Maryland General Hospital was originally designed as a teaching hospital for the medical college, something that was not very common in the U.S. at the time. Before the early 1900s, medical colleges in the United States were fairly unregulated - not the very structured post-graduate school we know today. In 1910, Abraham Flexner completed his exhaustive Medical Education in the United States and Canada, which chronicled the facilities of medical schools. The only one that he found really outstanding was Johns Hopkins Medical School, with it's prerequisite undergraduate course requirements, hands-on education, and state-of-the-art facilities. This became the standard for medical schools across the country, and what we recognize as medical school today.
In 1899, the Maryland Lying-In hospital was advertised as delivering 150 babies. Until the 1930s, most women delivered at home with midwives. Doctors were making a concerted effort to be the medical providers for expecting mothers, and had "Outside Obstetrics Services" to try to replicate the service midwives offered. Obstetric nurses would check on women in the months leading up to delivery, and the baby was delivered at home with the nurse and a doctor. This wasn't how many doctors wanted to deliver, since they often didn't feel as if they were on their own home-turf. They couldn't go into surgery if needed, they might have had a hard time sanitizing delivery tools, and it was the woman's own home.
In 1901, the Sisters of Charity, a Catholic Order, took over the running of the actual hospital. In Flexner's 1909 report, he notes that the entrance requirement is "Much less than a four-year high school education. Advanced standing is freely granted to failed students dropped out of other schools," but does compliment the facilities.
Calling an obstetrics ward a "lying-in hospital" decreased over time, and as science advanced (including pain relief during birth) and women became used to the idea of doctors delivering their babies, hospitals became the most likely place to deliver. Even today, over 90% of deliveries happen in the hospital.
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