Exit the Midwives
So, if you were an expectant Duluth mother in 1918, where would you likely have your baby? Perhaps a midwife would assist you, but most likely a doctor would attend the birth at your home. In 1918, the earliest year such numbers seem to be available, 26.1 percent of births (633 in Duluth) occurred in a hospital, 60.9 percent were at home with a physician, and 13 percent were at home with “other person in attendance.” An “other person” was likely a midwife.
More and more doctors encouraged expectant mothers to go to the hospital for the birth. In 1920, 538 babies were born at St. Mary’s, and the hospital planned to dedicate an entire floor of their new addition as a maternity ward. St. Luke’s, meanwhile, was overcrowded. In 1921, the News Tribune reported that “eight patients occupy a room meant to hold just five” and that “one emergency maternity case had to spend the night on a stretcher placed in the corridor.” St. Luke’s helped deliver 343 babies the following year. Overall, by 1922 only 6 percent of Duluth babies were born at home “with other person in attendance,” 50 percent were born at home with a doctor attending, and 44 percent were born at a hospital.
This trend toward hospital births continued quickly in the 1920s. In 1927, the Webber Hospital opened in West Duluth and within 24 hours, three babies were born there. A 1929 Hospital News publication by St. Mary’s hospital proudly stated that 610 babies were born there in the last year and explained that “Not many years ago it was rather uncommon for a mother to go to a hospital for maternity service, but today thousands of babies are born in hospitals and among educated and progressive people hospital maternity service is the usual thing and it is uncommon for such service to be rendered in the homes of these people.” The hospitals offered a fairly antiseptic experience, with doctors and nurses firmly in charge and a variety of “modern” techniques and medications employed to ease or assist labor. Gone were the days of a female midwife tending mothers in their own homes.
In 1926, St. Mary’s Hospital reported a total of 670 births, including 436 normal births, 191 instrument (forceps) births, 24 “versions,” 14 breeches and 5 Caesarian Sections. Mothers often stayed for up to 10 days to recover, and babies were kept firmly wrapped and separated in the “clean” nursery, with nurses wearing masks to bring babies to visit their mothers in the maternity ward a few times a day. However, these precautions didn’t always work; St. Mary’s 1929 report discusses the recurring cases of the contagious skin malady impetigo in the nursery.
The “versions” mentioned in the 1920s statistics are variations of the “Potter Version,” a technique advocated by Dr. Irving Potter of Buffalo, New York, to “invert” a baby inside the womb so that it will come out feet first as a way to prevent tearing that tended to occur with “instrument births.” Dr. W. A Coventry, a prominent Duluth doctor and later Head of the St. Mary’s Obstetrics Department, wrote an article for the June 1922 Minnesota Medicine Journal advocating for this rather invasive method because he felt that “the delivery of the normal obstetrical patient is becoming more and more a pathological process instead of a perfectly normal, physiological one.” He felt that the “version” might help alleviate the suffering of women, a consequence of their increasingly frail state. In the 1920s, “modern women” were seen to be hypersensitive and weakened and therefore needed more assistance to give birth.
Another Duluth doctor dismissed the process as a “fad” in the discussion section of the Minnesota Medicine Journal and points out that it is only considered painless because the woman is anesthetized. The 1935 St. Mary’s report mentions that “Now all obstetrical patients are given ethylene anesthesia during delivery.” While all of these “modern developments” were perhaps well-intentioned, if a woman wanted to be awake for the birth of her child, or consider having her baby at home, she would find it hard to argue with Dr. Coventry, who not only delivered 5,200 babies during his career but was also highly respected as the 1927 President of the Duluth Chamber of Commerce.
By 1937, 91.6 percent of births in Duluth occurred at a hospital attended by a physician, 8.2 were at home with a physician present, and 0.2 (a total of 4 births) happened at home with “other person in attendance.” Doctors and hospitals were firmly in charge. of the birthing process. Oral history interviews conducted with women who gave birth in Duluth starting in the 1930s–1950s often include recollections that while the expectant mothers themselves may have been born at home, they felt without question that giving birth at the hospital was simply the thing to do. One father remembered that in 1938 it cost $60 in advance to pay for delivery and hospital costs at St. Luke’s, including ten full days of bed rest for the mother, something he and his wife felt was essential. Expecting parents had become big believers in hospital births.
The last midwife listed in the Polk City Directory of Duluth appeared in 1948.