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A Brief History of Obstetrical Care at Pennsylvania Hospital
In the early history of Pennsylvania Hospital, the need for
a maternity department was not officially recognized by the medical
profession. The Managers opposed it because they did not wish
to appear to encourage immorality; it was considered improper
for legitimate children to be born outside of the home. The Managers
also opposed establishing a foundling asylum, thought to be a
necessary adjunct. Obstetrical cases were, however, occasionally
received. The birth of the first child at the hospital was on
July 17, 1765: "Born a female child of Martha Robinson a
poor patient."
The advantages of having accommodations for such cases wasn't
realized until 37 years after that first birth and some 50 years
after the hospital's founding. An act of the Legislature dated
April 11, 1793 set forth provisions for establishing a Lying-in
(maternity) Department at Pennsylvania Hospital; ten years later
these provisions were finally acted upon. The Lying-in Department
officially opened on May 20, 1803; the first admission, though,
had been on March 30th, and the first birth of a female child
on April 27th.
The first physician specialty recognized by the Board of Managers
was obstetrics. When the annual election of physicians and surgeons
was held on May 12, 1823, the members of the staff were defined
separately for the first time in the hospital's history. Designated "Physicians
for the Lying-in Department" were Thomas Chalkey James and
John Moore. Unfortunately, the department was closed in 1854,
partially due to a terrible outbreak of puerperal (childbed)
fever that claimed the lives of many lying-in patients.
Pennsylvania Hospital's involvement with obstetrical care had
not ended. Affiliations with other lying-in facilities in the
city eventually led the hospital back into the "baby business." One
was the Philadelphia Lying-in Charity for Attending Indigent
Women in their own Home, founded in 1828 by Dr. Joseph Warrington
and chartered in 1832. In 1839, he organized the Philadelphia
Nurse Society, which in part trained women in obstetric nursing.
The Lying-in Charity and the Nurse Society were united as one
institution in 1851. In 1856, Dr. Elwood Wilson assumed its head.
In 1863, the institution became known as the Philadelphia Lying-in
Charity and Nurse Society. By 1923, its Board of Managers was
made up largely of men who were also Managers of Pennsylvania
Hospital, and an affiliation was made between the two institutions.
The Spruce Building was erected in 1929 to house the new combined
service; the lying-in facility was located there until 1971,
when they were moved to the newly erected Preston Building.
A second affiliate, organized in 1872 to provide care for unmarried
women, was originally called the State Hospital for Women and
Infants; the name was changed in 1882 to the Maternity Hospital.
For forty years only unmarried women were admitted. One of the
main objects of the hospital had been to offer privacy and a
chance for social readjustment to unfortunate young women. Many
hospitals sent their student nurses to the Maternity Hospital
for obstetrical training. In 1930, the Maternity Hospital was
affiliated with Pennsylvania Hospital and merged with the services
in the Spruce Building.
In 1960, a third affiliation was made with the Preston Retreat,
named for Dr. Jonas Preston, a 19th century Philadelphia obstetrician
and philanthropist. He created an endowment to benefit "indigent
married women of good character," and the Preston Retreat
was founded in 1865 through this bequest. Prior to the formal
affiliation, the institutions shared mutually beneficial programs
(the retreat providing a training site for the hospital's School
of Nursing). In September 1971, the Preston Building opened (as
the result of another bequest of Dr. Preston). Lying-in services
were moved to the new building and the Spruce Building ceased
to operate as a maternity facility.
Since the opening of the Preston Building, Pennsylvania Hospital
has been the home of many innovations in fertility treatment
and obstetrical care. In 1978, the first antenatal testing unit
(ATU) in the region was created to diagnose and evaluate the
fetus. In 1985, the first GIFT (gamete intrafallopian transfer)
pregnancy in Philadelphia was achieved, one of the first GIFT
programs in the United States; by 1995, Pennsylvania Hospital
had hosted 1,000 live births from GIFT and other assisted reproductive
technologies. The first laparoscopic assisted vaginal hysterectomy
in Philadelphia was performed at Pennsylvania Hospital in 1985.
And in 1996, Pennsylvania Hospital opened the first perinatal
evaluation and treatment unit (PETU) in the region to assist
in the evaluation of high-risk situations which develop during
labor, as well as perform procedures such as amniocentesis and
fetal surgery. In the over 230 years since the first birth here,
Pennsylvania Hospital has laid the groundwork for many crucial
advances in obstetrical care and remains committed to continuing
that tradition in the years to come.
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