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DEATON: This is an interview with Miss Martha Lady for the Oral History Project, Frontier Nursing Service, at approximately 2:30 p.m. on August 4th, 1978 at Springfield, Ohio by Dale Deaton. Do you recall the first time that you became acquainted or heard about the Frontier Nursing Service?

LADY: I don't think I can recall the very first time. I had an aunt who was a midwife, and I was quite young when she became a midwife, and so I was quite a young person when I first heard about Frontier Nursing Service. And since I had planned at that time to go as a missionary to Africa, this fascinated me very much because I had planned all along to be a nurse and I thought this sounded very, very interesting. So I was quite young.

DEATON: Do you know where your aunt had her training at as . . . for 00:01:00. . . to be a midwife?

LADY: There, at Frontier Nursing.

DEATON: Oh, she did?

LADY: Umhmm.

DEATON: And what was her name?

LADY: Rhoda Lenhert.

DEATON: Hmm. Do you have any idea about what time she was there? About . . . approximately what year?

LADY: No, I don't. I'm sorry.

DEATON: Hmm. And you're . . . you're originally from Kansas?

LADY: That's right.

DEATON: And what . . . what other training did you have before you went to the ?

LADY: Well, I . . . I took my high school training in Kan-. . . in the State of Kansas, then I went to a church school in Pennsylvania for two years of college, junior high, and took . . . finished up in a church school in California. And from there I went to Western Res-. . . Case Western Reserve University for my basic training in nursing and there, again, I had a contact with a midwife who was Eileen Holden who was my basic nursing instructor in obstetrics. And I think she really sold us on obstetrics as much as any one person. And I had 00:02:00planned to go to Africa shortly after I finished with my nursing, and . . . act-. . . well, actually I planned to take my midwifery before I went to Africa, and then it ended up they needed a nurse and I went ahead with the pur-. . . I had been accepted in the Class of '54. And . . . but I went to Africa instead and came back and I took it in '60. But this is something I had in my mind for as long as I can remember, to be a midwife. So I . . . I took public . . . I did visiting nurse's work in Cleveland after I finished my training before going to Africa.

DEATON: Well, while you were in Africa the first time, were there that many trained nurse-midwives there?

LADY: My aunt was there at that time and one other. There were two, both Frontier Nursing Service graduates.

DEATON: And what country were you in?

LADY: They were in Rhodesia. Well, that's what . . .

DEATON: And you took the nurses-midwife training at Hyden in 1960?

00:03:00

LADY: Sixty-'61, winter.

DEATON: And where did you go from there?

LADY: I went back to Rhodesia. I spent three years in Rhodesia, then went up to Zam-. . . Northern Rhodesia, what is now Zambia, after that.

DEATON: When you were planning to go to . . . to the for the training, do you recall if you remembered or if you knew about any other place in the United States that offered midwifery training at the time?

LADY: I'm not sure that I . . . I think I knew there were some, but I wasn't interested in them. This was something . . . well, my aunt had gone here and I had the feeling that this was the type of training that would be a little better and a little more easily adapted to what I'd be doing in Africa. little more of a basic kind of . . . type of work and a little more in the rough.

DEATON: Umhmm. Because of the rural setting?

LADY: That's right. Plus the fact I'm a rural person [chuckle] and I 00:04:00prefer it.

DEATON: Uh-huh. Hmm. Do you recall the people or the instructors in the School of Midwifery when you were at Hyden?

LADY: Carolyn Banghart was our main instructor and Molly Lee was her assistant. Dr. Beasley was the medical director I recall very well.

DEATON: What was your impression of those people while you were there?

LADY: I have always had a lot of respect for Dr. Beasley. And he left just about the time we were finished. But we . . . we thought he was just about it. And Carolyn Banghart was an excellent teacher. And as far as classroom instructor, I felt she was one of the better ones I've ever had anywhere.

DEATON: How long was the training?

LADY: Six months.

DEATON: Do you remember what your ideas and impressions were? Did you have a concept of what the Appalachian area was like before you 00:05:00went to Hyden?

LADY: Not really, no. Not really. It was a new experience for me, these . . . these people, altogether new. I was intrigued with the similarities I found between them and the people I worked with in Africa.

DEATON: Could you expand on that?

LADY: I'm not exactly sure if I can, but I know that in my class there were four of us who were home on furlough from Africa, and we all had the same type of feeling. I think part of it is their close living in na-. . . with nature, especially your women that were having babies. To them this wasn't any big deal. This is what I'm here for. I'm . . . I was born to have children, let's get down to work and have a baby. And that's . . . they went to work as though this is something . . . what we do and let's not make a big fuss about it, very much like our African women did. But I think it was just sort of a basic oneness with nature. Something that . . . I don't know what it was, but there was something very, very closely connected. And I 00:06:00. . . I have found it quite easily to really become very intrigued with them and be very attached to 'em, really.

DEATON: Have you talked to other midwives who worked not only in Africa but other countries around the world in rural settings who may have felt the same?

LADY: No, I haven't. These other girls I worked with were from different parts of Africa. But I think it's basically that they're a basic type of person. That they're not complicated with a bunch of . . . their lives aren't complicated with a lot of civilization. I don't mean civilization, but a lot of fancy tape, fixings from . . . I don't know. I don't know what it is except that it's a . . . as one of our doctors in Africa said, "Life is basic," and that's pretty much what it was. Just not as complicated. Maybe that's the word I want.

DEATON: Well, do you recall your reaction to the area and the people when you first . . .

LADY: I loved it.

DEATON: . . . went up there?

LADY: I loved it. That was . . . I . . . I really did. I was 00:07:00very, very fascinated with the country and the people. I . . . I felt at the time if I didn't go back to Africa, I could work down there without any problems.

DEATON: Did you meet Mary Breckinridge while you were there?

LADY: Yes. She had her ninetieth birthday when we were there.

DEATON: Did you get to talk with her very much?

LADY: Just to sit down and talk a lot, no. It was more in a group . . . in general conversation. I never heard a whole lot of her stories. She wasn't really awfully strong when I was there and she wasn't quite as public as she had been earlier.

DEATON: What was your impression of her? How . . . what type of a person did you perceive her as being? If you had to provide a good description of her physically and mentally and so forth, and the effect that she had on people around her, how would you describe her?

LADY: Physically she was not strong at the time I knew her, but she 00:08:00somehow had a command of . . . over everybody in the room and the place. Her presence was felt even . . . well, her presence was there even though she might have been upstairs in another room. You . . . you knew that she was there, that she was in command. I . . . I don't know quite how else to say it briefly. 'Course I never knew her when she was out doing a lot of her riding, that sort of stuff, but I was impressed with the fact that she was very much aware of who was where. Now, we were there as students. We were there for only a short time, but she seemed to know who we were and what we were there for. I think that's . . .

DEATON: How did the . . . the people who were the instructors in the school at the time, the other workers there with the , did they 00:09:00make references to her, or how do you think that they felt about her? How did they view her? Was she sort of the person they went to with problems or was . . . or was she more . . . had more of the image of a field commander of the whole operation?

LADY: I would say a field commander would be a little more of the impression I had at the time I was there. 'Course my contacts with the program there was mainly at the hospital. And Wendover, we got out there usually once a . . . once a week. When they usually had their weekly get-togethers out there, we used to go out there if we weren't on call. But I . . . I sort of had . . . now Miss [Helen] Browne may have had . . . I think she often was . . . her advice was sought. I think . . . I sort of had a feeling maybe it was more out of politeness maybe, that . . . I'm not sure, really. But I think maybe she was sort of a field commander and didn't make all the little decisions. But I'm not sure. [Chuckle] I have too strong of an 00:10:00opinion there.

DEATON: Uh-huh. Well, after you left Hyden, and after you completed your training, could you sort of go into some detail about the work that you did in Africa, the various peoples that you came in contact with there?

LADY: My first three years in Africa, after my midwifery, were spent in a little clinic . . . a rural clinic in Rhodesia. We were twenty- six miles from the nearest doctor. And this was the place I really loved. We had one Afric-. . . I had one African nurse and she did the normal deliveries, and she'd call [chuckling] me for the problems. But no, we took turns. Every other week we would be on call for deliveries. And we had . . . the two of us in this little hospital would up . . . have up to twenty-five, thirty deliveries a month. So we had a fairly good workout. Not as much as you get some places, but we had a general clinic plus our obstetrics. And we would have ten, 00:11:00twenty women waiting there to deliver. Any problems I had usually had to go to the government hospital twenty-five, twenty-six miles away, and we'd cart them in a van. And so I had quite a bit of obstetrics those first three years. Very, very much on the normal side. 'Course after having . . . do you want me to go beyond the three years?

DEATON: Umhmm.

LADY: Then I went up to Zambia, or Northern Rhodesia at that time. The women had their babies at home and you . . . we saw very few of 'em unless they had problems. So what came to our hospitals up there were problems. Really . . . really often very big ones. The first hospital I worked at was just a little clinic and there, again, I was about twenty- five miles from the government hospital where I could take my problems. But I . . . I saw some of the worst obstetrical problems in Zambia as I've seen anywhere in my experience. I mean we 00:12:00saw more than one come in with a ruptured uterus. Had been in labor for four days and had no way to get in. And you'd take 'em on to the government hospital and . . . but I was amazed at some things that I had to deliver and got along pretty well. I would hate to try it here. Then I spent some time as well in a . . . in a larger hospital where we did have a doctor. In this particular case I think most of the time I was the only midwife those first years. The nurse . . . African nurses did the normal deliveries and then we would be called. If it was something we couldn't take care of, then we would call the doctor. So they called us for twins and breeches, and lots of times we did that rather than call the doctor. And if the doctor had to be called, it was usually for forceps or a Caesarian.

DEATON: What was the organization that you worked through to get to Africa and you worked through in that?

00:13:00

LADY: It was mission work for my church, The Brethren in Christ.

DEATON: Umhmm. And when your African duty was over, you returned. Did you come back to Springfield from Africa?

LADY: I had two terms. I went . . . I went out to Africa for two terms after my midwifery. I just came back . . . retired from Africa about four years ago. And I spent a year with my parents in Kansas. My parents were getting older and I worked in a general hospital in Kansas hoping I could get over the culture shock of medicine that year, but I didn't quite do it. [Laughs] I didn't really get into it till I got into obstetrics, then I . . . then I came to Springfield. I had heard about Springfield through our American College of Nurse-Midwives, their journal, and they had a write-up in this . . . in this paper about this set-up here and . . . plus the fact they had a refresher program which I felt I needed since I had done only obstetrics and midwifery in Africa and never in this country. 00:14:00So I applied for the refresher course.

DEATON: And that was through the American College of . . .

LADY: That's right.

DEATON: . . . of Nurse-Midwives? What type of program did they have established here in Springfield?

LADY: Well, at that time, we had a refresher program which was set up for girls who have had their midwifery overseas, their midwifery training. And in order for them to beca-. . . become certified nurse-midwives in this country, they have to take a certification exam. But before they take the exam they have to take a refresher course here. So this course is mainly set up for them. And I got into it, I know, only because I said I was willing to work in midwifery in this part of the . . . in this part of the states. I have family near here, and I figure this would be a chance to practice midwifery and yet be close to family. And I'm sure that's one reason I got into the program.

DEATON: Does . . . does this training program operate through a hospital here . . .

LADY: Yes. [Chuckle]

DEATON: . . . or an association with hospitals?

LADY: It's a very unique type of a set-up. We . . . this was set 00:15:00up by a Dr. Beasley, who was a friend of Dr. . . . I'm sorry, Dr. Burnett, who was a friend of Dr. Beasley's. And he was a doctor who took everybody. Those who couldn't pay. I mean if they couldn't get anywhere else, he would take 'em. And he was swamped. And I don't know if it was Dr. Beasley or somebody else suggested a midwife to him. So he advertised and one came. The off-. . . the office, the waiting room was full of patients. You had to work. [Chuckle]

DEATON: Do you . . . do you know her name offhand?

LADY: It's Mrs. Simpson. I'm sorry, her first name's slipped me. I'm sorry. It'll come.

DEATON: Well, Simpson's fine.

LADY: It . . . it . . . the center's been named for her. But, yes, I have met her. And then gradually he . . . he sort of had the midwives under him, and gradually they added more midwives, then the doc-. . . the hospital took over and hired the midwives. And 00:16:00he acted as the medical director for awhile, but at just about the time I started as a staff nurse-midwife here, we got a full- time medical director hired by the hospital. So we were hired by the hospital but our little office was off someplace else. And they come . . . they have to get financial clearing through the hospital. But they come to us, not through a hospital clinic. They come out of choice in most cases.

DEATON: Now the hospital's name is what?

LADY: Community.

DEATON: Community Hospital?

LADY: It's Community Hospital here in Springfield.

DEATON: And what's the name of the clinic?

LADY: Simpson Center for Maternal Health.

DEATON: Umhmm. Okay.

LADY: At this point, we don't have the refresher course anymore. It was under federal funding and our three years is up, and we got permission to continue the program but not the finances.

DEATON: Aha! Do you have any idea of the number of people that took that refresher course during those three years?

LADY: I think there . . . well, there . . . it's been . . . the refresher course has been more than three years. I'm not sure how many 00:17:00years, but there's been over a hundred have gone through. They took about twelve for . . . about twelve a year.

DEATON: Umhmm. How many nurse midwives work for the Center now and are working for the . . .

LADY: Eight of us.

DEATON: Eight? Do you have an idea of . . . of, say, an average of the . . . the number of mothers and babies that you would cared for?

LADY: We have fifty to sixty deliveries a month.

DEATON: And who's the . . .

LADY: We do a third of the hospital deliveries.

DEATON: . . . who are the doctors that provide the back-up mostly?

LADY: All the doctors on the staff except one have to take call for us. [Chuckle] It's part of the requirement of being on [chuckle] the staff. The one is an older man that has a little trouble accepting new ideas, and . . . but he did deliver a baby for us the other night. Got . . . the nurse-midwife got in trouble with a . . . stuck shoulders, and he came in and delivered it. So they all are our back- up, but Dr. [Zyphyll Gergiss?] from Egypt is our medical director. We 00:18:00do the initial examination on the patients and then he screens them, and he's the one we consult if we run into any physical problems. And he's the one that does the . . . schedules C-sections and things like that. But if it's an emergency one, it's whoever is on call. On the whole, we get quite good cooperation. We do quite well.

DEATON: Over the past few years in the United States more mothers or more pregnant women, I suppose would be a better word, have had an increased interest in natural childbirth. What's the range of the . . . the mothers or the . . . the people that you care for? Do they have any type of . . . sort of an average economic background or social background, or could . . .

LADY: At this point, we have the . . . are getting a great number of 00:19:00the lower sociological, social-economic status. There . . . less and less of the doctors are taking welfare patients, so we are getting welfare patients and those who have trouble paying. And as a result, we're getting a lot of our . . . the young teenagers. We're getting a lot of the ones with a lot of social problems, really. We're getting a lot of problems period, and it's getting worse. But we do have some who come to us because they want the nurse-midwifery delivery. And as a rule, once you've had . . . they've had one with us, they come back for more.

DEATON: Why do you think that is? What . . . what is there about having a nurse-midwife attending . . .

LADY: Attention.

DEATON: . . . as opposed to another physician?

LADY: Attention.

DEATON: Could you describe that a little better?

LADY: They . . . they will tal-. . . they will tell . . . well, once in awhile we'll have some . . . some of our young girls come in because they're afraid to have a man. They want a . . . and they . . . till you get 'em through the . . . the doctor examination, 00:20:00you know, you tell 'em, "Now, that's the last you'll see the doctor unless you have any trouble." Oh, they're . . . they're terribly relieved. But they're really uptight and they just . . . well, they just think it's easier with a woman. There's a lot of 'em that say that. But they . . . they will talk about the time and attention. We [sighs] . . . we try to . . . we try to do a lot of . . . quite a bit of teaching during their . . . the prenatal period. We have a lot of films we show them, and we encourage attendance in our prenatal classes. And we have our own classes. And I think it's been easier as a result for the unmarried girl to come to classes. And the last couple years, they're coming quite well because the word is getting around that it isn't so hard when you have classes. And we . . . we . . . the midwives take turns cla-. . . teaching, but we all have very much the same philosophy. And what one teaches usually pretty well fi-. . . we know how we like to work with the girls in labor. 00:21:00So we . . . that's the way we teach 'em. We . . . we spend a lot in prenatal. We . . . we encourage 'em to ask questions, and we try to spend a lot of time answering questions. We encourage anybody in the family who wants to . . . who they want to bring in to hear the baby's heartbeat and all this sort of stuff. The fath-. . . we really try to work with the father in as much as possible. And if it's a mother or whoever, some support person. And then when they're in labor, we usually give them the pre-. . . their care during labor. The labor room nurses will help us with the admission procedures, but we are the ones that give them their care during labor, as much as we are physically able to do. If we have . . . if there's somebody in labor and we're delivering in the delivery room, of course the other nurses follow our patients, but we work with 'em pretty close during labor, and they recognize that. We spend a lot of time with 'em. Then afterwards, we do teaching . . . we do teaching rounds and there, again, we will spend, well, as much as necessary in working with 00:22:00these patients. Getting them started on birth control, things like that, while they're in the hospital. And most of 'em, if they've had an experience with the doctor, will come back 'cause . . . partly because we take time to answer their questions and talk with them. All kinds of phone calls that nobody would dare call a doctor about because we get a lot of them with questions we think are really most unnecessary, but lots of times we recognize that what they need is somebody to talk to. We get along well. Plus the fact, we've been able to work in quite a bid of social help. Our social workers at the hospital work very closely with us and are really good to our patients. And then, a couple years ago, a young fellow in mental health got interested in starting peer support groups for these unmarried girls, or anybody who had nobody to help them. Nobody to give them support during labor, during their pregnancy, so he started a group for some of our problem patients and that has continued.

DEATON: Now, those are people who've given birth with a midwife 00:23:00attending? How did this . . . how does the peer support group work? How does the . . .

LADY: It's mainly girls that we come in . . . we take this history . . . initial history, and it's . . . they've got all kinds of problems. There may be problems in their home with their parents, or else it might be a woman whose husband simply deserted her and she is alone. She may new in the town, have very few friends. It's just a matter of getting these girls together and let 'em talk about their problems and realize they're not . . . that . . . they sort of support each other. It's worked pretty well in a couple cases, not all of them. But it has gotten us in the mental health agency that if we . . . after they deliver, we ask 'em to come and follow-up some of these problems. And some of 'em needed it. [Chuckle] Now, I wasn't sure what you meant about natural childbirth. What do you mean by natural childbirth?

DEATON: Oh, okay. Well, that was probably a mis-. . . that was a misused word on my part. I'm . . . the . . . I suppose . . .

00:24:00

LADY: [Inaudible].

DEATON: . . . the emphasis has been really without . . .

LADY: Medication.

DEATON: . . . yeah, without medication, . . .

LADY: Yeah.

DEATON: . . . without anesthesia of some kind.

LADY: Well, we . . . we . . .

DEATON: Is that . . . well, clarify me on that. Does that . . . does that sort of go hand in hand with the rest of . . .

LADY: I . . . I don't . . . you're not the only one I ask that question to.

DEATON: Yeah.

LADY: These pa-. . . see, we have patients come in, they'll say they don't want natural childbirth, I will say, "What do you mean by natural childbirth?" I say, "We try to make it as natural as we can, but we do use medications." There are some women who cannot go through it without a little bit of help, and lots of times all it is is a little mild tranquilizer and they're . . . they go through on . . . fine on their own with . . . with somebody there. We . . . we use a lot of what we can psychosomatic type of . . . that is, . . .

DEATON: Now, explain that for me.

LADY: . . . yeah, I mean, just to . . . well, we say . . . they c-. . . the doctors comment about our low dosage of medications. We do not give nearly the dose. I'd say we give about half of what the doctors give and our patients get through just as well. And we say 00:25:00it's because we're there. We say it's . . . it's the midwife being there, breathing with them, encouraging, "Now, you're doing fine," and it gets 'em through it. And most of our patients come back and say it wasn't as bad as they expected, and we feel like that's what we want. But we do use medication. And we have found most women usually needed it. And we try to encourage 'em to feel that they have not made a . . . made a failure of it if they have to have medication.

DEATON: Is this one of several or . . . or the only program of this type in the United States now?

LADY: I think it's the only one just like this one. That . . . the ones that are associated with a hospital are usually in a clinic setting and we aren't. We have our own office. And they don't come to the hospital to see us, they come to our office. And I . . . I think it's unique in that respect.

DEATON: I suppose sort of what I'm going after is that regardless . . 00:26:00. or . . . yeah, regardless of . . . of preconceived ideas and concepts that most Americans have had about midwives, is that there really is a need and a place for midwives in this country now.

LADY: We think there is.

DEATON: Do you . . . do you feel like there's an increase in the need for it given . . . well, your commenting about the rural setting in . . . in Hyden when you were with the Frontier Nursing Service and a rural setting in Africa when you were there. And here in Springfield, you're in a kind of . . . oh, a fairly comparable-sized city in relation to . . . to most of America, and yet there's a real need for midwives here. How do you . . . how do you view the future of the program?

LADY: I think our biggest problem right now is really convincing doctors. I think there's a fantastic opportunity for nurses if we could . . . if we could show doctors that we're not rivals. We like to work with them. And I . . . I mean by that, give them their time 00:27:00and skills and training to take care of the high-risk patient and let us do the normal ones. I think we could do an awful lot in helping doctors in the teaching of patients. Take an awful lot of the time off answering their questions. There's quite a number of nurses who . . . nurse-midwives who are working in private practice with doctors, and I think . . . I think those doctors are on the ball [chuckle] 'cause they've got somebody in there that can take time to answer all these patients' questions and keep their time, which is expensive time, for the real problems. Now, that . . . that's one place I think is a big help. And, of course, just reaching people who are not getting prenatal care any other way. Now that's what's happened here in Springfield. Since the midwives are here, the number of walk-ins in our hospital have been cut down to almost zero. Just almost down to nothing. Once in awhile you'll get a couple. There was a time when they had the midwives . . . we had to take them, but we don't take 00:28:00them anymore because they're usually high-risk. But they're getting many, many less than they used to.

DEATON: Do you have an idea of the cost of the . . . the total cost for prenatal, delivery, post-partum care and all that for [inaudible] . . .

LADY: I'm not exactly sure what it is 'cause I think it's something I block out of my mind. It's high. It's expensive.

DEATON: Is it . . .

LADY: Our service is not cheap here because we . . . our . . . what has happened is that we've had to cover for people who cannot pay. The hospital sets the price.

DEATON: Oh! So is it . . . oh, I see. I won't . . . you don't . . . the nurse-midwives really don't have any control over that? It's what the hospital . . .

LADY: We have none whatsoever.

DEATON: How does that . . . how would it compare under . . .

LADY: With the doctors?

DEATON: . . . umhmm, with the . . . the cost of a doctor's care?

LADY: It costs every bit as much.

DEATON: Is that . . . hmm.

LADY: That's the thing that kind of bothers us.

DEATON: Hmm. How do you . . . how do you feel it would compare if 00:29:00the nurse-midwives had their own delivery facility, post-partum care facility and all that?

LADY: It would cut it down a lot.

DEATON: Umhmm.

LADY: Yeah. It . . . see, if we were taking on . . . if . . . like what . . . what they have in birth centers, you know, like we have in New . . . they have in New York. See, you wouldn't have to have all these machinery, compli-. . . for complicated problems. Now we do monitor. We do fetal monitoring here, but I don't think it would be as extensive if you had only low-risk patients. And that's what a nurse-midwife would ideally have. And it . . . it would be a lot cheaper. I . . . I don't know too much about the cost angle of it, but I'm really sorry that it has to be as expensive. Because if we had . . . it's the high-risk ones that make it expensive, and that's what we're getting right now in our program here. We have far too many high-risk. It's because they're the low income, their the pre-. . . 00:30:00the teenagers, thirteen, fourteen-year-olds that are having babies.

DEATON: Umhmm. And they . . . they're in an economic group that they can't really afford . . .

LADY: That's right.

DEATON: . . . a doctor's care?

LADY: That's right.

DEATON: Hmm. That . . . I . . . that really s-. . . surprises me, actually, because your . . . the group of people who should not be, or should not have to accept the responsibility for those people are the ones that are providing, more or less, the only medical care that they can receive. Do you see it the same way?

LADY: I agree with you. We haven't been very happy about the set-up, but there's not a whole lot we can do about it.

DEATON: Umhmm. The other midwives with the clinic, or with the Center, . . .

LADY: Umhmm.

DEATON: . . . do you know where they received their training at?

LADY: Agnes Chan is our director. She got hers in New York somewhere.

00:31:00

DEATON: What's her last name?

LADY: Chan. Agnes Chan. She is from Taiwan. She's Chinese. I think a good number of them came from overseas, h-. . . I mean took their training in England or Scotland, and then got into the program here through the midwifery refresher program. That's how we got a lot of our staff. They're American girls that travel . . . that trained in England. Now, some of the newer girls we've gotten, there's one who came from the University of Chica-. . . Illinois in Chicago. There's one who came from St. Louis and we'd had one from Mississippi and one from Kentucky University. So the newer ones now are coming from elsewhere. We used to have . . . there were at least two others on this staff that were from Frontier Nursing, but they're not there any longer. One is in Dayton now where she's hoping to set up a program, but it's not going too good.

DEATON: What's her name?

LADY: Velma Lutz. L-u-t-z. She's at Good Samaritan, I think it is. 00:32:00The other one is working in . . . with a couple obstetricians in New . . . in Pennsylvania and loves it. Just doing . . . doing her thing, . . .

DEATON: And who's . . .

LADY: . . . she and another midwife. Jan [Ruch?]. She's gone up there and they've . . . those two midwives can have their patients and they can do what they want to do. Very . . . very free to operate l-. . . as they want to, and that's what most midwives would like to do.

DEATON: Umhmm. So I . . . I get the feeling that that's what you think they should . . .

LADY: Well, . . .

DEATON: . . . should [inaudible] . . .

LADY: . . . have a little bit of freedom, yeah. We don't have as much as we would like here.

DEATON: Umhmm. Hmm. LADY: . . . actually had . . . my aunt was in Africa. There was another girl who was in Africa. She's still there as a midwife. Now, there's two others. But we could use more midwives there.

DEATON: Umhmm. Now, does the federal government . . . through health 00:33:00programs, Medicaid, Medicare and so forth, is the federal government the one that actually picks up the cost of most of this?

LADY: We are paid . . . insurance pays. Some of our patients who have insurance, we get paid for that, and welfare pays, ADC [Aid to Dependent Children]. Is that what you mean?

DEATON: Umhmm.

LADY: Yeah.

DEATON: Well . . . well, the Frontier Nursing Service has been sort of . . . well, it's been a philanthropic organization since its conception. Do you have any ideas about the future of Frontier Nursing Service?

LADY: Can't rightly say [chuckling] that I do. I . . . the program has changed so much. I've had a little trouble keeping up what has . . . is actually going on down there. I've . . . I have been back two times for very brief visits. But I . . . I . . . I'm impressed with the way they're pioneering in this field of family 00:34:00practitioner. I think it's fantastic. And I see no reason why there shouldn't be a good future for that type of thing. I wish they could get a place where they could get more deliveries down there. I'm sorry Dr. [John] Rock came along with his pills, but it's kind of important, too.

DEATON: Uh-huh. Well, the other midwives that you've known that have received training in . . . in other parts of the United States, the . . . the newer centers now that are . . . that have been established around the universities, and the ones who received their training in England, have you discussed or compared the schools? What . . . what are some of the other peoples' opinion about Frontier Nursing Service?

LADY: I think Frontier Nursing Service has a pretty good name as far as I know. We . . . we [chuckling] . . . we . . . we are reacting a little bit to some of the newer graduates coming out from the . . . with their masters. The . . . there is something that those of us who were down at Frontier Nursing Service got that you don't get 00:35:00too much anymore, I don't think. It's this . . . I think when we were down there it was sort of spirit of pioneering, you know, doing things on the rough. There was just a little bit of adventure-type to it and . . . and there was a sort of a sense of . . . sense of working together, being united in this thing. And I think everybody kind of goes his own way now. And we're noticing especially some of these new graduates. They come in there brainstorming the place with their new ideas, and we get nothing but static, really. We're getting static from the nurses, we get static from the doctors until they kind of calm down and realize it's . . . and I don't think we've gotten that so much [sighs] from those from Frontier Nursing Service but, then again, some of those were older, had been working other places first, which makes a little difference in your attitude of a job.

DEATON: Do think there was possibly an element of romanticism with going to the Frontier Nursing Service training and all that?

LADY: Perhaps. I mean, we don't have these frontiers [chuckling] 00:36:00anymore.

DEATON: Yeah.

LADY: There might be a bit of that. I don't know if there was particularly . . . the fact I had gone to Africa, I got . . . I got plenty of that there. But it's far from being romantic, if that's what you're [chuckle] . . .

DEATON: Umhmm. Yeah.

LADY: I . . . there . . . there was a . . . a sense of having to work together because we didn't have everything easy. You had to work for it when we . . . at that time, you know, they were still using horses to a certain extent. Not as much as they had earlier when I was there. And, yeah, it just wasn't that easy getting out to some of these places and you were dependent upon other people to a certain extent, and yet you were independent. But you saw other people they had a special value to them. They were important to you. It's a . . . it's a ab-. . . it's a feeling that I . . . I think is kind of hard to describe, and I know Molly Lee talks about it. That you 00:37:00all had . . . kind of worked for that one goal because we had to to get it done. Well now, you know, you're just kind of doing your thing. It's . . . it's not in your job . . . job description. [Chuckle]

DEATON: Umhmm. Yeah. Is there anything else about your work in Africa, your work as a midwife here in Springfield or other areas, or anything else about the Frontier Nursing Service or the people that you've known there that we haven't talked about that you would like to tell me about?

LADY: Well, I felt having had my training at Frontier Nursing Service definitely was the type of preparation I needed for overseas. For one thing, you learned down there that, you know, you don't have to have the best of everything. You don't have to have the most modern, and you do a pretty decent job with a clean delivery, not necessarily a sterile one, which I thought was fantastic to be able to take to Africa. And we were able to use so many of our ideas down there to good use there in Africa. I've never been sorry that I didn't get my 00:38:00masters with it. I mean it might have been nice, but I thought I got something else much more valuable. Some of the friendships I made from my class down there. And with this reunion we had a trip down there. It was a very interesting one. We looked up a couple of our patients, one . . . one particularly that had been very, very ill that she just nearly died. And . . . plus another one who's had a heart condition. We looked her up. We didn't get to find her. We did find out where she worked and we found somebody that knew her, so we left a message for her. But she's the one that had a bad heart condition and her husband was giving her kind of a rough time. He was drunk a good bit of the time and she wanted to go and have that surgery and he wouldn't let her. And just about a year or so after we left there, she shot him. [Laughs]

DEATON: Fatally? [Chuckling]

LADY: You know, there were a few people that I don't think we'll ever forget. She was . . . she was a real educated . . . she had a . . . she had beautiful handwriting and could express herself 00:39:00beautifully in writing. It was . . . she was an unusual woman. She works at one of those toll br-. . . gates there on that road.

DEATON: Uh-huh. Oh, the one there at Hyden?

LADY: Not at Hyden. It was the next one.

DEATON: Oh, the Red Bird toll booth.

LADY: I think . . .

DEATON: The one [inaudible].

LADY: . . . was it that . . . yeah, I think it was the Red Bird one.

DEATON: Uh-huh. Who were the other people in the class that . . . that you were at ?

LADY: Helen Trachsel, who's married to a Potter now. She's been in Bolivia, South America. Jewel Olson . . . OLson. Mary Nell Harper. Elaine Douglas. Jody LaVonne. Betty Mantay.

DEATON: And I think that every one of you went overseas for . . .

LADY: That's right.

DEATON: . . . for a few years.

LADY: That's right. They're all there except me, overseas now. We had a reunion about ten years ago in Nairobi . . . Nairobi, Kenya.

00:40:00

DEATON: And the last one was . . .

LADY: Down here.

DEATON: . . . when you were at Wendover recently?

LADY: There were five of us who got together in Africa. I thought that was a rather unusual set of circumstances. I . . . I don't know exactly enough what the program is down there now as far as midwifery is concerned to know how it would fit into an urban setting, but I definitely in a rural setting. I think that what they're getting down there would definitely be of good value, and some of the stuff like what we did overseas, eveb more than what we got then. I mean, I think some of the stuff they're giving now, we need desperately that type of work. And I'm kind of sorry I didn't have a bit of a longer period of training, except at that point I thought six months was an awfully long time. But I value very, very much my experiences down there and just . . . just working with the women and . . . like the little girl that worked in the hospital and talked about the birds hollering in the 00:41:00morning. Just things like that I thought were very delightful things to remember. And we were there for a winter. And I remember they were a little concerned about us coming from Africa for that winter. But most of us had been from places like Nebraska and Kansas and Washington where we'd had a lot colder weather [chuckling] if we . . . Min-. . . Minnesota. And we . . . we . . . we thoroughly enjoyed the Kentucky winter. It was one of the most beautiful seasons. I . . . it was a real treat getting to climb those hills back there in the snow. I loved it. Of course learned to drive a Jeep and that sort of stuff.

DEATON: Well, when . . . when you were students, did the students pay their tuition or was that paid by a scholarship?

LADY: We paid.

DEATON: You . . . the students paid. Do you remember what the cost was for the six months?

LADY: I think it was six or eight hundred dollars, I'm not sure which.

DEATON: Now, that was just for the training . . . midwifery training?

LADY: Just for what?

DEATON: Was . . . was the . . . was that cost just for the training? That did not . . . did that include the room and board or 00:42:00any other types of living arrangements?

LADY: I'm sorry, I'm not sure. I . . . I know my . . . the nursing association of my church paid a part of it and my uncle... [End Tape #1, Side #2]

LADY: ...paid the rest of it. I know it was sort of given to me as . 00:43:00. . sort of a scholarship type of thing because I was going overs-. . . but I . . . I . . . I have the feeling it was around eight hundred dollars and I think that was everything, but I'm not sure.

DEATON: Did you go out to any of the centers while you were there?

LADY: Yes, I was at Bru-. . . Brutus for two weeks. We had no deliveries when I was out there, but I enjoyed it.

DEATON: Anything else that you can think of?

LADY: Not offhand.

DEATON: I thank you.

LADY: Umhmm. [Interruption in taping]

DEATON: Let's continue.

LADY: All right. The medical facilities in Zambia, especially after independence, were every man is the same, no matter what. And some of the government hospitals leave a great deal to be desired. And we used to have patients come into our hospital rather than the government 00:44:00hospital because then you got . . . you got better care there. But when it came to an Amer-. . . a white woman or a European woman having a baby, she was a little hard put some place . . . at times to find a place to have a baby. So quite a number would come to us and ask to have their babies at our hospital. It made it a little bit awkward because they had to come quite some distance, and so they needed some place to stay when . . . to wait. So it usually meant we had [inaudible] have to provide for these people. But besides our own missionaries, they would deliver there. And often these . . . of course these American doctors I was working with didn't know that much about midwives. And when it came to a white woman delivering, then they would deliver the white woman. It's a little hard to explain [chuckle] but that's the way it was done. So then we got a doctor from Holland . . . from the Netherlands, and he, of course, knew about midwives and he could see no reason, if it's a normal [birth], why, the doctor had to get up to do these deliveries. And [inaudible] midwife 00:45:00[inaudible]. We had two women that were . . . were due from outside of our group. And there was a little bit of a fear of [inaudible] because there'd be a change. We weren't sure how this was going to be taken. And it would be my week and . . . week to be on call when these two women came in. But I was amazed, I had no problems. The first one was a Canadian woman. Of course it was her first experience with . . . with midwives, but it . . . it turned out to be a very happy experience. In fact, she had less discomfort afterwards than she'd had with her other baby. Don't ask me why, but she . . . you know as far as stitches were concerned, much less discomfort. The other was an English woman. "Well," she said, "this is what I expected. My sister's a midwife." She said, "I don't ex-. . . I'm not used to having doctors deliver me." A doctor delivered her first one. So they turned out to be very happy experiences and it's been that way since. The normal ones that the white women and midwives go ahead and deliver with no problems. And our American women, everybody had fallen right in with it.

DEATON: Do you think that the biggest opposition that the midwives have 00:46:00is American doctors?

LADY: Right. I rather think so. [Laughs] I'm not sure I should say that in public, but I really think so. Once the women learn to know you, there is no problem. These women are . . . our patients here in Springfield, they'll come . . . we've had 'em come back for four and five now, and there's so many tears. And they . . . after they have, no, they're gonna go to the midwives. And some of [inaudible] somebody a little disgruntled. But we've had some that we thought were disgruntled and came back to us.

DEATON: Have you known anyone that was a patient or, well, someone who gave birth with . . . with a midwife attending and then decided to go into midwifery themselves?

LADY: I'm not sure I've had. I have seen some student nurses here that come around. They . . . they rotate through our office. They spend 00:47:00at least a day or two in their time observing in our office. And we've had a num-. . . quite a number have come back to us for deliveries. They've observed in the doctor's office and observed in ours and they come to the midwives for deliveries 'cause they liked what they saw in the office . . .

DEATON: That's good.

LADY: . . . and in the labor room . . . delivery rooms. And there's a couple, I mean, that have expressed going into midwifery, but I don't know if I know any that actually have. I have encouraged a couple girls in midwifery, especially some that didn't get into medical school and have gone into nursing. I think a little bit more of a challenge than just, excuse me, regular nursing. [Chuckle]

DEATON: Thank you. [End of Interview]