|Midwives Once Vital - And May Be Again|
By Gwen Keane
Once Midwives were a vital necessity here in the Northern Neck. However, there is very little recorded history on the subject of Midwives in rural Virginia.
Fortunately, one of our very own retired Midwives, Claudine Curry Smith, kept notes and records, as well as the active mind she retains today, to record her experiences and the environment that Midwives faced.
Claudine Curry Smith, who literally wrote the book on being a midwife.
For more than 30 years Claudine practiced the proud tradition of being a Midwife. In her book “My Bag Was Always Packed,” which she co-authored with Mildred H. B. Roberson, she describes those experiences here in the Northern Neck as well as the local culture and the existing life style.
Today at age 82, Claudine continues to enjoy more than 70 years of marriage to James Smith Sr. They have raised five children. In 1981 Claudine retired as a Midwife and after having driven a school bus for 37 years in 1987 she retired from that job also.
In the last two years there has been much local public awareness regarding the loss of the Obstetrics Department at our local hospital, Rappahannock General. The burden now lies on the pregnant woman in labor and family to get her safely to Fredericksburg, Richmond or Newport News for delivering the baby. There is much irony in having lost the delivery services provided by our local hospital since 1977. In the mid 1950’s there were at least two local physicians in Kilmarnock who established delivery clinics. And, thirty years later those clinics were closed because we now had an Obstetrics Department in our local hospital.
Our community continues to change. Some things that we as a community use to enjoy are now lost. We had a movie theater in Kilmarnock, a drive-in theater in Kilmarnock, a miniature golf course, a Dairy Queen, public beaches and during the summer months there were Saturday night live band dances held at White Stone Beach. We even had the Safeway Store move in to Kilmarnock twice and leave twice. And we even once had a very extensive and well-constructed public playground adjoining what is now the Lancaster Middle School.
But our community losses are balanced with gains; especially with the expansion and commitment of volunteerism. In the 1950’s all patients were transported to Richmond hospitals in either a private vehicle or a herse provided by our local funeral home owners, Mr. Elmore or Mr. Haynie. Today, our dedicated and well-trained volunteers provide citizens with transportation via the local rescue squads. Also today, due to the generosity and the vision of others, we have a free clinic to service the needs of those who cannot afford medical and dental services.
However, we still do not have a local sanctioned system to provide for the safe delivery of babies. As Claudine describes in her book “The difference and distance of travel to hospitals in Richmond made hospital delivery an unreasonable choice for local women. Well today, although we are still the same distance from Richmond, our expectant mothers have no choice.
In the days of Midwives, you became a Midwife primarily through the apprenticeship system. To be a Midwife you learned by working under the tutorage of another Midwife (usually a family member) and sometimes a physician led the way.
In Virginia, the informal system for Midwives became formalized in 1950, when the Department of Health was created. Prior to 1950, when a woman was pregnant and planned to deliver at home, she would contact a Midwife and tell her when she would “be needing her.” When she went into labor a family member or neighbor would contact the Midwife and say her services were needed.
Claudine, as a Midwife, would tell her patients in advance to have hot water on and the basin ready so she could wash the mother. The patients were also told to have pads and plenty of newspaper to prepare the bed. Most of the homes she went to were located down long dirt lanes. Some of the homes only had kerosene for lighting and wood stoves by which to heat. Running water was not always available.
Claudine understood the economic status of her patients. Some patients did not have the needed supplies so Claudine always made sure in the trunk of her car she had clean sheets for the bed and newspaper, as well as old gowns she would use to make baby clothes when waiting for the baby to arrive. Sometimes the Midwife would be paid $20 at the time of delivery and also given a tip. Some patients, however, would volunteer to pay on the installment plan by offering $5 a month. This was an era when “Pregnancy was considered a natural occurrence not requiring medical management.”
The good Midwife practiced good bedside manners and devoted her attention to the patient. Claudine says “I remember how I would give the patient a cup of tea, talk with her, and joke with her to try and get her to relax. And once the baby arrived, if it wasn’t crying after slapping its buttock, I’d get two pails of water, one lukewarm and one cold and I’d dip the baby first in one, then in the other for 4 or 5 times. I got this advice from one of my grandmothers and a great aunt who also had been Midwives. So I thought if it was “old timey” advice then I was gonna try it and sure enough - it worked. And too, you kind of started by saying a silent prayer to God.”
After 1950 there was a requirement for Midwives to be licensed. It then became the responsibility of public health nurses to provide training and a Midwife manual was developed. There was a Midwife bag and you were only allowed to carry the items listed in the manual. No gloves were allowed because the Midwife was not allowed to put her hands inside of the mother.
When the system became formalized, Midwives were no longer allowed to deliver babies unless the patient had been to a doctor and had him sign a card showing approval for the Midwife to deliver the baby. If Claudine didn’t get a signed card from the patient in advance, she couldn’t go deliver the baby, unless she called the doctor and got permission. She also was required to call the doctor if the delivery was taking too long or if it was clear it was going to be a troublesome birth. Claudine recalls once when a premature baby was born to a woman whose husband ran “a joint (beer joint or something)” and Claudine called the doctor to discuss the situation. He told her to make an incubator and to ride with both the husband and baby to Richmond.
When they got to Richmond they were met by waiting staff members at the hospital. Later the staff asked Claudine if she was the one who had made the incubator. She said yes. “I put the baby in a cardboard box, wrapped it up warmly and surrounded the baby by whiskey bottles that held warm water.” Because there was no hot water bottle available, this Midwife had to be creative and her outstanding creativity caught the attention of the hospital staff.
In 1977 the state of Virginia banned the licensing of Midwives. Those already practicing could continue. By the time Claudine retired, she had delivered 200 babies and assisted doctors in the delivery of 300 more babies.
According to Claudine, “back in the days of Midwives and local
clinics, the word “malpractice” was not part of the vocabulary
or the suggestion of suing. When something went wrong the attitude was
“Well, I know they did their best.” And even today, Claudine
Smith embraces the concept of “doing her best” as she continues
on loving and caring about family and people in her community.
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