Lying-In, in 1887

If you were pregnant in the 1880s, the first thing you would been is scared.  Although many women may have been pleased they completed their womanly duties, the reality was that childbirth could mean injury, disease, and death.  Rich women had doctors come to their homes.  The women who could not afford doctors called on midwives.  And those who could not afford good midwives were often placed in the hands of practitioners who didn't know what they were doing.  Elite members of Baltimore society thought that number was too high, and that everyone deserved medical care.  In May of 1887, the Free Lying-In Hospital of the University of Maryland opened in Baltimore under the direction of Dr. George W. Miltenberger and Dr. L. Ernest Neale. 

The year that the Lying-In hospital opened, the only other hospitals for women in Baltimore were the Maryland Woman's Hospital (at 112 E. Saratoga St.) and the Maternite Lying-In-Asylum at 113 E. Lombard St., both associated with the College of Physicians and Surgeons.    Part of the reason that medical schools opened hospitals was so that their students could learn by seeing patients, not just sitting in a classroom.  Intern years and residencies were not officially part of the medical school curriculum yet.  The Lying-In Hospital gave the University of Maryland, where Dr. Miltenberger and Dr. Neale were both graduates of and professors at, a perfect opportunity to help and teach.

"The large proportion of needy poor and unfortunates in every large city calls loudly for aid for simple charity's sake, while the benefits to the community, both present and future, from an institution where practical instruction at the bed-side could be afforded to advanced students, are self-evident."                - First Annual Report p. 8

The Lying-In Hospital came at the advent of the new era of hospital.  The wards were large, with high ceilings and white-washed walls.  The beds were made of painted iron.  The simple construction made them easy to clean.  On top of the bed frame there were wire-spring mattresses, a relatively new invention that was much cleaner and hygienic than stuffed mattresses.  Although they didn't have running water in the wards (Baltimore would not have a city-wide sewer system for another 24 years), polished-surface basin and pitcher were used for cleaning patients. 

The beds weren't the only attempts at hygiene within the hospital. The doctors and nurses were proud of their antiseptic use, happily disinfecting beds, bedding, equipment, and themselves.  The cleanliness was born out of fear.  Child bed fever, also known as septicemia or blood poisoning, was a common cause of death among women giving birth. 

A female ward at Massachusetts General Hospital in 1888.  The furnishings would have been similar to the Lying-In Hospital.

Another distinct feature was that both white and black people were attended to in the hospital.  Johns Hopkins would become famous for serving all races of poor people a few years later, but the Lying-In Hospital was already doing it.  However, the report does make a specific point that the two wards are separate from one another.

In their first seven months of operation, the hospital saw 62 women, 57 of whom gave birth.  Two women died, most likely a result of postpartum hemorrhage since no cases of septicemia were reported. Four out of fifty-eight children died, a relatively low rate compared to national infant mortality, which continued to be as high as twenty percent in some areas into the 21st century.

I'll end with my favorite quote from the 1st report:

"All malt liquors, wines, spirits, etc., brought to the house shall be placed in charge of the Matron, and used only by order of the attending physicians."