Anyone who watched TV sitcoms in the middle of the 20th century will be familiar with images of the typical “baby on the way” scenario. A frantic husband throwing on a sport coat over pajamas and a wife draped in a tentlike garment bumble their way to the hospital where an efficient nurse awaits with a wheelchair and a reassuring word. The wife is handily passed along to be whisked off screen while the husband waves forlornly at swinging doors wobbling under a sign marking labor and delivery.
A commercial break later and the husband has found his trousers, a necktie and a box of cigars that he proudly shares with the beaming crowd of onlookers gathered at a baby viewing window. Meanwhile, the mother is absent until she rolls through the swinging doors and is presented to her husband with a sparkling baby wrapped in a blanket.
Apart from the requisite comedy of errors, this picture is fairly accurate. Fathers were largely chauffeurs and mothers were equally disregarded. The act of delivering a child was solely in the hands of a medical staff; expectant parents, even mothers, were excluded.
Condescension and paternalism
“There were some very weird ideas among doctors at that time,” says Pamela Chubbuck, co-founder of the American Society for Psychoprophalaxis in Obstetrics in the Washington D.C. area in 1963. “Many people just thought and taught that childbirth was excruciatingly painful. That childbirth was like having surgery, definitely a medical procedure. And they [doctors] would take over and be the heroes.”
Chubbuck, 81, disagreed with that philosophy and hoped from her first pregnancy to have children naturally. The mother of three sons and one adopted daughter, Chubbuck delivered her first child in 1961. She was 18 and living in Pennsylvania and says that although she didn’t know what she was doing, she told her doctor that she wanted to have natural childbirth.
“The doctor patted my hand and said, ‘There, there, not to worry, I will take care of you,’” she recalls. “Many OB doctors were against natural childbirth. They wanted to be in control of the process instead of educating moms to be in control, and stepping back unless they were needed,” says Chubbuck.
During her first labor she recalls that she knew to relax and breathe, but nothing about changing position or other ways to aid delivery. Without asking they gave her Demerol, she says. For Chubbuck, who wanted to be present for the birth of her child, being drugged without her consent was particularly disturbing.
Chubbuck’s second child was born in Connecticut in 1963. Fortunately for Chubbuck, her doctor gave her a copy of the book, “Thank you, Dr. Lamaze” by Marjorie Karmel. Karmel was assisted in a natural birth by Fernand Lamaze, who introduced his method in France in 1951. Lamaze based his method on techniques he had observed in Russia that included childbirth education classes, relaxation and breathing techniques. Central to his concept was the emotional support of others, specifically a trained nurse.
“When I got the book I knew this was the thing to do,” says Chubbuck. “It was so wonderful and so easy compared to the first baby. I was hooked on telling others for the rest of my life.”
By the time she delivered her third child in 1965, she was teaching childbirth classes to other women. Not only did Chubbuck educate pregnant women, but also the doctors who were treating them. “Back then the belief was childbirth was really bad and really painful.
Because there were few female obstetricians in her area at that time, she was largely dealing with men. Some, she recalls, were very receptive to her information and offered her opportunities to learn more. Eventually, she was helping doctors deliver babies and became a midwife.
Along with advocating for Lamaze education, Chubbuck championed breastfeeding. In 1980, she became a La Leche League Leader.
Unnatural childbirth
Obstetric nurse, Susan Dougherty, 67, says, “When I first started, it was fairly unusual to have a family member in the room.” According to Dougherty, a woman was moved from a bed in a labor room and shuffled onto a stretcher to be taken to a delivery room. Then she was shuffled off the stretcher onto a delivery bed.”
“Everything was metal and sterile. Everyone was dressed for surgery.” If family was allowed to come in, she says, they had to dress in full surgical attire.
A nurse since 1982 and a Doctor of Nursing practice since 2014, Dougherty currently teaches at the Athens campus of AU/UGA’s nursing school.
Over the last 40 years, Dougherty has attended many births and has seen birthing practices go through many changes. “For years and years, we did it all the same. We didn’t necessarily know that there was a better option,” says Dougherty.
Linda Thompson, 75, has two sons born in 1968 and 1971 in Augusta. She remembers having very easy labors due to a having a high pain threshold. However, with both children she was given twilight sleep and delivered both without being aware of anything.
She regrets that she did not get the first touch with her babies and that her husband was not allowed in the room. “We know now how important touch is to a newborn. We also know that fathers in the delivery room is better,” says Thompson.
Debbie Meeks, 70, says she vividly remembers a mask coming over her face when she delivered her first child in 1975. She says, “I was young and dumb and didn’t ask any questions. You just went to the doctor and they told you what to do.”
By the time Meeks delivered her second child in 1980, she was able to be awake with a local anesthetic and her husband was with her. Her third, born in 1982, was delivered with no anesthesia at all.
The twilight zone
Of the changes in birthing practices in the last 50 years, Dougherty says, “The biggest conceptual change is that it has become much less medical and formal.”
Dougherty believes one factor in the changes over time is the evolution of anesthesia. For years women had the twilight sleep drug scopolamine, an amnesiac that caused a woman not to remember the experience. With the advent of epidurals and Lamaze practices women had more options for pain control. Likewise, she credits women becoming more vocal and empowered in the 1960s and 1970s, asking more questions and speaking up about their preferences. Dougherty echoes Chubbuck’s thoughts saying childbirth practices have been affected by the growth of the women’s movement.
“Women didn’t have to be submissive and quiet,” she says. “The woman was the consumer. Women wanted to be more present and wanted family present. Women wanted to be active participants.”
One significant change in childbirth practices is the acceptance of breastfeeding. For many years, breastfeeding was discouraged by medical professionals as an inferior way to nourish a baby.
Dougherty says, “La Leche has done a lot of good for a lot of people. Breast feeding is learned behavior, and it’s one of the hardest things that a mother can do. Moms think it will be easy, and when it’s not it’s discouraging.”
Thompson recalls wanting to breastfeed, but being told to bottle feed her sons. “We were poor and formula was expensive,” she says. She received no support for her desire to nurse her sons and she felt pressured to the point of having no options.
All Better Now?
When asked if she thinks child birth practices have gotten better or worse, Dougherty says that’s a complicated question.
“Obstetrics has gotten more litigious” she says.
The advent of fetal monitors has considerably changed the process of labor and delivery. “It’s become more and more common practice to connect a woman to a monitor. It helps, because we know more, but then we have to do more,” she says. Dougherty explains that Cesarean sections increased because medical staff were compelled to respond to information from monitors. “We became less tolerant for waiting things through.”
Chubbuck says that by making conscious choices for natural practices, “People voted with their wallets, and we changed the world.” She says there is still a lot to be done, and she continues to advocate for unmedicated birth and as little medical intervention as possible.
“A non-medicated infant is a healthier infant. A non-medicated mother is a healthier mother,” Chubbuck says. “We want to make it as calm and easy as possible. Safe. Upbeat. I told students at the end of my 6-week Lamaze classes…Have fun having your baby!”
On every woman’s bookshelf
A revolutionary book, “Our Bodies, Ourselves,” was an outgrowth of a women’s liberation conference in Boston in 1969. As a group of women who attended began meeting and sharing their stories about sexuality, relationships, their bodies, and their health, they realized they were profoundly ignorant about the most basic aspects of women’s sexual and reproductive functioning. They began to ask questions about common procedures such as hysterectomies, cesarean sections, and the use of hormones. They discovered that very little research had been done about women’s health and the safety and efficacy of common medical procedures and treatments.
As they researched and asked questions, they realized the need for this information was enormous, and thus, “Our Bodies, Ourselves,” was born as a pamphlet and then a book in 1973. While no longer being printed, there is a website and used copies are widely available; the 9th and final edition was published in 2011. In that year, Time Magazine named it as one of the 100 best nonfiction books and the original was part of an exhibit in the Library of Congress exhibit of “88 Books That Shaped America.”
On the website, it’s pointed out that in 1970, more than 92 percent of all physicians were men, as were an even greater percentage of obstetricians and gynecologists. Today, women make up about 28 percent of all physicians and 75 percent of those are now training to be ob-gyns.
