in the work-house.  St. Thomas’ Hospital in London had lying-in wards during the fifteenth century and was set-up by a charitable donation by Richard Whittington for unmarried mothers. However, during the eighteenth and nineteenth centuries the number of non-workhouse lying-in hospitals in London was on the increase:

General Lying-In Hospital, York Road, Lambeth.  Originally, opened in 1767 as the Westminster New Lying-In Hospital in Westminster Bridge Road, Lambeth.  Single mothers as well as married women were admitted.  In 1818 it changed its name to the General Lying-In Hospital and moved to York Road, Lambeth in 1828.  The Hospital closed in 1971 but this fine-looking building still exists today.  Florence Nightingale took a particular interest in the Hospital’s midwifery training programme;
Queen Charlotte’s Hospital, Goldhawk Road.  The Hospital opened in 1809, moved to Marylebone Road in 1813 and Goldhawk Road in 1940.  The Hospital admitted both single and married women;
City of London Lying-In Hospital, City Road, Finsbury.  Opened in 1750.  The building was badly bombed in 1940-1. Eventually the Hospital was moved to Hanley Road, Islington and closed in 1983;
British Lying-In Hospital, Endell Street, Holburn.  Opened in 1749 and closed in 1913.  Only married women were admitted;
New General Lying-in Hospital, Oxford Road, near Hanover Square.  Opened in 1767 under the name Queen’s Hospital.  It moved to Store Street near Tottenham Court Road, where patients did include single women.  The Hospital closed in 1800.
These hospitals were predominantly intended for the “wives of poor industrious tradesmen or distressed House-keepers and the wives of soldiers and sailors”.  London teaching hospitals did not admit women for childbirth before the late nineteenth century.  Medical students and staff sometimes delivered women in their own homes.

In the 18th century, male surgeons would often intervene in the delivery process and a new group of medical men emerged, men-midwives or ‘accoucheurs’. Developments in obstetrical instrument design helped to improve the chances of a successful labour, particularly for those women whose babies lay in different positions in the birth canal.  Pain relief options for women were limited and included, opium, brandy and after 1847, chloroform. The pioneer of the use of chloroform in childbirth was Sir James Simpson.  Ergotamine was also given to women to stem the flow of blood.

Florence Nightingale (1820-1910) is an important figure in the history of midwifery and pressed for midwifery as a career for educated women.  She established a training school for midwives in King’s College Hospital at the end of 1861.  A fully-equipped maternity ward was set-up at the Hospital and the physician accoucheurs agreed to give six months’ training to the midwives.  The midwives were trained to work in hospitals and also to deliver women in their own homes.  The tuition was provided for free but the students had to pay for their own board and lodging.  However, after just 2 years the scheme suffered a devastating blow – an outbreak of Puerperal Sepsis in the lying-in wards, following the delivery of a woman suffering from Erysipelas.   This event forced the training programme to be shut down.  Florence Nightingale was devastated and she immediately launched an investigation into the incident, writing to numerous physicians to seek opinion and advice.  She wanted to establish a set of reliable statistics of mortality in childbirth for women who gave birth in the lying-in wards.  She soon discovered that this information would be extremely difficult to come by.  The medical profession viewed her ‘interference’ with suspicion and many would not co-operate with her repeated requests for data.  However, Florence was not of the disposition to give-up easily and eventually, with the help of Dr John Sutherland (of the Sanitary Commission), was able to publish a slim volume of her findings in 1871, titled, Introductory Notes on Lying-in Institutions.  She calculated that the death rate for women giving birth in the lying-in institutions was 33.3 per thousand and the rate for home births was 5.1 per thousand.  The conclusion was drawn that death in institutions was due to the prevalence of Puerperal fever, an infection caused by insanitary conditions.  Florence advocated smaller hospitals, individual rooms for delivery, scrupulous cleanliness, shorter stays in hospital and banning medical students from attending births immediately after visiting the dissection room, which was common practice at the time. She believed that in taking these measures the huge morbidity figures could be drastically reduced.

Puerperal Sepsis, or childbed fever as it is often referred to, has claimed the lives of many women over the centuries, including a number of famous individuals such as Henry VIII’s wives Jane Seymour and Katherine Parr, Mrs Isabella Beeton and Mary Shelley’s mother Mary Wollstonecraft.  The disease is a iatrogenic disease, caused by doctors and remained a common cause of death in childbirth until the early part of the 20th century. Infectious organisms on the hands of the birth attendants are transferred to the woman’s uterus.  The most common organism is  Streptococcus, the virulent beta-haemolytic (group A).  The disease usually begins on the third day after delivery.  Typical symptoms include: high temperature; severe headache; raised pulse; severe abdominal pain; vomiting and diarrhoea.  Death occurs when the infection spreads, resulting in peritonitis and septicaemia.

Obstetric forceps first appeared in the 17th century and many of the instruments were named after the obstetrician who invented them.  In each set of delivery instruments there would be two or three forceps, often with ebony or ivory handles, perforators, cranioclasts and decapitation hooks.  When there was no safe way of delivering a live baby, the delivery was obstructed and the mother’s life hung in the balance, gruesome measures were resorted to.  The perforators were used to open the baby’s skull, then the cranioclasts were brought in to crush it and finally the hooks were employed to remove the deceased infant in parts. The vectis, half a forcep, was a popular delivery instrument during the nineteenth century.  The vectis was used to manoeuvre the foetus into the normal position for child-birth.  Technically it converted the impassable brow or shoulder positions to the normal vertex (top of the head) presentation.

Caesarean Section is now a much practiced form of delivery in the UK, with nearly 163,000 procedures performed in 2010-11. Caesarean delivery dates back to ancient times with Egyptian and Roman law sanctioning its use after the mother’s death in order to allow the infant a chance to survive. In medieval Christian times it was believed by some that those infants that survived such a procedure were in possession of great strength and special powers.  Although many medieval Christians also viewed this practice with suspicion and as an ‘unnatural’ birth.  In the Renaissance, midwives were brought in to perform post-mortem caesareans. The first successful caesarean on a live woman took place in 1500. In the eighteenth and nineteenth centuries there were even reports of women performing the operation upon themselves.  A midwife called Mary Donelly was the first to perform a successful caesarean operation in Ireland in 1738.  Although popular, the caesarean remained a rare procedure until the late nineteenth century.  Eduardo Porro (1842-1902) was an Italian obstetrician who pioneered a technique to minimize haemorrhage and sepsis risks in caesarean operations by removing the mother’s uterus at the same time. During the 1950s, when Jennifer Worth was practising as a midwife, the caesarean section rate was 3%.  Today the rate is approximately 25%.

In 1928, Sister Mary Laetitia Flieger, R.N. published a report in The American Journal of Nursing on current midwifery practices in the UK.  She reports that pregnant women were instructed to take care of their breasts by washing them with hot and cold water, morning and evening, then rub the nipples with a rough towel.  In the last month women were told to clean the nipples with soap and water using a soft nail brush.  Sister Flieger reported that diet was taken seriously by the British midwives, who suggested that no red meat should be allowed during the last month and only a little chicken and rabbit, together with plenty of fish should be consumed.  Once labour had commenced, unless it was to be a breech delivery, a forceful enema would be given.  She also mentioned that The Central Midwives’ Board (the then governing body for UK midwives) recommended that the number of intimate examinations given to the women should be limited in order to avoid the dangers of sepsis.  It is interesting to note that by the 1920s the practice of infection prevention is taken seriously. Thanks must go to the hard work and research that Florence Nightingale conducted nearly seventy years previously.  Flieger also reported on the delivery style in the UK for a non-breech delivery.  The woman should lie on her left side and an assistant raise the woman’s leg to affect delivery.  If there is a pendulous abdomen, breech delivery or forceps delivery then the women is delivered on her back.  During the puerperium (lying-in period) the woman’s perineum is swabbed about five times a day with a weak solution of iodine or lysol under thoroughly aseptic conditions.  She also gives UK childbirth mortality rates for the mother in 1928 as being approximately 3,000 deaths in relation to 800,000 babies being born.

IMAGE: 19th obstetric instruments. Vectis forceps shown on the left. The Old Operating Theatre Museum, London.

FROM: comestepbackintime.wordpress.com

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African American Midwives

From: legacymuseum.org

Throughout the nineteenth century and until the 1950s, African American midwives delivered nearly all black babies and many white ones. Before the Civil War every plantation had at least one midwife.

Midwives used their own birth experiences, medical knowledge, herbal remedies, patent medicines, and ritual incantations. They also drew on spiritual help from God. They believed they had received a spiritual call and were said to have “the gift” and to possess “mother wit.”

In 1913, Dr. Walter A. Plecker, Virginia’s first registrar of vital statistics, blamed midwives for a maternal death rate that was three times as high for African American as for white women. Plecker led the state bureaucracy in a public health campaign that eventually wiped out midwifery. In 1912 there were 9,500 midwives in Virginia; in 1950 only 1,500 had permits. By the end of the 1950s, African American midwives had nearly disappeared.

IMAGE: Margaret Jones, Lynchburg Midwife

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Margaret Jones, Lynchburg Midwife (1823-1904)

From: legacymuseum.org

Margaret Jones, born a slave, was owned by John Hollins of Hollins Mill. Later a midwife in Lynchburg, Mrs. Jones was “a woman of the highest respectability, loved and honored by all who knew her, both white and colored.”

The craft of midwifery was often passed down in families, with young women apprenticed to older ones. Besides helping pregnant women give birth, midwives made sure that new mothers rested in bed in a darkened room for ten days to two weeks. New mothers were not allowed to wash their hair, go out of doors too soon, or eat anything that might slow down the healing process.

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