Facts of Birth

P: ''The profession of being a mother today is more dangerous than the average masculine profession, with all its risks." P: "Home delivery, even under the poorest conditions, is safer than hospital delivery." P: "Six thousand women die annually in the U. S. from puerperal infection." P: "In the ten largest [U. S.] cities hospitalization now ranges between 56% and 85% of all live births. The majority of [the nation's] births, however, still take place at home, 1,500,000 out of the 2,200,000 annually." P: "These statements certainly are astonishing. However, if we would really adopt the opinion that the increasing hospitalization of parturient women is not an improvement, is it a development which depends at all on us obstetricians, or the medical profession? Could we, even if we would, stop this development and bring back the times when every married woman had her baby in her home? We could not! This rapidly increasing demand for hospitalization of delivery cases, which is found all over the world, does not come alone from the medical profession but is a demand of the public itself. The reasons seem to be multiple. Poor economic conditions with insufficient housing explain the conditions in Germany, because there the parturient woman may have her baby in a good public hospital without any charge. ... In America it seems that the comforts of the hospital compete with the disadvantages of apartments and hotels. . . . Furthermore, here also, with living conditions getting worse, many women are forced to abandon the expensive private physician and to choose cheaper or even charity hospitals. Besides this, the hospital delivery has great advantages over the delivery in the private home; better equipment, experienced assistants, and immediate help in case of emergency. Therefore, even if considered desirable, an attempt to stem the flow of patients to the maternities would fail, and, realizing the dangers lurking in hospitals, we should do everything to improve conditions of the institutional delivery, so that it will turn out to be safer than home delivery. ..." P: "To be able to make such improvements we must first determine what is wrong with the hospital delivery. Why do more women die in the well equipped, fully staffed hospitals than die in the primitive home?"

Chicago's militant Obstetrician Joseph Bolivar DeLee, founder of remarkably sanitary Chicago Lying-in Hospital, last week threw the morbid facts into Medicine's teeth,* tamped them down Medicine's throat with the heavily honest Journal of the American Medical Association. Roared Dr. DeLee: "Evidence enough to convince any jury of husbands or any committee of life insurance adjusters. . . . The general hospital is a veritable cesspool of infection. . . . Meddlesome midwifery and puerperal infection seem to cause the greater part of the mortality, either singly or in combination. . . . Meddlesome midwifery must be abated or made safe. Something is wrong with the maternity wards of general hospitals, and a great deal ought to be done about it. My recommendation is architectural and administrative isolation of the clean maternity, until more is known about the nature of puerperal infection."

*Collector of facts: Dr. Heinz Siedentopf, privatdozent University of Leipzig, currently exchange lecturer at the University of Chicago.

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