July 3, 2011

Article Describing Midwifery In New York, 1915

Because Economic Conditions Demand Her, the Midwife, a Relic of Hygienically Dark Ages, is Being Developed Into a Scientific, Ministering Angel.

New York Times, Thursday, February, 18, 1915

By Jeannette Young Norton

The midwife is here to stay.  Tradition and economic condition have made her a necessity, and the New York Health Department has been forced to recognize her.  Ignorant, dirty, careless, superstition, she may have been in the past, but since the Bureau of Child Hygiene has taken charge of her training, the midwife has become careful, clean and efficient, and midwifery is ranked as a legal and honorable profession.

It was just four years ago that an attempt to better the midwife was initiated with the establishing of the Bellevue Hospital School for Midwives.  Dr. George O'Hanlon, general medican superintendent of Bellevue an Allied Hospitals, was placed in charge.  It has been through Dr. O'Hanlon that many good ideas have been taken from the best schools of the kind in Europe and put into practice here.  He is in sympathy with the profession of midwifery, and believes that the midwife fills a place in the households where she is desired that no physician or nurse could occupy.  And so the midwife is here to stay.

As part of the work of the Child Hygiene Bureau, the midwife situation had to be met and dealt with by Dr. S. Josephine Baker, the department's physician."

Dr. Baker then went on to explain why the midwife was a necessity, and why the physician and the trained nurse could never take her place.

Why She Is a Necessity.
"The duties of the midwife do not end with her attendance at the confinement.  She washes and dresses the baby; preforms all the duties of a nurse to the mother and new-born baby.  Then she puts the home in order, prepares the next meal for the family, attends to the mending, the marketing, and any other immediate need.  She starts the older children off to school, and has lunceon ready for them when they return.  For the next ten days after the new baby arrives, she returns and renders these same services.  Her duties are complex and arduous.  It goes without saying that a physician, or even a trained nurse, could not fill such a position."

And then, too, the midwife's fees for almost two weeks continuous service are no greater than a physician's for a few hours attendance at a birth.  The price ranges from $10 upward, according to the patient's income.

Only one Case of Blindness on Record.
"During the last year there occured in New York City 140,000 births.  Fifty-three thousand of these babies were helped into the world by  midwives," said Dr. Baker.  "The amazing thing is that out of this entire number only one case of blindness was recorded during the entire year.  It speaks well for the midwives.
"During the last four years," Dr. Baker continued, "since the need of control became evident, I have been in intimate touch with the midwife problem, and feel that in its complexity it is not equalled by any other than concerns the whole field of public health work for children; yet New York City, with its greater needs owing to its large foreign population, has solved the problem most completely by the establishment of this school.

"Upon investigation we found that many midwives were unlicensed, were criminally careless in vital points connected with the birth and the care of the mother and baby, and that on many occasions they even neglected to register the birth.  But the worst result of their appalling ignorance was the number of blind babies recorded."

Immediate steps were taken and all women practising midwifery who could be located were searched out and put through a cursory examination.  Those who showed a fair amount of intelligence and ability were licensed and obliged to follow the rules laid down by the Board of Health.  If they continued their practice the license had to be renewed annually.

The Establishment of School.
"This was our first attempt to better the condition," Dr. Baker explained.  "In this manner the Board of Health obtained the power to regulate the practice of midwifery.  Then it was discovered that there was no place in the United States where the midwife could receive proper training.  There are many such schools in Europe, but there were none in this country until the Bellevue Hospital school was established here."

Fifty pupils at the time can be accomodated at the midwife training school.  The present class includes women of seven nationalities, and they range in age from twenty-three to thirty-five years.  They live at the school, recieve their maintenance and training free, but provide their own uniforms and text books, and pay for their personal laundry.  They must know how to read and write in their own language, and must present certificates of health and character before they are admitted to the school.

"The Board of Health has made provision for the midwife who doesn't know what to do when abnormal conditions arise," continued Dr. Baker.  "There are five physicians and eleven nurses at the call of the non-graduate midwife, and the school fo rmidwives provides two physicians and five nurses who ar eat the disposal of the graudates.

"The course of instruction includes the theory of obstetries," Dr. Baker explained.  "It is eminently practical in its nature, and as far as possible is taught by means of actual demonstration.  The pupils are required to be present at eighty births during the course, and each prospective midwife assumes complete responsibility at twenty of these births, under the direction of the house physician.

"During the last year forty midwives completed the course at the training school and recieved their diplomas," said Dr. Baker.  "The course lasts six months.  This year there are already forty pupils enrolled for the first term, so there will dobutless be twice as many graduates as there were last year.  Just now there are eighteen mothers at the school under the pupils' observation."

The New Type of Midwife.
With the coming of a thorough training for midwives the older women in the profession are slowly dropping away.  Not being willing to bow to the regulation imposed by the Board of Health, or perhaps unable to, they have ceased renewing their licenses.  Those who do renew their license belong to the new type who attend public lectures on their work and who fit themselves as best they can to continue their practice.

"In a short time the 40 per cent of expectant mothers who call in a midwife will be cared for by competent experts," declared Dr. Baker.

The status of the midwife is discussed freely by physicians, surgeons and nurses, all of whom claim the birth problem as their own.  But regardless of their arguments, and of the general advance in medical science, and of twilight sleep, the midwife's place in the scheme of things is secure.  She fills too big a niche in the humble home to be replaced, and now that she is becoming trained and efficient her calling is an honorable one.

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