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  Winter 2013 Issue Excerpts

Here's a bit of what you'll find in the Winter 2013 issue.
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Grandma Gable opening layout

“Grandma Gable, she brought Ralph”: Midwifery and the Lincoln, Nebraska, Department of Health in the Early Twentieth Century - Rebecca J. Anderson

Eight midwives gathered at Lincoln’s North Side Neighborhood House on a cool and rainy July afternoon in 1915 to meet with Dr. Chauncey Chapman, the Lincoln Department of Health’s newly appointed superintendent. Chapman had officially begun his duties just the day before and one of the first items on his agenda was the organization of the midwives. Earlier in his career, Chapman had worked with Chicago’s health department, which had been regulating and supervising midwives since 1896. Chapman hoped that the Lincoln midwives would voluntarily agree to a similar arrangement. At the time that he called the midwives together, he was aware of nine midwives who had attended one-sixth of all the births registered in Lincoln the previous year. Unfortunately, Dr. Chapman was unaware until shortly before the meeting that most of the midwives could not understand English. So while they were all gathered together, visiting nurse Catherine Wollgast, whose parents had brought her to the United States from Germany as a young child, did her best to translate Chapman’s message.

This was not the first time that Lincoln’s midwives had dealt with the health department. In 1911, Maggie Kuckes had been brought before the police court on a complaint from then health superintendent Spealman for failure to report births. When Marie Deines had entered the health department office after running out of birth registration forms in 1914, she soon discovered that she had been unintentionally breaking the law by holding onto the forms until the end of the year. The situation was resolved but not before she had become upset and only when a national guardsman stepped in to help translate, “by mixing what he [knew] of Spanish and German.” Unable to get the midwives’ clientele to switch to physicians, the health department’s previous administration had tried and failed to change the midwives’ practices.  However, Chapman made it clear that this time, their participation was fully voluntary, that their input would be considered, and that if they chose not to organize with the health department, there would be no further attempts to organize them in the near future. The organization of Lincoln’s midwives is an example of a public health agency attempting to work within the value system of a community rather than rigidly adhering to another governmental agency’s interpretation of the law.

This program was a local example of a phenomenon which was occurring all over the United States as physicians worked to establish control over attendance at childbirth. According to Lincoln physician Inez C. Philbrick, obstetrics was being practiced for financial motives by new physicians trying to build their practice. “Since the taking over of obstetrical practice by male practitioners as an entering wedge in obtaining family practice and a sure source of small income, obstetrics has been the pot boiler of the profession, the chief resource of the young and inexperienced and least trained physician, to be abandoned as soon as possible for a less arduous and rest-disturbing and more remunerative field.” During the 1800s, Anglo-American women had been increasingly calling on physicians to attend them when they went into labor, so that by the end of the century, midwives were becoming less commonplace. By the beginning of the twentieth century, they were found primarily in immigrant, African-American, and isolated rural communities in regions like Appalachia and western Nebraska.

Midwives were often included with the osteopaths, magnetic healers, Christian Scientists and other “quack” physicians whose practices physicians were targeting with tightened medical laws. The elimination of midwives was proposed as the solution for problems ranging from infant blindness and high infant mortality rates to illegal abortions and poorly trained physicians. Although immigrant midwives were often better trained attendants than the average general practice physician, not every midwife was a safe practitioner. There was a lack of quality educational opportunities. Diploma mills abounded, and many women had to travel away from home for several months in order to attend one of the few respectable midwifery schools.  As a result, some women died needlessly in childbirth, like Violet Lemmons, who bled to death in 1890 under the watch of Christian Science practitioner and “metaphysical obstetrician” Jennie Fenn. Her demise ignited the push to bolster Nebraska’s medical law. When the immigration surge began in the late 1800s, the midwife became a symbol of all that the immigrant represented – supposedly dirty, ignorant, and responsible for the unchecked reproduction threatening to destroy America’s “racial balance.” J. Lue Sutherland, a Grand Island physician and one of Nebraska’s most vocal opponents of midwifery, made no attempt to hide his nativist sentiments in his attacks on Hebamme Smutzigfinger. While some physicians advocated for elimination of midwives, public health officials were more likely to support efforts to regulate and educate them. It was in this context that Chapman conceived his plan for organizing the Lincoln midwives and starting a midwifery school through the Lincoln Municipal Health Department.


The entire essay appears in the Winter 2013 issue.



The Barbours opening layout


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