Was it time yet?

Fannie Witten moved around her family’s part of the house, probably going about her regular housework, cooking, cleaning, and doing laundry. Her two-year old daughter Sarah might have been toddling around the wood floors. Fannie, her husband Max, and little Sarah shared the three-story brick house with another family, the Ellovitzs. Sarah Ellovitz and her two children might have been home, but the husbands worked long days in the sweatshop garment factories in the neighborhood.

As Fannie went about her day, slowly, but at regular intervals, a tightening started radiating across her belly, becoming more and more painful each time. She had been through this before, but memory does a good job of forgetting about pain. The contractions, now coming closer and closer together meant the baby was ready. The next hours would be painful, scary, and exhausting, and Fannie knew she needed Tante Rosa.

Come, now.

Rosa Fineberg stepped out of her house on the crisp fall day in November 1908 with a large, black bag in her hand. Her leather shoes touched the uneven stones beneath her feet, her tall stature made smaller by the two- and three-story row houses that surrounded her. Tante Rosa was a midwife, and everyday she left her house to visit her expectant mothers.

On the corner a grocery store advertised wares in Yiddish, and just around the corner was the Russiche Schul, where Rosa attended services every Friday night, and around the next corner was the kosher meat market, where much to the dismay of the health department, the butcher kept chickens in the basement. Rosa had arrived from Ekatrinoslav in the Russian empire in the 1890s with her daughters, leaving her husband behind, an unusual move for any woman at the time. She had made these blocks of Baltimore, Maryland her home. She had trained as a midwife in Russia, and she continued working in Baltimore to make a living, and because she had a special calling for the work.

Rosa made her way down Lombard street to South Exeter street to Fannie Witten’s home. The neighborhood of Jonestown was dominated by Russian Jewish immigrants like Rosa and Fannie, who had fled pogroms and persecution in Eastern Europe. Although these streets were an escape from the violence of Russia, many Jewish immigrants were still confined by economics and discrimination. Jonestown was one of the few places newly arrived Jewish immigrants could find a place to live they could afford. The area had first been an enclave for German Jews who arrived in the 1840s, and when they moved to larger homes, they were willing to rent property to another Jewish arrival looking to make it in America.

The walk to Fannie’s was one Rosa had made before and a walk she would make again. She stepped up to the three-story brick house, her hair piled atop her head and her waist cinched by a corset. Rosa checked in on her mothers in the months that led each to their due dates. A midwife looked for the highest point on a mother’s belly, determined how many weeks had passed and how many days were left before baby arrived. Rosa’s visits were to make sure the pregnancy was developing normally.

In Jonestown, there were at least thirteen other practicing Russian Jewish midwives and across the city, 150 white, Black, immigrant, and native-born women delivered some 4,000 babies that year. Fannie trusted Rosa above all the others and, two years ago, had called her for the delivery of her daughter Sarah. Women like Fannie wanted women like Rosa. Expectant mothers called midwives in their neighborhood, who spoke their language, who knew their culture. Many Jonestown women didn’t speak English, only Yiddish, and during this uncertain time, Rosa could explain to expectant mothers what was about to happen. Women had faith in midwives, and Fannie had faith in Rosa.

That faith might not have stopped questions from racing through Fannie’s mind. Flashes of fear could come like a whirlwind. What if she fell ill with an infection? Who would take care of little Sarah if she died? Who would take care of the family? What if the baby went blind from an eye infection? Women and babies died in and after labor, and labor could cause serious injuries. One out of every eight babies didn’t reach her first birthday, and for every thousand pregnant women, almost seven died as a result of childbearing. In her lifetime, Fannie would lose a baby and, chances were, she already knew a woman who had died in labor.

The comfort of the midwife was concrete, yet undefinable: the comfort of being at home with a trusted neighbor; of knowing the midwife had your interest at the top of her priorities; of time, patience, and having someone who listened. Rosa also offered an almost magical comfort. In the neighborhood, rumor was: a simple touch of Rosa’s hand could make pain and fear vanish. Rosa’s own daughter wondered why Rosa had this unexplainable healing power and had appreciated it during her own labors. At the time, the doctors at Johns Hopkins Hospital in Baltimore couldn’t offer much in the way of pain management or comfort, all the doctors were white men who spoke English.

Inside the brick house, Rosa likely also saw Sarah Ellovitz and her children. Sarah and Fannie’s husbands both worked in the garment industry six days a week, ten hours a day. In the summer of 1908, Sarah had given birth to her second child and, although almost 12 years older than 26-year-old Fannie, they were now experiencing motherhood together.

Fannie breathed and pushed. The baby was coming, forcing himself out of her uterus and into the birth canal.

Rosa pulled out her black bag. Sometimes people whispered that she must have kept gold coins in there. In reality, she probably didn’t keep more money than the five to ten dollars she was paid to deliver a baby. She may have had her little red record book inside, and her informal record keeping device, a string with knots tied for each baby she delivered. She would also keep tools to make her job easier: needles and catgut sutures, clean gauze or cotton cloth, soap, a medicine that stimulated contractions called ergot, maybe boric acid. She knew about antiseptics and keeping the area around her patients clean. She needed to have freshly laundered sheets, an extra pad to soak up blood and fluids, and boiled water to clean mother and baby.

Rosa would examine Fannie to make sure the baby was properly placed with his head facing down inside the uterus. Any other position was called a breech, dangerous for both the mother and child. If the baby remained in that position as labor progressed, Rosa would call for a doctor. She would press her ear against a cone that rested on Fannie’s belly to listen for the baby’s heartbeat. Anything unusual in the tick-tick rhythm could tell her if something was about to go wrong.

Fannie’s water broke.

The pain came, at closer and closer intervals, and Fannie might not have been able to speak through it.

Push.

When the pains got very close, Rosa knew she would have to clean the vulva and inner surfaces of Fannie’s thighs. She would use hot water and soap to make sure the mother was as clean as possible.

Rosa listened, once again, for signs of distress, which could indicate that the umbilical cord was wrapped around the baby’s neck. Always listening for the tick-tick of the baby’s heart. With clean hands, Rosa could apply pressure to the skin around the vaginal opening to feel how far down the baby’s head was.

Then, as the cervix became fully dilated, the baby moved into the birth canal. A sudden panic struck Fannie. She’d had this feeling before and knew she need not worry. Had this been her first child, the panic could have been chilling. She understood that the pain was a natural warning to a mother that, in this next stage of labor, she should not be alone. For the uninitiated, the floor is disappearing, there is no salvation. Even knowing what was next, Fannie may have screamed out for help. Rosa knew, Fannie had to start pushing in earnest.

With each contraction, Fannie had to go against her instincts and push. She was already in pain and, with each push, she created more pain for herself. With each push, the baby’s head was moving farther down the birth canal, expanding the soft tissue, even causing small tears. Sweating, grunting, tightening, clenching. This was labor.

The baby’s head emerged first and, even if everything had gone well until this point, there was still the chance for complications. Rosa had to check to make sure the cord was not wrapped around the baby’s neck. If it was and it was still loose, Rosa could slip it over the baby’s head immediately. If the cord was tight and the baby’s face looked discolored and distressed, she’d have to cut the cord immediately and extract him as fast as possible. She’d have to save the baby from choking. For a normal birth, Rosa would simply grab the baby boy and help him out.

He took his first breath and loud, forceful cries let everyone know he was alright. Rosa could not move him too far before she cut the umbilical cord, still attached to the placenta inside Fannie. Even the slightest tug could cause her more discomfort. When the cord ceased to pulsate with blood, Rosa clamped it in two places and then cut in between. She scooped up the baby boy and put him in a blanket and, to the side, perhaps in a bassinet. Fannie’s job wasn’t done.

The placenta still needed to come out. If the organ that had helped nourish her baby did not pass properly, Fannie might get an infection, which easily led to death. If the placenta was removed improperly, excessive bleeding could also kill her. Fannie needed to push more. She was physically exhausted, her body covered in sweat, and perhaps her birth canal had even torn. Pushing more was probably the last thing she wanted to do, but it wasn’t an option. Once the placenta was out, she could hold her baby boy.

Now you can rest.

Rosa cleaned up mother, baby, and the house as part of her job. She returned for a whole week after the birth to take care of mother and baby. She also provided ongoing labor. For religious reasons, Fannie would have been separated from her husband for seven nights, and Max’s unrelenting work hours meant he didn’t have time to take care of Fannie or the family. But little Sarah still needed care, the family still needed meals, laundry, and a tidy house, and a newborn needed everything. The baby had to be fed every four to five hours and he needed clean diapers and clothes, which had to be washed outside since the house didn’t have running water and Baltimore had no municipal sewers. Her neighbor Sarah could only help so much, she had her own family. After the birth of this child, the Wittens were only a family of four, but most of the families Rosa attended had three or more children; sometimes Rosa was there to deliver the 11th, 12th, or 13th baby. Simple household help was almost a necessity.

Perhaps that day the baby was born, or perhaps it was eight days later—after Fannie’s baby was officially named at his Brit Milah—Rosa Fineberg opened one of her little red record books and filled out the eleventh page. ✎

1. Sex: Male No. Child of Mother: 3
2. Name of Child: Julius
3. Race or Color: White
4. Date: Nov. 20 / 08
5. Place of Birth: 229 S. Exeter
6. Full Name of Mother: Fannie Witten
7. Mother’s Maiden Name: Kline
8. Mother’s Birthplace: Russia
9. Full Name of Father: Max Witten
10. Father’s Occupation: Tailor
11. Father’s Birthplace: Russia

This page was how she officially recorded baby Julius’s birth. Informally, she added a knot to the more than one thousand on the string she carried with her.

Tante Rosa kept those books and that string, they were precious to her, but most midwives didn’t leave records behind. There were hundreds of women delivering babies in Baltimore, thousands across the country, and they were all different: a midwife could be single, married, widowed, old, young, Black, white, native-born, immigrant, literate, illiterate. The midwife was everywhere, catching babies. She provided healthcare for women, for her neighbors, her daughters, most of whom could not afford a doctor. For immigrant families in the Jonestown neighborhood, and working-class women across the country, life without the midwife was unimaginable.

To the male doctors at Hopkins and other upper-class members of Baltimore society who involved themselves in public health work, women like Rosa were a faceless, nameless entity, simply known as the midwife. These women were not always considered a benefit to the community. Only some had real professional training, and some didn’t even speak English, and many middle and upper-class Americans were increasingly convinced that the midwife did more harm than good to mothers. Even though medical school and training weren’t formalized, they thought male doctors should be delivering babies. Public health workers in almost every state were convinced that unregulated midwives, women like Tante Rosa, caused the deaths of women and babies, and were determined to do something about it.
 
 

✎ Page 11 of Rosa Fineberg’s notebook has been reproduced with permission of the Jewish Museum of Maryland. (MS 180/ 1966.003.022)


KRISTINA GADDY believes in the power of narrative nonfiction and history. She writes for OZY‘s Flashback section, and has written for The Washington Post, The Baltimore Sun, and historical publications, and recently co-produced a radio story on the Lee-Jackson Monument and Confederate legacy in Baltimore. She loves digging in archives and discovering obscure history, and came to writing after working in museums, where she co-curated and designed exhibits, digitized and archived local history collections, and produced a CD of field recordings of a ballad-singer and banjo-player Currence Hammonds. She has a MFA in creative nonfiction writing from Goucher College and B.A.s in History and Modern Languages from UMBC.