Hello, again History Lovers,
In the early 1900s, over half of U.S. births took place at home with the assistance of a midwife. Some home births were attended by a doctor and/or nurse, and in some situations only the assistance of the women of the family was available. A mere ten percent of births took place in a hospital.
In an effort to better protect the health of both mother and infant, the U.S. Federal Children’s Bureau in Washington D.C. published guidelines for preparing a sanitary home environment for the birthing process. To further disperse the information The Farmer’s Wife–A Magazine For Farm Women published the information in the May 1921 issue. Today’s post is a reprint of that article.
Preparations For A Home Birth
The importance of arranging for the best medical and nursing care available cannot be overemphasized. It is advisable to engage the doctor as early in pregnancy as possible so that he may have the case under observation and make the routine examinations of the urine and may deal at once with any negative symptoms that may arise.
It is becoming more and more common for women to go to a hospital to be confined. The hospital has many advantages over the private house at such a time, for it is cheaper, safer, and far more convenient.
If the confinement is to take place at home, however arrangements should be made for it well in advance in order to avoid haste and confusion at the last minute. It will be found that to engage a competent nurse for at least two weeks and preferably for four, is an economy in the long run.
It is necessary to have plenty of sterile dressings ready for the doctor to use, as they are an essential precaution against the danger of infection. They should be prepared two or three weeks before the expected date of confinement. The following articles are likely to be needed:
- Two to four pounds of absorbent cotton.
- One large package of sterile gauze (25 yards).
- Four rolls of cotton batting.
- Two yards of stout muslin for abdominal binders.
- Twelve old towels or diapers.
- Two old sheets.
- Two yards of bobbin, or very narrow tape, for tying the cord.
From these supplies, the necessary pads, bandages, and dressings are made and all are then sterilized in accordance with these exact directions which follow.
Sanitary pads. These are pads ten inches long and four inches wide which are used to absorb the discharges after the mother has been delivered. As absorbent cotton is comparatively expensive, it will be found more economical to make the greater part of each pad of cotton batting, facing one side with a layer of the absorbent kind. Cut the sterile gauze into pieces of the right size to fold around the cotton and expend two or three inches beyond it at each end. These pads should be about an inch thick, and at least five dozen will be needed. They are pinned front and back to the abdominal binder, which is simply a strip of cotton cloth twelve inches wide and long enough to be fastened comfortably around the abdomen.
Delivery pads. These pads should be a yard square and four inches thick. Cotton batting may form the principal part of the thickness but the top layer of absorbent cotton should be at least one inch thick. Make two of these pads. Cotton waste, if boiled in washing soda and dried thoroughly in the sun, makes a cheap and effective filling in place of batting but as the texture is very loose a thick layer must be used. For later use, they should be covered with old sheets which have been sterilized.
Gauze sponges. Two dozen of these will be needed. They are made by cutting sterile gauze into 18-inch lengths, the width of the gauze. Fold one raw edge down about three inches; double the strip by putting the selvage edges together, having the raw edges of the fold on the outside. Fold this into thirds both ways and turn the sponge inside out, so as to have all the raw edges inside.
Cotton pledgets. These are wads of absorbent cotton, the size of an egg, having the ends of the cotton twisted into the roll. Make several dozen and put them into a small pillowcase or cheesecloth bag.
Gauze squares. Cut fifty 4-inch squares of the gauze. These will be used to wash the baby’s eyes and for other purposes.
Bobbin. Cut ordinary cotton bobbin into six 9-inch lengths for tying the cord.
When these supplies are all made, they should be put into cheesecloth bags, for ease in handling, then sterilized.
How to sterilize. Sterilizing is the process of subjecting anything to the action of heat for a sufficient length of time to free it from all the disease germs that may be present. It is possible to sterilize the dressing in the oven but as dry heat is less effective than moist heat and there is always a danger of scorching, it is better to use steam. The smaller things may be sterilized in a large kettle or saucepan and the larger ones in the wash boiler. For the first, invert a bowl several inches high in the bottom of a perfectly clean saucepan, lay a plate on the bowl, and on the plate place the dressings which have first been put into a cheesecloth bag to facilitate handling. Put enough water to cover the bowl, and then tightly cover the kettle or saucepan. The articles must remain for one hour after the water begins to boil. They are then taken out, dried, done up in sterilized cotton cloth, and put away. They must not be removed from the bags and handled as little as possible.
A convenient method of sterilizing in the boiler is as follows: Take a strip of stout muslin that is somewhat longer than the boiler and fasten it securely to the handles of the boiler by means of a stout drawstring run through each end and, for additional security, down each side as well; the strip should hang down to about one-third the depth of the boiler. This makes a sort of hammock in which the dressings are placed. The boiler is filled about one-quarter full of water and covered tightly, and the articles are left to steam for an hour after the water begins to boil. When they are removed, they should be dried thoroughly in the sun by pinning the bags to the clothesline. If this is not possible, they can be dried in the oven, with care being taken not to burn them. When the dressings are dried, they are immediately wrapped (still left in the cheesecloth bags) in a sterilized cotton cloth or a sheet, and put away in a closed drawer and not touched or handled in any way until they are taken out for the doctor’s use.
A single metal bed and a comfortable mattress are the best. The ordinary double bed is very inconvenient as it is too wide and too low. If a low bed must be used, it may easily be elevated by putting blocks, 6 or 8 inches high, under the four legs, first removing the casters so that there will be no danger of the bed slipping off. If the mattress sags in the middle a board or two may be placed across the bed to support it. The bed should be placed in such a position that both the doctor and the nurse can get at it at once and so that a good light falls upon it both in the daytime and at night.
In making the bed for the delivery, the under sheet which is put on over the mattress pad should be folded under at the four corners and pinned securely to the mattress with safety pins. A piece of rubber sheeting or oilcloth, which has first been wiped on both sides with a cloth wet in some antiseptic solution, should then be placed across the middle of the bed, and over this, a sheet folded once lengthwise. In taking care of the patient, it will be found far easier to change this drawsheet than to change the under-sheet that covers the whole mattress. If desired, a pad made of several thicknesses of newspaper done up in an old sheet that has been sterilized may be used instead of the oilcloth.
The things to be kept in mind in connection with all preparations for confinement are the necessity for the best medical and nursing care available and the prime importance of absolute cleanliness. Everything possible should be done to prevent any infection. What is commonly called childbed fever is a wholly preventable disease. Its causes and the measures necessary to prevent it are well known, and skilled medical and nursing care reduce to a minimum the possibility of its occurrence.
The above article was originally published in The Farmer’s Wife–A Magazine For Farm Women, May 1921, Page 452; Webb Publishing Company, St. Paul, Minnesota. Articles may be edited for length and clarity.