By Deena Blumenfeld
This is the third in a series of historical fiction birth stories. The people are fictitious, but their experiences are common for the time period. The series will continue until we reach the end of the 20th century. The last post looked at birth in the 1920s. Today we hear from the perspective of a labor and delivery nurse at one of the most famous maternity hospitals, the Chicago Lying-in hospital. It is a fictitious account with historically accurate details.
Jan 20, 1937
I do wonder, sometimes, if we are actually improving childbirth for our patients. My nursing training and four years of working at the Chicago Lying-in hospital under Dr. Joseph DeLee, has given me a great appreciation for modern medicine. We take the utmost care to provide a healthy and safe experience for the mothers who come through the doors of our great hospital.
Our rates of purpureal fever are reduced since we have all been required to wash our hands before and after we treat patients. Yet, we still lose mothers to this childbed fever every week. This bright, white sterile environment is much healthier for mothers than giving birth in their own beds where we cannot sterilize everything. I am grateful to see more and more mothers coming through our doors every month so we may deliver their babies safely.
We follow the strictest procedures for the mothers and babies in our care. Yet, I see too many mothers and babies who are unwell or who do not leave our hospital alive. Our mothers are in large wards, separated by curtains as they labor and for recovery. If there is a flu, or other disease, they will contract the illness in large numbers. The newborn babies do not tolerate these diseases well either.
On the other hand, our technological devices have advanced labor for women. Yesterday, a mother came in to our hospital very heavy with child. As we have never assessed this mother before, we were unsure of her prenatal history or how far into her pregnancy she was. Most mothers receive no prenatal observation. We usually see them when they present in labor.
This mother, upon manual palpation and fundal height measurement, appeared to us to be well over due at 42 or 43 weeks gestation. She was swollen and presented symptoms of early toxemia. With internal examination, she was not dilated at all. The pinard revealed that baby’s heart tones were reassuring and that baby was vertex. Dr. Williams determined that this mother needed to have her labor induced to prevent further decline in her health.
I prepped her with the usual shave and enema and draped her with the appropriate sheets to preserve her dignity. Once she was in her bed on the ward, Dr. Williams brought in the new balloon catheter. He inserted it into the patient’s cervix. I held her shoulders, so she would be still. I could feel her discomfort, though she tried to hide it. Over a period of time, the balloon catheter did its job beautifully and the patient was dilated to 3 cm. Her labor pains had begun as well, though they were still mild and wide apart in their timing.
The patient was wanting to get up and out of bed, so my management of her became more stern. She is not allowed to be up and moving. Staying in bed is required in hospital. As time progressed, she became more resistant to our rules and was needing active restraint to keep her abed. Dr. Williams called for the Twilight Sleep to be administered to keep her calm, quiet and under control. Once she was sedated, I was able to sort out her bed and listen to the baby occasionally.
Upon her cervix reaching a complete dilation, some hours later, I wheeled her into the delivery room. She had an uneventful delivery. I trussed her legs up in stirrups, she was given an episiotomy and baby was pulled forth as a midforceps delivery.
Once mother had revived from her Twilight Sleep, her blood pressure was normal and her swelling resolved. She was saved from her toxemia with steady use of obstetrical technology. Without the balloon catheter induction and the forceps delivery she may have become fully toxemic. I am grateful for Dr. Williams skills in saving this mother and child.
As I do not work in the postpartum ward, I will not see this mother again. I do hope she and the child fare well.
It is important to note that during the 1930s about 35% of all births took place in hospital. The new, modern obstetrical practices were being pioneered by DeLee and his colleagues were more often about promoting the primacy of the physician, with less regard to the well-being of the mother. For more on this, please visit silentmother.com.
Deena Blumenfeld ERYT, RPYT, LCCE, FACCE is the maven behind Shining Light Prenatal Education. She has been working with women since 2008 as a prenatal yoga instructor, doula, childbirth educator and teacher of teachers. She specializes in women’s health for all phases of reproduction: fertility, pregnancy, childbirth, postpartum and pelvic floor health. Her two children put her on her path to serving other women throughout their childbearing years. She can be reached through her websites, shininglightprenatal.com and silentmother.com
- A Reclamation of Childbirth https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1595162/
- The History of Midwifery and Childbirth in America: A Time Line https://www.midwiferytoday.com/articles/timeline.asp
- Birthing Practices, Encyclopedia of Chicago http://www.encyclopedia.chicagohistory.org/pages/139.html
- Joseph DeLee https://en.wikipedia.org/wiki/Joseph_DeLee
- The History of Chicago Lying-in Hospital http://chicagolyinginboard.uchicago.edu/clihistory.html
- Balloon Dilators for Labor Induction: a Historical Review https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3885146/
- Forceps in Childbirth https://en.wikipedia.org/wiki/Forceps_in_childbirth