Section on Midwifery ~ Am Assoc. for the Study & Prevention of Infant Mortality ~ 1912

by faithgibson on September 22, 2012

American Association for Study and Prevention of Infant Mortality
Transactions of the Third Annual Meeting
Cleveland, Ohio October, 2-5, 1912
pages 219-221

Friday, October 4, 11 A. M.

MARY SHERWOOD, M. D., Baltimore


From the time of Eve one sex has been singled out to play the most important role in the continuation of the raceā€”the charge of the impregnated ovum, its nutrition and its delivery into the world as a completed entity. The failure to perform this high biological function may be due to various mechanical causes, or to failure in the application of the known laws of asepsis and anti-asepsis, or to failure to recognize certain general conditions which imperil the life of the mother or the child. The expectant mother has need of guidance by those who are qualified to apply the facts of science to the condition of pregnancy, she needs to be surrounded in childbirth by such conditions and such scientific care as will bring confinement to a successful issue, she needs such instruction as will enable her to give the child the right start in life. The mother needs care, therefore, before, during and after childbirth. This need is as old as the race, and will be as unceasing as the perpetuity of the race.

This is the section on Midwifery in its broad sense, not the section on Midwives. Its purpose is to determine to what extent present methods of obstetrical practice in America are a factor in preventable infant mortality and what reforms are necessary in order to insure to every infant the right to be well born.

Last year’s discussion in this section showed plainly the inadequate preparation of many physicians for the practice of obstetrics. The responsibility for the deaths of infants which are due to bad obstetrics must be shared by physicians, midwives and the general public which permits present conditions to continue.

The program of today consists of a discussion of maternity hospitals and their out-patient services, obstetrical dispensaries and other agencies which in many large cities give adequate care to women in confinement. It is believed that the extension of such agencies would gradually eliminate the ignorant midwife from the practice of obstetrics. Two papers will be presented and a free discussion will follow.

Several important studies of midwifery conditions and of substitute agencies in various cities have been made during the year. The Boston Lying-In Hospital and its out-patient service has been reported by Dr. James Lincoln Huntington; Dr. Goler has presented a report of the maternity hospitals of Rochester, New York; Dr. Alice Weld Tallant, a report of the Maternity Hospital of the Women’s Medical College of Pennsylvania and its out-patient service.

Pre-natal Work

Boston Lying-in Hospital. Physician and nurse give instruction as to diet of mothers and preparation for maternal nursing; nurse instructs the mother as to preparation of clothing for baby and bed; monthly examinations of kidneys are made by physician (and oftener if indicated). All primiparae are examined by physicians before delivery, if normal, case is delivered by students. All house cases are delivered by a physician, the majority of out cases are delivered by students under careful supervision. A district nurse visits these cases for ten days or more after delivery. Very effective pre-natal work is done by the Committee on Infant Social Service of the Woman’s Municipal League of Boston, of which Mrs. Wm. Lowell Putnam is chairman.

Philadelphia: No systematic pre-natal work is done by the maternity department of the Woman’s Medical College Hospital. The visiting nurses of the division of Child Hygiene of the Bureau of Health give instruction as to diet of mothers and preparation for maternal nursing. Provision is made for relief from hard work before confinement and advice given as to arrangements for suitable care in confinement. This division was organized in July 1910 and 1500 cases were visited in 1911.

Rochester, N. T.: In Rochester General Hospital, prospective mothers whether or not expecting to be delivered in the hospital may receive pre-natal instruction in the free and outpatient department as to diet, and the condition of the kidneys is watched by the out-patient physician. Pre-natal work is done by one nurse supplied by private philanthropy. In 32 cases, instruction was given as to diet, maternal nursing and preparation of clothing for baby and bed. The condition of the kidneys was watched in all cases. Advice as to selection of hospital and physician was given in eighteen cases. Belief from hard work was secured in one case. Material aid was furnished in twenty-one cases. Fourteen of these patients had previously employed a midwife.

Statistics reported in these studies show an increase in the number of cases attended in the past five years; that the babies are maternally nursed in nearly all the cases attended; that the percentage of mothers and babies discharged well is very high; 487 cases in the Woman’s Medical of Philadelphia without the loss of a single mother; 522 cases in Rochester with only one maternal death. The facts reported indicate that the quality of work done is far superior to the service rendered by the average midwife.

American Association for Study and Prevention of Infant Mortality
Transactions of the Third Annual Meeting
Cleveland, Ohio October, 2-5, 1912
pages 219-221