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Sunday, January 24, 2010

Coming Full Circle: Three Generations of Mothers

Even though I'm not sure I could "do" a home birth, I've been acutely interested in it lately. I think it's a deeply personal decision - one that I've become a huge advocate for. If you feel comfortable in your choices and want to do it, go for it, I say. Although some might find that odd if they find out one thing about my family: my great-grandmother, and her baby, both died as a result of a home birth.

It's become almost the stuff of legend in our family: my mom and I often discuss it and have theories. We don't bring it up with my grandmother, because at her age she has memory problems and some topics make her very emotional. So while I've often wanted to, I don't bring up childbirth with her because I'm not sure she'd remember it, or it might upset her.

In the spring of 1925, my 40-year-old great-grandmother gave birth to twin girls. They were born on the family's Ohio farm, where their four siblings were also born. A doctor attended their birth. Unfortunately, no one who could really answer many questions is still alive now, and we've only been able to piece together some facts and thus speculate on what happened.

We do know these things: the first baby, my grandma's twin, came out very blue. I pondered this - was she breech, and got stuck? Head down, but with cord compression? Maybe I'm over-thinking things because of what we know now that might be able to offer some clues. Whatever the case, the baby did live but only for several days. Her mother, Floy, developed severe peritonitis and also died as well.

From what information I have then, I speculated that perhaps the baby was breech, and the doctor either tried unsuccessfully to turn her, or delivered her badly, causing hypoxia in the baby and traumatic internal injury to Floy. Perhaps he used forceps that might have caused an injury; we'll probably never know.

One thing that strikes me, though, is that the doctor apparently was known for his unclean work habits. My great uncle recalled once how the children visited his office for vaccinations or a shot of some kind, and the doctor gave them one - with grease and motor oil dripping down his hands and arms from working on his car.

As I read further, I discovered that proper hand-washing technique for infection control had already been established by Dr. Louis Pasteur in the late 1800s, and by 1910 Dr. Josephine Baker had started a hygiene program for child care providers - to the alarm and protest of physicians who basically thought that it was "...ruining medical practice by...keeping babies well." No doubt it is tragic events like Floy's death that began the hospital birth movement. And yet, during the 19th century,
"Up to 25% of women who delivered their babies in hospitals died from childbed fever (puerperal sepsis), later found to be caused by Streptococcus pyogenes bacteria." 
And, not coincidentally, even today hospital-acquired infections are still a problem.

Unfortunately, there are no medical records that we can study to find out anything else about Floy. The local courthouse experienced flood, fire and theft at various points, which means their records are incomplete. And the doctor, apparently, destroyed his records, which isn't too uncommon anyway.

Despite their deaths, I think somehow my mother - in her before-her-time birth crunchiness that I talked about earlier - and my own birth 'nerdiness' - have come about because of a subconscious connection with our grandmother. Not so much to vindicate, maybe, but to complete the circle, somehow. Perhaps we birthed in a manner of our choosing not so much for ourselves, but for her.

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