Then and Now: History Edition
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    THEN & NOW: PAGE 3C PRESS & DAKOTAN n MONDAY, SEPTEMBER 25, 2017 This photo, from Bob Karolevitz s book A Commitment to Care, shows the Sacred heart Hospital nursery filled to capacity. Birth Right The Practice Of Delivering Babies Has Changed Greatly Through The Years BY CHANCE MULLINIX T news@yankton.net he method of delivering babies has come a long way in the past few years, not to mention since pioneers first came to the area. There are stories of Native American mothers giving birth while rowing a boat, and then washing themselves off in a river before returning to work. Similar stories are not uncommon. Delivering babies has become a bigger lifetime milestone since then. Many things have changed over the years, according to two retired Yankton doctors. Dr. David Holzwarth, delivered almost 4,000 babies as a doctor in Yankton. He retired in 1999, after working for 30 years. Holzwarth told the Press and Dakotan that one of the greatest advancements in his field of work was ultrasound. Back when I was in practice, we used X-ray to evaluate the pregnancy, because we didn t have any other way to monitor, except by touching the woman s abdomen, Holzwarth said. We didn t want to use X-rays any more than absolutely necessary. Now, we have ultrasound, which was a huge step in getting imaging of the fetus inside the uterus to determine position and any abnormalities. Ultrasound has gotten more and more sophisticated, which allows more accurate readings to be done now. Before this sophisticated technology became available in the delivery room, doctors relied on screw caps and X-rays to monitor a baby in the womb. Caesarian sections (C-sections) have become much more common in the modern world. Holzwarth estimated that 4 percent of births in the 1970s and 1980s were by C-section. In a 2015 report from the Centers for Disease Control and Prevention (CDC), almost one-third of all babies were delivered by Csection that year. Generally, it seems to me that the medical-legal aspect of obstetrics became more litigious, and so more C-sections were done and are being done, Holzwarth said. The biggest change I can see is resorting to C-section as opposed to vaginal delivery much, much more quickly. One of Holzwarth s colleagues, Dr. Mal Jameson, said that he noticed the trend as well. Some of (the C-section rate increasing) is due to being more watchful and knowledgeable about the baby, Jameson told the Press and Dakotan. On the other hand, if you don t do one and the baby dies, or has oxygen deficit that gives them a long-term brain injury, then you did the wrong thing and prob- PHOTO: AVERA SACRED HEART HOSPITAL Delivering babies and caring for newborns has changed a great deal, but quality care is still the top priority of the physicians, nurses and others who are part of the process. ably will be sued for it. And maybe you should be. Jameson worked as a doctor for 41 years, beginning in Sioux Falls in 1955. He moved to Yankton in 1971, where he stayed until he retired in 1996. He quit delivering babies in 1990. Jameson served in the Navy and only became a doctor because of the results of an aptitude test he took after he left the military. Jameson never specialized in any one field, instead dabbling in many. This led to him delivering many babies during his career. Mothers are spending less time in hospitals recovering, and are going back to work sooner. Mothers once spent 1-2 weeks in the hospital recovering, although many didn t need that much time to recover. Holzwarth said this is mainly driven by two reasons. One, I think economics has driven that, he said. Number two, we ve learned that these moms can recover at home really well. Being able to get the patient ambulatory soon after delivery has cut down on the recovery time of mothers, as far as blood clots in the legs are concerned. Hospitals are not necessarily the safest place to be, when it comes to infectious diseases. The patient is so often better off at home. He recalled his days delivering babies in the poor neighborhoods of Chicago, where he said he learned the most valuable information. When I delivered in Chicago, we wanted them to stay at home, because we thought they were much better in their own environments at their own homes than in hospitals, Holzwarth said. I think that holds true now as well particularly if they have a support system, like a partner, grandma or mother and they do quite well. Jameson said insurance companies have dictated a mother s decision to stay in the hospital. It wasn t unusual to keep mothers in the hospital for a week after giving birth, he said. In the baby book my mother had, it said she stayed in the hospital for two weeks due to a hard delivery. Now, they kick (mothers) out after a day or two. Family sizes are shrinking as well. Mothers would have many children when Jameson first started. This change was driven by a couple things. If you had a farm family, you would have more hands to help out on the farm, he said. Also, infectious diseases took a lot of kids young. It wasn t unusual to see kids die within a year (of birth) from measles, mumps, whooping cough and a bunch of things, pneumonia. While there have been a multitude of changes since the 1970s, there s one important aspect that has stayed the same, Holzwarth said. The instigating process remains unchanged, he joked. Immunization Had Big Impact On SD BY ROB NIELSEN rob.nielsen@yankton.net W hen was the last time you heard of someone with smallpox? How many people in South Dakota have polio? Thanks to immunizations, many of the great scourges of 100 years ago are no longer a natural threat in the western world or the world as a whole. South Dakota state epidemiologist Lon Kightlinger spoke with the Press & Dakotan about how the state has become a national example for immunization and how the practice of vaccination has impacted the state over time. PHOTO: AVERA SACRED HEART HOSPITAL Avera Sacred Heart Hospital CEO Doug Ekeren is shown getting a flu shot from Nurse Moonbeam in this publicity photo. South Dakota has registered the highest flu vaccination rates in the country for five of the last six years. HISTORY Modern western immunization practices trace their roots back to England of the 1700s, when it was discovered that milk maidens who had been exposed to cowpox didn t develop the dreaded disease smallpox. They took pus from cows and from the hand of milk maidens who would be milking cows that had cowpox, Kightlinger said. They d get these sores on their hands, and it was a fairly mild sore, but you put two and two together and they saw these milk maids didn t get smallpox. They started exposing other people in the population, who were not milk maids, to the pus of these milk maids by putting a little scratch on their arm and putting the pus on them. It would cause We are number one for flu shots in the whole country. We ve been number one five out of the past six years. We just have great flu vaccination participation. Lon Kightlinger a little sore on the person and they would be protected from smallpox. As understanding of human immunity grew, scientists started developing vaccinations for other diseases, especially as the 20th century came along. The 1950s became a benchmark for immunization. That s when South Dakota faced one of the most feared diseases in the country at the time polio. Our biggest outbreak was in 1952, Kightlinger said. Here in South Dakota, we had 1,017 cases of polio. We had a hospital that just took care of polio patients because it paralyzed people, especially children. It was an absolute scourge and people were very frightened by it. A breakthrough came soon after that would SHOTS | PAGE 4C
    Immunization Had Big Impact on SD
    Birth Right
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