Winnipeg doctors’ innovation a boon for postwar baby boom

Adapted from Obstetrics, Gynecology and Reproductive Sciences in Manitoba: A History, published by Heartland Associates and the department of obstetrics, gynecology and reproductive sciences, University of Manitoba. Reprinted with permission of the publishers.

The Second World War was finally over and physicians and nurses serving overseas returned to Manitoba to resume their careers at city and rural hospitals. At the end of 1945 and the beginning of 1946, there was optimism and hope for the future. The Canadian economy was strong and about to enter more than a decade of prosperity. The invention of television was about to occupy the leisure time of anyone who could afford one. By the mid-’50s, as the cost of a TV declined, millions of Canadians could proudly own one.

More significantly, young people were in a rush to get married, own a house with a picket fence on a quiet street and have children — lots of them.

The so-called “baby boom” started in 1946 and lasted until 1965. Canada’s birthrate grew exponentially with more than 8.2 million children born or an average of nearly 412,000 per year. While in 1937 the annual number of live births per 1,000 inhabitants was 20.1, it increased to 27.2 in 1946 and remained between 27 and 28.5 for the next 13 years when it started to slightly decrease. One of the results was that Manitoba’s population jumped from 729,744 in 1941 to 921,686 in 1961; in that same period, Winnipeg’s population rose from 221,960 to 265,429.

Most families had three or more children. This was a consequence of superior health care, advanced medicine — by the mid-to-late ’40s antibiotics were widely used — and effective obstetric techniques that drastically reduced maternal and newborn death rates. Caesarean or C-sections were still risky to the mother and newborn but became much safer after Dr. Edward Hon of the department of obstetrics and gynecology at Yale University School of Medicine invented electronic fetal heart rate (FHR) monitoring in 1958.

In the early 1940s, pediatrician and scientist Bruce Chown’s groundbreaking research with the blood factor known as the Rhesus factor or Rh also saved the lives of countless infants. By 1945, as Nova Scotia writer Julie Vandervoort notes, Chown “started doing replacement transfusions within hours of the delivery, and the technique was working.” According to Dr. Harry Medovy, who succeeded Chown as the pediatric head of Children’s Hospital, “Dr. Chown and his staff were answering calls at all hours in delivery rooms at all of the city hospitals … Approximately 250 affected babies were seen each year; the babies saved providing the exhilaration; those who died (about 25 per cent), the depression.”

Chown’s lab was initially located in the basement of Children’s Hospital, but in 1956 it was moved to the Maternity Pavilion. Later, Chown, working with pediatrician John “Jack” Bowman and other scientists, developed a serum called Rh immune globulin that prevented Rh disease. It was licensed in Canada in 1968 and Bowman and Chown founded the Winnipeg Rh Institute as a non-profit corporation, with Bowman as medical director.

In the early 1940s, an average of 500 women for every 100,000 live births had died; by 1951 that number had declined to a hundred and it kept dropping. If mothers did die while giving birth during the ’50s, it was often owing to toxemia — now called pre-eclampsia — when pregnant women develop “high blood pressure, protein in their urine, and swelling in their legs, feet, and hands.” Prenatal care was not as thorough as it is now and the problem, which often went undiagnosed, could be fatal to mother and newborn. Women living outside Winnipeg also were at risk from hemorrhaging if blood transfusions were not readily available. Following groundbreaking research by American biochemist Vincent du Vigneaud in 1954, the pituitary hormone oxytocin was used as a remedy for severe post-partum hemorrhaging.

From the perspective of Winnipeg obstetricians, maternity wards across the city were busier than ever. Typically, a doctor was awakened at home in the middle of the night by a patient in labour. The physician, in turn, called maternity wards where he had privileges only to be informed that there were no beds available.

Sometimes patients ended up in hospital corridors awaiting a delivery room. More than once, doctors reacted angrily to this untenable situation. As early as 1944, Frederick McGuinness — who two years later was appointed the first head of the newly combined obstetrics and gynecology department (Dr. John McQueen was co-head in 1946) at the University of Manitoba and the Winnipeg General Hospital (WGH) — was well aware of this situation and knew that it would become worse. That year, in the department’s annual report, it was noted that there were 1,400 births, including 13 sets of twins. Clearly, the 50 beds at the WGH’s maternity ward were not sufficient to meet the growing demand of Winnipeg’s expectant mothers and a solution had to be found.

McGuinness, working behind the scenes with Dr. Harry Coppinger, the WGH’s superintendent and the hospital’s board of directors, discussed plans for a new stand-alone maternity hospital — a necessary safeguard against spreading infection to expectant mothers. Soon, homes close to the WGH on Notre Dame Avenue between Pearl and Emily streets were purchased and demolished. Early in 1946, stories in Winnipeg newspapers announced the construction of a “maternity pavilion,” which would have upwards of a hundred beds, more than double the number on the WGH’s maternity ward. The cost for this new hospital, which was to be connected to the WGH by a tunnel, was estimated to be $750,000 — an amount that was to double by the time the Maternity Pavilion was opened in the spring of 1950.

The process of erecting the hospital was slow. According to Elinor Black, the first woman to be appointed head of the obstetrics and gynecology department at the university and the WGH in 1951 (and the first woman to head a university medical department in Canada), obstetricians, gynecologists and nurses were not consulted on the design or about any aspect of the building — a fact that irked Black for decades. (In truth, McGuinness asked his department colleagues for input about the new hospital in 1948, during which time Black was visiting hospitals in Europe.) In 1947, another 2,030 babies were born in the WGH’s maternity ward “under conditions of very great crowding,” Coppinger said in an interview with journalists. Finances were the main obstacle to starting the project. Finally, in March 1948, the city agreed to a request from the WGH board that it guarantee a debenture of $900,000 and construction on the five-storey hospital began a few months later. Grants were also received from the federal and provincial governments.

By mid-January 1950, the new hospital was nearing completion. There were to be 150 beds with six public wards, 48 semi-private rooms and 12 private rooms. The first three floors were for wards and nurseries; the fourth floor was reserved for labour and delivery rooms; and the top floor was to be used — at least temporarily — as quarters for nurses.

Reporters permitted a sneak peek gushed about the flash boards at the nurses’ stations that alerted the nurses to patients’ signal calls; the nurseries, half blue and half pink; the modern formula room linked to a bottle-washing room, a large sterilizer and capacity for preparing formula for 600 baby feedings an hour; and the air conditioning. “Even worried and restless fathers have been provided for,” the Winnipeg Free Press added. “There is a big waiting room near the main entrance large enough for pacing. There are smaller ones on each ward floor. The staff even promises there will be enough ashtrays for any chain-smoking males.”

During the spring a $250,000 campaign was undertaken to raise funds for required furnishings and equipment. On April 15, Grace Johnson was named as the director of the new hospital. She was a former head nurse of the WGH’s maternity ward and a teaching supervisor for obstetrical nursing. During the war, she had been the head nurse of the neurological and plastic surgery unit of the Canadian Army in England for about three years.

The official opening took place on the evening of April 26 with Manitoba premier Douglas Campbell and his wife Gladys in attendance along with other dignitaries. Visitors that night and afterward were enthralled by the colourful décor — the archway that “gleams in mulberry splendour,” as one journalist put it, and the light lime-green walls. “Mothers will find it’s like having a baby in glorious Technicolor,” another attendee declared.

The plan was to move patients from the WGH maternity ward to the new building over the next two weeks with May 6 as the date the Maternity Pavilion was to be fully operational. But a catastrophe was in the making upsetting that smooth transition. “We moved into this building on May 6, 1950 at the height of the Winnipeg flood,” Elinor Black, then one of the senior obstetricians in the department, later told journalist Charles Templeton in a television interview. “Isn’t that rather an inconvenient time?” Templeton asked. It was.

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