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Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page i WOMEN, GENDER, AND HEALTH Susan L. Smith and Nancy Tomes, Series Editors Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page ii Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page iii Nurse-Midwifery The Birth of a New American Profession LAURA E. ETTINGER THE OHIO STATE UNIVERSITY PRESS COLUMBUS Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page iv Copyright © 2006 by The Ohio State University. All rights reserved. Library of Congress Cataloging-in-Publication Data Ettinger, Laura Elizabeth, 1968– Nurse-midwifery : the birth of a new American profession / Laura E. Ettinger. p. cm.—(Women, gender, and health) Includes bibliographical references and index. ISBN-13: 978–0-8142–1023–9 (cloth : alk. paper) ISBN-13: 978–0-8142–5150–8 (pbk. : alk. paper) ISBN-13: 978–0-8142–9100–9 (cd-rom) 1. Midwifery—United States—History. 2. Midwives—United States—History. I. Title. II. Series. RG950.E77 2006 618.2—dc22 2006003984 Cover design by Laurence Nozik. Text design by Jennifer Shoffey Forsythe. Type set in Adobe Caslon. Printed by Thomson-Shore, Inc. Portions of chapter 2 from “Mary Breckinridge,” American National Biography, edited by John Garraty, copyright © 1999 by the American Council of Learned Societies. Used by permission of Oxford University Press, Inc. Portions of chapters 2 and 3 from “Nurse-Midwives, the Mass Media, and the Politics of Maternal Health Care in the United States, 1925–1955,” Laura E. Ettinger, Nursing History Review 7 (1999), copyright © 1999, Springer Publishing Company, Inc., New York 10036. Used by permission. Portions of chapter 5 from “Mission to Mothers: Nuns, Latino Families, and the Founding of Santa Fe’s Catholic Maternity Institute,” Women, Health, and Nation: Canada and the United States Since 1945, edited by Georgina Feldberg, Molly Ladd- Taylor, Alison Li, and Kathryn McPherson, copyright © 2003 by McGill-Queen’s University Press. Used by permission. The paper used in this publication meets the minimum requirements of the American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials. ANSI Z39.48–1992. 9 8 7 6 5 4 3 2 1 Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page v For Phyllis and David Ettinger and Jondavid DeLong With love and gratitude Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page vi Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page vii CONTENTS List of Illustrations ix Acknowledgments xiii Chapter 1 Conception: Nurse-Midwives and the Professionalization of Childbirth 1 PART I: Early Labor Pains, 1925–1940 Chapter 2 Eastern Kentucky’s Frontier Nursing Service: Mary Breckinridge’s Mission, Survival Strategies, and Race 31 Chapter 3 New York City’s Maternity Center Association: Educational Opportunities and Urban Constraints 72 PART II: Active Labor, 1940–1960 Chapter 4 Transitions: New Directions, New Limitations 105 Chapter 5 Traditions: Home Birth in a High-Tech Age 136 Chapter 6 Don’t Push: Struggling to Create a Political Strategy and Professional Identity 168 Epilogue Afterbirth: Learning from the Past, Looking to the Future 186 Notes 203 Bibliography 249 Index 265 vii Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page viii Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page ix ILLUSTRATIONS Figures Figure 1 Frontier Nursing Service founder Mary Breckinridge on horse- back. Courtesy of the Audio-Visual Archives, Special Collections and Archives, University of Kentucky Libraries. 34 Figure 2 Betsy Parsons from Hartford, Connecticut, “Courier at Work,” pictured on the cover of the Winter 1934 issue of The Quarterly Bulletin of the Frontier Nursing Service, Inc. Courtesy of the Audio-Visual Archives, Special Collections and Archives, University of Kentucky Libraries. 42 Figure 3 Shown in a 1937 article in Life, the caption above this photo read: “Prenatal visits during which the blood pressure is taken are part of the routine for the busy Kentucky Frontier Nurses. Note the primitive plainness of this Kentucky mountaineer’s well-scrubbed home, the sturdy well-bred features of its hard-working mistress.” (“Frontier Nursing Ser- vice Brings Health to Kentucky Mountaineers,” Life 2, no. 24 (14 June 1937): 35.) Courtesy of the Audio-Visual Archives, Special Collections and Archives, University of Kentucky Libraries. 57 Figure 4 A Frontier Nursing Service nurse-midwife makes a postpartum home visit to a mother and her family, c. 1930s. Courtesy of the Audio- Visual Archives, Special Collections and Archives, University of Ken- tucky Libraries. 66 Figure 5 Maternity Center Association’s Lobenstine School of Midwifery instructor Rose McNaught teaches student nurse-midwife Margaret ix Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page x Illustrations Thomas how to take a patient’s blood pressure, late 1930s. From the per- sonal collection of Helen Varney Burst, CNM; originally from the Mater- nity Center Association. 73 Figure 6 Rose McNaught teaches student nurse-midwives at Maternity Center Association’s Lobenstine School of Midwifery, c. 1930s. Courtesy of the Maternity Center Association. 86 Figure 7 Maternity Center Association home-birth setup, c. 1930s. From the personal collection of Helen Varney Burst, CNM; originally from the Maternity Center Association. 97 Figure 8 Class of student nurse-midwives at Columbia University, c. 1960. From the personal collection of Helen Varney Burst, CNM; origi- nally from the Maternity Center Association. 123 Figure 9 Nurse-midwife Maude Callen, a graduate of the Tuskegee School of Nurse-Midwifery, conducts a class at the State Board of Health’s Midwife Institute at Frogmore on Saint Helena Island, South Carolina, c. 1950. Callen and a group of her students—traditional midwives—surround a pregnant woman on a stretcher. Courtesy of the National Library of Medicine. 151 Figure 10 African-American children in 1949 at the school clinic in Cainhoy, South Carolina, wait their turn to be weighed by nurse-midwife Eugenia Broughton, a graduate that year of Maternity Center Associa- tion’s Lobenstine School of Midwifery who worked closely with Maude Callen. Courtesy of the National Library of Medicine. 152 Figure 11 Catholic Maternity Institute’s Sister Catherine Shean with a family after delivery, 1953. The custom was to offer a prayer of thanksgiv- ing following the birth. Courtesy of the Medical Mission Sisters Archives. 160 Figure 12 Sister Betty Dougherty assisting a pregnant woman into La Casita, the United States’s first out-of-hospital birth center, at Catholic Maternity Institute, Santa Fe, New Mexico (date unknown). Courtesy of the Medical Mission Sisters Archives. 162 Tables Table 2.1 Frontier Nursing Service and Comparison Groups: Maternal Mortality Rate (per 10,000 births), 1925–1937. 70 x Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page xi Illustrations Table 3.1 Employment of the First Twenty Graduates of the Lobenstine School of Midwifery (years of graduation, 1933–1935). 87 Table 3.2 Maternity Center Association and Comparison Groups: Maternal Mortality Rate (per 10,000 births), 1932–1936. 100 Table 4.1 Percentage of American Births in Hospitals, 1935–1960. 108 xi Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page xii Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page xiii ACKNOWLEDGMENTS I AM filled with gratitude as I think about the many people who have helped and supported me throughout the writing of this book. My book has benefited greatly from the comments and suggestions of a number of scholars and editors.Theodore Brown and Lynn Gordon were instrumental in getting this project—and its author—off the ground when the book was in its earliest stages. I am very thankful for all of their com- ments on my work, as well as their warm support while I was a graduate student at the University of Rochester. I also thank Molly Ladd-Taylor and Joan Lynaugh for their comments on my articles on the history of nurse-midwives, and Kathleen Mahoney and Sara Adams for their com- ments on earlier drafts of sections of the book. I am grateful to Lauren Osborne for helping me understand the mysteries of the book publishing process. Thank you to former and current series co-editors Rima Apple, Janet Golden, Susan L. Smith, and Nancy Tomes for taking on my book and carrying it to completion. Former and current Ohio State University Press editors Heather Lee Miller, Sandy Crooms, and Maggie Diehl have been wonderful people with whom to work. I would like to thank the editors of Nursing History Review; Women, Health, and Nation: Canada and the United States since 1945; and American National Biography for permission to reprint previously published work. Portions of chapter 2 appeared in “Mary Breckinridge,” American National Biography, Vol. 3, ed. John A. Garraty and Mark C. Carnes (New York: Oxford University Press, 1999): 462–63. Parts of chapters 2 and 3 xiii Ettinger_fm_3rd.qxd 5/1/2006 2:51 PM Page xiv Acknowledgments appeared in an earlier form in “Nurse-Midwives, the Mass Media, and the Politics of Maternal Health Care in the United States, 1925–1955,” Nurs- ing History Review 7 (1999): 47–66. Sections of chapter 5 appeared in “Mission to Mothers: Nuns, Latino Families, and the Founding of Santa Fe’s Catholic Maternity Institute,” Women, Health, and Nation: Canada and the United States Since 1945, ed. Georgina Feldberg, Molly Ladd-Taylor, Alison Li, and Kathryn McPherson (Montreal: McGill-Queen’s Univer- sity Press, 2003): 144–60. I am grateful to the staff at the following archives, libraries, and insti- tutions for helping me find materials: National Library of Medicine, Maternity Center Association, Medical Mission Sisters Archives, Univer- sity of Kentucky, University of New Mexico, Johns Hopkins University School of Medicine, University of Rochester, and Clarkson University. I especially thank Maureen Corry and Carol Sakala for allowing me access to the stored materials at Maternity Center Association, Stephanie Mor- ris for helping me find materials on Catholic Maternity Institute at the Medical Mission Sisters Archives, and William Mitchell and the entire staff at Archives and Special Collections at the University of Kentucky for making my stays in Lexington such a pleasure.

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