Log onto Squarespace
Archives
« What do we do with the GDM study? | Main | The Science of Woo »
Wednesday
Mar032010

Birth: 1987

Coming across these photos I took in the late 80's, I nodded, totally remembering every minute of my time in the Frankfurt Army Regional Medical Center (FARMC -no longer in existence). I'd gone to a few births before moving to Frankfurt, but once I was there, I had a steady stream of women invite me to their births. I've said, for years, that I was a doula long before there was the word doula, but I came across Sarah's birth plan that we'd worked on (1986) and on the top is the word "doula" with a ? next to it. I was as surprised as anyone! I called myself a Birth Assistant back then. Oh, probably Labor Assistant -until someone asked me if I was a Union Organizer; then I changed it to birth.

So, here are some of the photos with short thoughts or stories that go with them. Ask questions. I hope you enjoy the history lesson.

I lived really close to FARMC and some of the women lived far in the outlying areas. Instead of hanging out in early labor at the hospital (where, if they were full, the women would be shipped out to a German hospital), they'd come to my house. I fed them, put them in the tub and tucked them into bed to nap. We also walked a lot. My kids got very used to seeing women in labor and were understanding enough, even though they were all under 5, to stay out of the mamas' way so they could labor without screaming kids.

Above is one client in labor with a previous client helping her as well. I smile looking at these, how hard I worked (and how successful I was!) in keeping women out of bed while they labored... both in my home and in the hospital.

The CNMs at FARMC were wonderful. They gave me chux pads to keep at home for the laboring women. Most of the moms who came to my house were my own clients, but I got a few calls from the nurses asking me to take someone in who lived 100km out. I gladly took anyone in.

This mama, not having fun in labor, is wrapped in a family heirloom. I love this photo.

You know how hard it can be to keep women out of bed nowadays in the hospital? It was just as difficult then, too. But, as long as I hung out with the women, they were permitted off the monitor for a couple of hours at a time. (There wasn't the 20-minutes-out-of-every-hour thing there is now.) I walked all over that huge hospital with those women! This is in the waiting room right inside the hospital doors of the old OB area.

During this time period, women labored in one room, delivered in another, recovered in another and then were in still another for the postpartum hospital period. When I first started at FARMC, women labored two to a room with a curtain separating the women. It seems astounding now to imagine two women in the same room, but we didn't even bat an eye about it. I remember one birth in particular when my client was zooming through her labor and the woman on the other side of the curtain had been laboring for over 24 hours... and was signing papers to have a cesarean. That poor woman cried with every contraction -hers and my client's. I was so glad when she was finally wheeled out, but the empty bed was quickly filled with another mom in early labor. She was scared to death hearing my woman in transition. Nothing like doula-ing for two women, explaining and comforting the stranger while supporting and breathing with my own client.

There was no such thing as an epidural for labor back then. I've heard some women say in their area it was, but it wasn't in Florida, Frankfurt or San Diego when I was in those areas in the late 80's. Because there was no epidural, women coped. It was hard and they worked with all of their beings, but they did it... all without being numb from the waist down. I never heard anyone ever say they wished they could be numb. The most anyone got was Demerol.

Oh, but there were paracervical and pudendal blocks. Both of these are considered localized anesthesia, the paracervical done during labor and the pudendal either in anticipation of an episiotomy or immediately after the birth to repair the episiotomy. I haven't seen either method used in at least 15 years.

When women didn't want to walk around, I'd drag a chair in and plop them in it. Anywhere but the bed. It's kind of amusing now, thinking how focused I was on keeping women out of the bed. To me, The Bed represented malpresentation, stagnation and a lot more pain.

A side note. We rarely saw posterior babies back in these old days. It was very rare that a mom had one and I cannot remember one woman having a cesarean for a persistent posterior baby. I wasn't attended births for a five-year period in the mid-90's and when I came back, it seemed every other woman had a posterior baby. The cesarean rate skyrocketed in that time, too, and I heard of so many women having one for the posterior kidlet that just couldn't turn. For awhile, I was baffled and then another midwife explained that in those five years, recliners in living rooms became commonplace and everyone started driving SUVs. It made perfect sense that as a woman leaned back in her comfy chair, the heavy part of the baby's head was going to swirl around to the back of the pelvis. Our bodies are meant to be upright and/or forward... picture gardening, cooking on the ground, walking to the river to get water... all activities we've done for eons. And suddenly, within a five-year period, the sedentary life consumed pregnant women.

She's still out of the bed. And leaning forward.

These women all had running IVs... hep(arin) locks weren't really an option unless you were a nurse or doc having a baby. (Today, they are saline locks instead of hep locks.)

 

This mom is pushing in the Delivery Room on her labor bed. Once the baby is crowning, she will scoot over to the delivery table.

This is the same mom on the delivery table after the birth. The CNM is in the gold scrubs. A Labor and Delivery Room back then would be the equivalent of an Operating Room; it was set up to do both if needed. Notice all the stock in the room! Precious space being taken up. Also, notice the midwife doesn't have gloves on. Of all things, that's probably the freakiest for me to see... how we rarely wore gloves.

This is the standard delivery set-up of the day. Mom's feet are in foot pedals ("stirrups" were replaced with these, but they aren't much better). Mom is on her back inbetween contractions and lifted by her partner to push during them. Notice the abundant drapes! Women were draped from top to bottom, leaving (barely) the vulva in view. The midwife at the bottom of the table has broken two rules: she's allowed the mom's leg to be seen and she doesn't have her face mask on. You can see the face mask around her neck. The dad is also not wearing a face mask; that was very rare and would only have happened with a CNM in attendance.

This (above) is how doctor-attended births looked. Everyone, even dad, in masks, the mom completely covered and her on her back. It's a sad picture to me. Mom isn't even looking at her baby. Babies were never put on mom's bellies. There was the beginning of the request to allow the cord to stop pulsating, but it was pretty much ignored (as it is today). The baby's head is born, the mouth and nose suctioned like mad, the baby born, the cord cut, the baby handed off (to the nurse on the right... who is not wearing gloves!!)

Across the room, the baby is wrapped, shown to mom and then taken to the Newborn Nursery where it was, in this hospital, SOP to "observe" the baby for a minimum of eight hours. Babies routinely were given bottles, or if mom said no bottles, then glucose water (in a bottle) was given. It's amazing any of us were able to successfully nurse.

Another part of what makes me sad in this picture is the cavalier way the nurse is standing there waiting for the baby. Almost like she's bored. The dad, at least, is taking some interest in the baby as a human being.

 

In a rare moment (which is, undoubtedly, why I took the picture), the dad was handed the baby. Note all of the nurses are not wearing gloves. Eek! There is a nurse crumpling a chux pad and she doesn't have gloves on, either. Hard to believe there was a time before HIV/AIDS, but there was. Someone pointed out the scrub dress. Those have gone bye bye... as have cloth scrub gowns. They were the best bathrobes, those scrub gowns.

Another very sad image... not that I saw it as such back then. This is another midwife (no mask) and she's suctioning the wincing baby. Mom's hands are reaching for her baby. They will not be filled.

One last photo.

A CNM had her husband construct this wedge so women didn't have to birth in the lithotomy position. I'd never seen anything like this -and still have not. I thought it was a wonderful gift to women pushing everywhere, to not have to be on their backs or have their necks nearly rupture from being pushed forward. I begged for the wedge for my clients. This was the only time a mom got to use it.

It's always good to peek back if we can... to see how things have changed and, sadly, how they haven't changed at all. It's been 23 years and we still have so, so far to go.

References (4)

References allow you to track sources for this article, as well as articles that were written in response to this article.

Reader Comments (16)

Yes, but really things have changed a LOT and we are going in the right direction. I am shocked and mortified that birth was this clinical. 8 hours of separation between Mom and her newborn baby for routine observation???!!! Oh my. We really have come a long way. Thank you for sticking with this mad mess and making the birth culture better, one couple and aspiring Midwife at a time.

March 3, 2010 | Unregistered CommenterDiana Hurwitz

It's one of the things that comes up a lot... does ANYTHING we do make a difference? Has anything *really* changed? Part of why I wanted to put these up was to highlight what has changed. It's good to have a little perspective when looking at what we have today. Not that today can't be much better, too, but you're right, we *have* come very far. Thanks for noticing.

March 3, 2010 | Registered CommenterNavelgazing Midwife

Very interesting, and brings to mind the photos I remember seeing of my own birth. (Very few, but we have a couple) I should ask my mom if she remembers where those are! She talked often of how she hated being flat on her back on the table pushing, how it just didn't make sense to not utilize gravity and likely necessitated the use of forceps in my birth.

At my brothers birth (94) and being back stateside, and civilian, things were significantly different. Birthing upright for one (well with the bed in the birthing chair style) and not having to share a room for another. (While recovering from my birth she shared the room with a lady that asked if she knew of a good place to buy a crib because the baby had "surprised" them!) However she did send my brother to the nursery for a bit to sleep (my dad being home with me at the time) and was quite disgruntled a few hours later when they would NOT bring him back to her. She kept asking and asking and it was always "oh we're waiting for this or that" and didn't bring him in until 9am. She was not thrilled, to say the least.

March 4, 2010 | Unregistered CommenterStassja

I had my first two children in 1989 and 1992. I hated the "mandatory" minimum 4 hour separation after birth of my babies while they were in the nursery. I never even thought to argue about it. In 2003, the hospital where I gave birth for the last time tried to do the same "mandatory" time in the nursery. I simply said no. :-)

I vaguely remember the drapes, enema, shave, etc for the 1989 and 1992 births. So much has changed........yet, we have so much more to change.

March 4, 2010 | Unregistered Commenteratyourcervix

As a child, I remember watching the video from my brother's birth (1984) and thinking that he had been born in a grassy field behind the hospital, since all I could see was the green scrubs and drapes filling the screen. I still laugh thinking about that!

March 4, 2010 | Unregistered CommenterKristyn

Hum, I was born in 1972 and at that time my mother said I was flopped right down on my belly after I was born, same with my sister the next year. Of course that was in the states in the Great Northwest too.

Of course she said her best labor was our 2nd brother who was born 9 years before me, the hospital was busy and at that time they did the three room switch for birth and mom had to labor in the hall for a while - she went into transition and pushing in the labor room and the nurse was screaming "Don't push! You can't deliver here!" Well, she did.

March 4, 2010 | Unregistered CommenterEthel

Fascinating post!

I agree, we have come a ways in some areas of birth (management), but then we have gone backwards with the whole epidural, mother suck in bed, pushing in lithotomy position, rise in c/s rates, etc.

I think your observation of the increasing number of posterior babies is interesting. It makes sense to me! I had a posterior baby (my 1st child), and not only was I admittedly lazy while pregnant with him, lounging around and reclining very often, but I when I was in labor (or should I say, induced) I was also stuck in bed with and epidural and waters that were broken much too soon IMO (OB broke them when I was barely dilated). Gee... I wonder of my OB saw the c/s coming.

Anyways, great post.

March 4, 2010 | Unregistered Commentermichele

One MAJOR change has been the way women with pre-natal or peri-natal losses are treated.
Perinatal hospice, Now I Lay me Down to Sleep...these are just a couple of examples of how far we've come from not letting women see, let alone hold their dead or dying babies. Sending women to recover on med- surg floors instead of in a room with 3 other women and their healthy babies.......
The pictures above are sad but how grieving mothers were treated in most hospitals around the US in the same years and in the decades before is even worse.

March 4, 2010 | Unregistered Commentermom9

Thanks for sharing these, very interesting. Some things are definitely improved, but unfortunately some of it is no better.

March 4, 2010 | Unregistered CommenterHeidi

I'm curious how common breastfeeding was among your clients in that time, in all the different places you lived. And in general, how common it was in Germany in that time.

March 4, 2010 | Unregistered CommenterTatiana

OUCH. That second batch of photos is truly terrifying. I cringed at every last one.

Laptops have also contributed to the rise in posterior babies...here at my desk I have to sit at least fairly straight, but a mom surfing the web from her couch or bed can recline all the way back. And what with the amount of time most of us spend online, that adds up to at least a few hours a day in that position.

March 4, 2010 | Unregistered CommenterJill P.

wow, what a great history lesson! I was born in Germany in 1981, in Nuremburg, at an Army hospital, via c/section. (for placenta abruption or placenta previa-my mom described it "the placenta was coming out first before the baby" and said she was bleeding all over the floor at home) 1982, she had to have a c/section in Nuremberg, because of "once a c/s, always a c/s"

the no gloves thign is certainly very interesting, as is the frequent room changing, and the laboring two women in teh same room. Of course, now, its hard to imagine that happening.

Hopefully, in teh future, women will look at how we do it now and be glad they dont have to do it that way. to think about how much better they have it.

March 4, 2010 | Unregistered CommenterRose

I was born in San Diego in 1987 (Kaiser Permanente on Zion Avenue.)

My parents tell me they had taken Lamaze classes and that their hospital had recently opened a "natural birth center". This post really drives home to me how unusual my parents' experience was.

My Mom was allowed a heparin lock and to take the monitoring belts off every hour or so to walk the halls. She gave birth to me in the same room she labored in (a nurse caught me, as her OB was busy with another patient), with no drapes or leg stirrups or even an episiotomy. My parents say I was not taken to the nursery and allowed to room-in. We have pictures of my Dad holding me (in his normal street clothes, no scrubs) and my Mom breastfeeding me right after birth.

I'm now a birth doula in Michigan and have been since 2006. :)

Thanks for sharing this.

March 4, 2010 | Unregistered CommenterJamie

I have to say looking at these photos made me think my hospital birth in 2005 was really not that bad! So things have gotten better.

All the moving from room to room is crazy. Also interesting to contrast the extensive draping with the lack of gloves - like the one part of their bodies that could actually transmit disease is the one part left exposed.

March 8, 2010 | Unregistered Commenterchingona

I was born in the Army hospital in Augsburg in 1976. My mother had awful back labor and they told her to stay on her back in bed and be quiet while my dad slept in the chair. 24 hours after her water had broken, they said time was up and she had to have a c-section. The last thing she heard was,"Put her under the shipment didn't come in." She said it took several days to before she came out of it. When she woke up the nurses told her,"C-section? You'll bottlefeed." So she did.

She had a scheduled c-section a few years later at another Army hospital because they told her she had to. She told me she hated that she wasn't allowed to go into labor and that my sister was taken out too early and didn't open her eyes for a week.

In 1987, she had twins at the Frankfurt Army Hospital. All through her pregnancy they told her she would have a c-section, but when she was in active labor the on-call doc told her she could have a TOL but since one baby was breech they might have to section the second one out. She was overwhelmed with the choice because she had been told it wasn't a possibility and then since she was in labor she couldn't consider it properly so she had another c-section. We were probably there at the same time as you. I wish she would have known you!

I didn't know she felt that way about her c-sections until I was preparing for my VBAC. I'm so glad she was able to be there for my daughter's birth.

March 11, 2010 | Unregistered Commentermamaseoul

I was born in CA in 1976 and, from my dad's description, I was a posterior baby though his description sounds like I finally flipped over before being born. My older brother was born in 1974 without pain meds and was delivered with forceps (ouch!) after being induced at 41+3 with AROM. My mother had a spinal with me because of the pain in her back. My mom was a L&D nurse and birthed me in the hospital she worked in. Other than just the high level details, I don't really know anything else about my birth since my mother passed away when I was a teenager.

April 3, 2010 | Unregistered CommenterKimberly

PostPost a New Comment

Enter your information below to add a new comment.

My response is on my own website »
Author Email (optional):
Author URL (optional):
Post:
 
Some HTML allowed: <a href="" title=""> <abbr title=""> <acronym title=""> <b> <blockquote cite=""> <code> <em> <i> <strike> <strong>