"In All Circumstances": Home Births and Collaborative Health Care in Ireland, 1900-1950

This article examines the development of a collaborative model of home-based reproductive caregiving in Ireland from 1900 to 1950, focusing on the interactions of different practitioners in childbirth cases in the domestic sphere. In Ireland the move to obstetrics and trained nursing and midwifery was gradual, complicated by the needs and wants of ordinary women, who were reluctant to give up their trusted care givers and who actively sought to maintain long-standing domestic health care traditions. The result was a hybrid and collaborative model of domestic reproductive health care, requiring the attention of different practitioners, placing them in the same space, and necessitating that they work together. This dynamic and evolving system provided most pregnant, laboring, and postparturient women with essential reproductive care, but it would be overtaken by hospital-based reproductive medicine by around 1950, remaining only in folklore and memory by the late twentieth century.

Angélique Marguerite Le Boursier du Coudray (1712-1790) - Pioneer of simulation

Madame du Coudray (1712-1790) was a French midwife who educated peers in rural areas. She was seen as a pioneer of simulation as she developed the first obstetric mannequin, known as 'the machine'. Complex cases could be simulated in a safe environment, which enabled midwives to improve their abilities in managing such deliveries.

BADGES/PINS OF NURSING AND MIDWIFERY SCHOOLS IN SLOVENIA FROM 1925 UNTIL EARLY 1980s

INTRODUCTION

Many nursing and midwifery schools in many countries around the world awarded or still award graduation badges or pins to their graduates. All graduates from different parts of the former Kingdom of Yugoslavia and later the Republic of Yugoslavia educated in Slovenian healthcare schools received badges from these schools. Some of the graduates later employed in medical institutions across former Yugoslavia wore these badges on their uniforms. The main purpose of this historical research was to establish which Slovenian health care schools awarded the graduation badges and what they looked like. It was also investigated why the badges ceased to be awarded and what motivated Angela Boškin Faculty of Health Care in Jesenice to reintroduce awarding the badges.

METHODS

Due to a lack of written sources, we conducted 393 face to face and telephonic interviews with former badge recipients across Slovenia. Their existing badges were photographed. On the authors' initiative, a private collection of badges was started.

RESULTS

It has been established that in the 20th century all Slovenian secondary health schools awarded badges. The Nursing College, Ljubljana also awarded graduation badges. Five different types of badges in many variants were issued. The first badges were awarded to graduates by Slovenian oldest Nursing School, Ljubljana in 1925. The badges ceased to be awarded in the late 1970s and the early 1980s. Some questions about probable reasons for cessation of awarding badges remain unanswered. Less than a fifth of interviewees kept their badges. Graduating nursing badges were reintroduced in Slovenia in 2017 with a new badge which is presented and depicted in this article. The motivation for the reintroduction of graduating badges is also investigated.

DISCUSSION AND CONCLUSION

Unfortunately, many Slovenian nurses and midwives are not sufficiently aware of the meaning and importance of their badges. Although badges are important for professional image and identity of nurses, badges as a symbol of nursing have become almost completely forgotten. Graduation badges are miniature works of art and are proof of the existence and development of Slovenian healthcare schools. Nursing badges present a part of nursing history as well as being our cultural heritage. The badges deserve to be written and talked about and should be displayed in a planned future Slovenian Health Care Museum.

['A case of decapitation'; calamity investigation in 1822]

A case of childbirth with a fatal outcome described in the book 'The King's Court Physician: the Adventurous Life of Franz Joseph Harbaur, 1776-1822' (De lijfarts van de koning. Het avontuurlijkeleven van Franz Joseph Harbaur, 1776-1822) puts the work of the Dutch Health and Youth Care Inspectorate into an historical context by pointing out the similarities between a calamity investigation held in 1822 and the situation today. Conflicts between medical disciplinary law and criminal law, boundary disputes between various professions (in this particular case midwives and gynaecologists) and questions of openness and transparency turn out to be nothing new. By doing case studies on how to deal with calamities, it is possible to gain insight into medical failures of the past and how they were managed. It is also possible to get a better picture of the expectations that medicine had to meet in the past, and how, and under what circumstances, these have changed. This information is of value in making choices in today's healthcare system.

Matthew Flinders Senior (1751-1802): Surgeon and 'man midwife'

Until the eighteenth century, midwifery was the sole domain of women, but changes in medical science saw it appropriated by medical men and the 'man-midwife' emerged. This paper demonstrates the work of a man-midwife in a small English village in one year, 1775, using his accounts and correspondence. The man was Matthew Flinders Senior, 'surgeon and man-midwife' at Donington, Lincolnshire. He was the father of Captain Matthew Flinders, the famous navigator who mapped the coast line of Australia and who coined that name. Primary sources, published as a collection by the Lincoln Record Society, were used. Flinders Senior made a good living from his midwifery, charging rates commensurate with those charged by obstetricians today (with reduced costs for the poor). His descriptions of his practice show how midwifery was conducted in rural England during the development of medicine as a high-status profession. The paper uses data from one year to provide a snap shot of the work of a rural surgeon and man-midwife, but much more is available in the published collection, providing ready access for researchers who may like to pursue such work further.

"Something Wasn't Clean": Black Midwifery, Birth, and Postwar Medical Education in All My Babies

Set in rural Georgia, the 1953 health film All My Babies: A Midwife's Own Story was a government-sponsored project intended as a training tool for midwives. The film was unique to feature a black midwife and a live birth at a time when southern health officials blamed midwives for the region's infant mortality rates. Produced by the young filmmaker George Stoney, All My Babies was praised for its educational value and, as this article demonstrates, was a popular feature in postwar medical education. Yet as it drew acclaim, the film also sparked debates within and beyond medical settings concerning its portrayal of midwifery, birth, and health care for African Americans. In tracing the controversies over the film's messages and representations, this article argues that All My Babies exemplified the power and limits of health films to address the complexities of race and health during an era of Jim Crow segregation.

For the good of the nation: scientific discourses endorsing the medicalization of childbirth in Peru, 1900-1940

Over the course of the twentieth century, a series of changes occurred in the understanding of childbirth, which went from being a natural reproductive phenomenon belonging to the female, domestic sphere to a professional medical matter handled in an institutional setting. Through procedures like the use of anesthesia, Cesarean sections, ultrasound and other techno-scientific interventions, rapid and significant improvements and changes took place in the health and life of society and of women. The medicalization of childbirth in the early twentieth century was part of a broader process of constructing the state and institutionalizing the patriarchy that was common throughout the region.

Santayana's Axiom: The South Dakota State Medical Association and Medical Practice Legislation in 1929 and 2017

In 1928 members of the South Dakota State Medical Association (SDSMA or the Association) held a special meeting in Huron to consider a basic science bill that conformed "…in its entirety to the conditions existing in our state." Their draft bill proposed a standardized examination for all practitioners of the healing arts. A legislative committee, with its attorney, "…was in Pierre during the early part of the 1929 legislative session to make sure the bill was properly launched and in effective channels." Shortly after its introduction, the bill was withdrawn due to opposition from one SDSMA district whose legislative representatives were among the most influential in the legislature. A similar bill promoted by the SDSMA in 1933 also failed. It would be another six years before a basic science bill was enacted by the legislature. Eighty-nine years later, a bill governing the practice of certified nurse practitioners (NP) and certified nurse midwives (NM), including a board independent of the South Dakota Board of Medical and Osteopathic Examiners, was considered (Senate Bill 61). Introduced by a senator who characterized herself as representing the "House of Nursing," the bill challenged "…the overarching role that medicine thinks and perceives that they may have regarding advanced practice nursing practice." SB 61 passed in the senate and house and was signed by the governor. For this legislation in the 1930s and in 2017, the SDSMA's interest was defining and maintaining control of medical practice under the twin rubrics of quality and patient welfare. In both circumstances, legislators and other health care professional organizations contested not only the SDSMA's motivations, but also the evidence supporting their efforts. Our research explored (1) whether the collective viewpoints and conduct of the legislature, the SDSMA, and non-physician medical professionals are comparable in the two circumstances; and (2) if the circumstances are comparable, can we derive a useful concept or theme that could help guide the SDSMA in the future?

Oral Histories of Nurse-Midwives in Georgia, 1970-1989: Blazing Trails, Building Fences, Raising Towers

INTRODUCTION

This article provides an account of the establishment and development of the contemporary nurse-midwifery profession in Georgia, which was previously undocumented. Oral history interviews with nurse-midwives who were in clinical and educational practice in Georgia during the 1970s and 1980s were collected and analyzed to identify factors that affected the establishment of nurse-midwifery in this state.

METHODS

This study relied on historical methodology. Oral history interviews provided primary sources for analysis. Secondary sources included archives belonging to the narrators' nurse-midwifery services as well as scholarly and professional publications from 1923 to the present. Data were analyzed using Miller-Rosser and colleagues' method.

RESULTS

In-depth interviews were conducted with 14 nurse-midwives who worked in clinical practice or education in Georgia in the 1970s and 1980s. The narrators' testimonies revealed facilitators for the establishment of nurse-midwifery in Georgia, including increasing access to care, providing woman-centered care, interprofessional relationships, and the support of peers. Resistance from the medical profession, financial constraints, and public misconceptions were identified as barriers for the profession.

DISCUSSION

Oral histories in this study provided insight into the experiences of nurse-midwives in Georgia as they practiced and taught in the 1970s and 1980s. Interprofessional connections and cooperation supported the nurse-midwifery profession, and relationships with peers anchored the nurse-midwives. Mentoring relationships and interprofessional collaboration supported the nurse-midwives as they adapted and evolved to meet the needs of women in Georgia.

Thomas Secker M.D.: Archbishop and man-midwife

This paper provides a biographical outline of the career of Thomas Secker, MD, who from 1758-68 was Archbishop of Canterbury. Although much has been written on Secker, this study seeks to highlight his training in medicine, which has been largely overlooked hitherto by historians.

Back to Bed: From Hospital to Home Obstetrics in the City of Chicago

This article analyzes the role of doctors and activists in Chicago who successfully redefined the practice and politics of childbirth both locally and ultimately nationwide. It begins with the story of Joseph DeLee's Chicago Maternity Center, responsible for supervising over 100,000 home births between 1932 and 1972. Most of the mothers cared for by the Center were nonwhite, poor, and had little or no access to prenatal care, yet their babies had a far higher survival rate than the nationwide average. Thousands of medical students from all over the Midwest experienced their first deliveries not in hospitals, but in these homes. The article then addresses a very different demographic: a rising number of middle-class white families in the suburbs of Chicago who, beginning in the 1950s, opted for out-of-hospital births. Many of them learned about home birth through their involvement in La Leche League, the breastfeeding organization formed in a Chicago suburb in 1956. Seemingly separated by class, race, and locale, the link between these two groups of home birthers was the philosophy and training in place at the Chicago Maternity Center.

Women Physicians in Byzantium

Women were allowed to practice the medical profession during the Byzantine Empire. The presence of female physicians was not an innovation of the Byzantine era but actually originated from ancient Greece and Rome. The studies and the training of women doctors were apparently equivalent to those of their male colleagues. The principal medical specialties of the female doctors were gynecology and midwifery. Byzantine legislation treated relatively equally both female and male doctors. For this reason, it can be assumed that the presence of female doctors was correlated with the position of women in Byzantine society. However, there is not sufficient information in the literature to clarify whether female and male doctors used to earn equal payment for the same service.

Professors, principals and textbooks from the Midwifery school in Zadar

Midwifery in Dalmatia was highly undeveloped at the beginning of the XIX century. The health report from 1813 suggested that there were only 48 midwives in the whole province, and none of them with a degree from the midwifery school. After abolishing the Central Schools ("Ecoles Centrales"), which were founded at the time of French reign, and which had the university range, the professors who stayed in Zadar continued their work and teaching in the Midwifery School, which was founded in 1820 according to the decision made by Emperor Franz I, and started working in 1821. Since the school was working continuously for the whole century, a lot of professors and principals passed through. Protomedicus of Dalmatia officially performed the duty of principals of the Midwifery School. Their life and work biographies were gathered in this paper. Although the newcomers were mostly illiterate, very contemporary and valuable textbooks were used at that time. The professors of this school wrote some of these textbooks. This paper analyses those textbooks from the current medical science and praxis point of view, which points out to its significance and contribution of its authors to the reputation that the School enjoyed at that time.

How history shaped the modern day midwife

The midwifery profession can be traced back over thousands of years. Globally, midwives have expressed noticeable changes to their role over the years, and the impact on childbearing women (Larsson et al 2009; Mavalankar and Vora 2008; Dickerson et al 2014). During this time the midwifery profession has battled continuously against external pressures and this, in turn, has shaped the role of the midwife and the midwifery profession as a whole. This article will provide an insight into the history of midwifery; the challenges both midwives and the midwifery profession have faced; how these challenges have changed; and how this has assisted the development of the 'modern day midwife'. Of course this could not be discussed without acknowledging the continuing impact on childbearing women in the United Kingdom and globally.

Childbirth among the Canadian Inuit: A review of the clinical and cultural literature

BACKGROUND

This study reviews the historical, anthropological and biomedical literature on childbirth among Canadian Inuit resident in the Canadian Arctic. The modern period is characterised by increased tension as southern intervention replaced traditional birthing with a biomedical model and evacuation to metropolitan hospitals for birth. Inuit concern over the erosion of traditional culture has confronted biomedical concern over perinatal outcomes. Recently, community birthing centres have been established in Nunavik and Nunavut in order to integrate traditional birthing techniques with biomedical support.

OBJECTIVES

To review the literature on Inuit childbirth in order to suggest avenues for future research.

STUDY DESIGN

Material for this review was gathered through combining library searches, database searches in ANTHROPOLOGYPlus, MEDLINE, CINAHL and Science-Direct, and a bibliographic search through the results.

RESULTS

Epidemiological studies of Inuit childbirth are outdated, inconclusive, or inseparable from non-Inuit data. Anthropological studies indicate that evacuation for childbirth has deleterious social and cultural effects and that there is considerable support for traditional communal birthing in combination with biomedical techniques and technology.

CONCLUSIONS

Investigation of alternative solutions to maintaining acceptable perinatal outcomes among the Inuit seems desirable. Epidemiological and comparative qualitative studies of perinatal outcomes across the Arctic are needed to reconcile the cultural desirability of communal birthing with claims of its medical feasibility.