Sunday, February 23, 2014

From a 1931 Obstetrics Textbook

A few months back, I found a gem of a book for $1 at a thrift store.  It's a rather fragile 1931 textbook written for those learning to be obstetric nurses.  I have a real interest in learning about pregnancy and childbirth, especially in the history of how these processes were approached in times past as compared to the modern ways.

Not surprisingly, things were rather different in the early 30's.  Many women still gave birth at home, though a lot of them went to special hospitals for the birth.  After the baby was born, women were expected to stay in bed (called "lying-in") for at least two weeks.  Doctors still often worked on women "blindly", reaching in to examine them under a sheet, so as to preserve her modesty.  And the doctors and nurses were absolutely obsessed with sterilization.  This isn't surprising.  At this time, people had finally come to understand that the "puerperal fever" which had tragically killed so many new mothers during the previous century was actually the result of infection - often unknowingly caused by the doctor himself.  But this was still before the advent of antibiotics.  So the best solution was to just be extremely rigorous about making everything completely and utterly aseptic.

So you get unsettling suggestions like,
"Some parturients [women in labor] are unruly, and persist, against advice, in putting the hands on the sterile abdominal towel or even on the vulva.  In such a case the nurse should tie them loosely at the head of the bed."
I can't say I'd appreciate giving birth with my hands tied to the bed.  My favorite part of this quote is that such women are called "unruly"!


The book explained another practice I just could not abide, the lying-in period after birth:
"The writer's practice is to allow the woman to have the back-rest on the fifth day, to sit bolt upright on the seventh day, to get out into a rocker or Morris chair on the tenth, stand on her feet on the eleventh, have the freedom of the room on the twelfth, and go down stairs on the fifteenth day."
Ugh.  I could be forced to spend maybe one day lying in bed after birth, but beyond that, it would be torturous.  I need to be up and moving again!


Some of the baby-care practices were pretty different from today as well.  It seems the nurses urged mothers to waste no time in getting the baby on a strict nursing schedule and to commence immediate sleep training:
"The baby is put to the breast every eight hours until the milk comes, then every four hours during the day, but not during the night.  The first nursing is a 6 A.M., the last at 10:30 P.M., and the child is put to the breast once during the night if it seems really necessary.  The four-hour schedule is for robust children.  Those under 2700 Gms. [5.95 lbs] and those that do not gain after the eighth day have a three-hour schedule: 6, 9, 12, 3, 6, and the last feeding about 10 P.M."
Four hours between nursing?!  How could anyone stand to wait so long?  Most babies would start screaming long before four hours had passed (and I'm sure the breasts would be uncomfortably teeming).  I'm all for gradual night-time weaning, but a newborn baby is just not ready to go for an eight-hour stretch without nursing at night.  I really wonder how many women still followed this schedule, after they were out from under the watchful eye of their nurses.


There was a section about the baby's layette, and what materials you should prepare.  So many women still made clothes by hand (either sewing, or knitting) at this time.  I was particularly interested in the recommendations for cloth diapers, since I wanted to see what was used then as compared to all the fancy types we have available these days.  The book recommends:
"Four to six dozen diapers of cotton diaper cloth 20x40 inches.  These can be bought in sealed packages or made at home.  Two dozen cheese-cloth squares 1 yard square to use folded inside the diaper.  Ten or twelve dozen pieces of clean white absorbent cloth 10 inches square (old linen or cotton) to be used inside the diapers."
I'm very curious about how this worked.  Did the "diaper" go on the outside sort of like a diaper cover, with the cheese-cloth acting as a "doubler" and the white absorbent cloth as a "diaper liner" (to use the cloth diaper parlance of today)?

In the section explaining the type of stockings you should get for your baby (presumably because the babies of the time were all put in dress-like garments, and their legs might get cold), they suggest
"machine-made woolens...which are easily washed and fit comfortably over the diaper at the knee."

Huh?  The knee?!  Just how huge were those diapers?  Or is it just because newborn's knees tend to be bend upwards all the time?


Anyways, it's been an interesting book to read.  I'm not even halfway through yet, but if I find anymore ponderables like these, I can share them in a future entry.  

Though I've peeked ahead to the "Grave Disturbances During Pregnancy" and "Complications During Labor" chapters and let me tell you, there are some pretty gruesome pictures there.  It might be best for me to wait until after I've given birth.


  1. Oh I wouldn't do well with the lying-in period at all. Within the first couple of hours of giving birth I'm wanting to go home and get back to living life as normally as possible. Getting me to stay at the hospital for longer than 24 hours is a fight. I told my husband that I really want to sign out against medical advice within hours of delivering this baby. After being stuck in the hospital for three days back in December I don't even want to spend one minute in one when it's time to have the baby.

    1. I totally understand where you're coming from - hospitals can get very frustrating, quickly. I take more of a middle-ground. For 24 hours, I'm happy to stay in the hospital being "pampered" (having meals brought to me, access to silly cable tv shows on HGTV, visitors, etc.). But only as long as I at leasthave free reign of the room! And anything beyond one day, and I'm sick of it.

      The midwives I use for my birth also operate a birth center. But if you have the baby there, they "kick you out" after only a few hours. That might just be a little too soon for me to jump back into my old duties :-P

  2. That nursing schedule is appalling. I'm not surprised that bottle feeding soared in popularity soon after this book was published. Formula "sticks" with babies longer than breast milk so they probably were happier with bottles if they were forced to wait four hours!

  3. Jealous! I used to be an obstetric nurse, i'd love that gem. lying in bed for so long would be dangerous given that postpartum women are so prone to forming blood clots. Ah well,I wonder what future women will think of our childbirth practices. Also, yikes, poor hungry babies!!