Federal Writers' Project – Life Histories/2015/Fall/Section 018/Herbert Clark

Overview
Herbert Clark (unknown - unknown) was a doctor in rural Carter, Alabama after World War I. His medical practice included childbirths at a time when they were a difficult and dangerous experience for women.

Early Life and Education
Herbert Clark was born in Fitzgerald, Alabama. His family lived in the South for six generations with male family members typically entering medicine or the ministry. This included his father who was a poor, white Methodist preacher. From a young age, Clark wanted to be a doctor. He cared for sick animals. If they did not heal with medicine, Clark cut into the animals like a surgeon to help them.

Clark attended the Southern University. After completing two years of premedical studies, he worked in the circulation department of the Evening Herald to earn money to continue his education. When his grandfather died, he was forced to return home to Fitzgerald. His Uncle Will, who practiced medicine and owned a drug store in Fitzgerald, offered him a place to live and a summer job so that he could attend winter classes. Clark finished at the University in 1916, and returned to Fitzgerald to work with his uncle.

WWI and Work Experience
Medical students were required to complete an internship as the last step of their training. The internship provided students with practice guided by an experienced doctor. In the early twentieth century, medical internships were limited. So the United States government introduced accredited hospital internships by admitting all young doctors into the Army as first lieutenants. Clark joined, receiving a full credit internship by working two years in various Army camps during World War I.

After his service, a superior officer offered Clark a position as a contract surgeon in New Jersey. With his Uncle Will sick with influenza, Clark gave up the position and returned to Fitzgerald to take care of his uncle's medical practice for six months. As a result of Clark's internship with the Army and his work experience during his uncle's illness, the State Board of Health offered Clark a position as an Assistant State Health Officer. Clark accepted and remained in that position for two years.

Career and Later Life
While an Assistant State Health Officer, Clark met Lucille West of Stimson. They married and moved to Carter where they raised two children. He started his first medical practice and worked as a contract surgeon for the local Civilian Conservation Camp in Carter. Clark described the town as having "growing pains and possibilities." It was a very poor town. When he arrived, it had no roads so it was common for his car to get stuck on the muddy trails while visiting patients. A pneumonia patient died when his car got stuck for three hours.

Farmers and their families comprised 90% of his patients. Due to crop failures, many were unable to pay bills for years. He handled lacerations, fractures, tonsillectomies and childbirths. Women had as many as seven children because of the lack of contraceptives, putting country doctors like Clark in high demand. Bringing babies into the world was a difficult task when Clark first started his practice, but advances in medical science, transportation and communication later reduced the hazards.

Young Doctors in WWI
With the United States entering World War I in 1917, the armed forces expansion caused a rise in the recruitment of young and recently qualified doctors. Young doctors filled many of the clinical posts since regular army doctors were consumed with administrative work. Phillip Gosse, who served with the 69 Field Ambulance during WWI, observed that temporarily commissioned young doctors were often “better qualified and more experienced in the technical side of medicine, surgery, or public health than the regular officers under whom they served.”

There were several theories for this phenomenon:


 * Young doctors “were trained in the new laboratory techniques” and studied modern germ theories. This better prepared them for the spread of diseases within the armed forces.


 * The young men were more creative, analytical, and original in their practice, making them “capable of rising to any demand that the war could make.”


 * The older doctors were not as physically strong as the younger ones, making them unable to withstand the fatigue and constant exposure in trenches.

Childbirth During the Early Twentieth Century
From the nineteenth to twentieth century, childbirth underwent a number of changes. The average family size decreased from 7.0 to 3.5 children because of an increase in the age of marriage, the move from farms to cities, and simply the desire for smaller families. In 1900 it was illegal under state and federal law to counsel patients and distribute information on contraception and contraceptive devices. It was not until 1912 that Margaret Sanger, a public health nurse, began the modern contraception movement. In 1916 she opened the first family planning clinic in Brooklyn, New York. Police shut down her clinic, but following court challenges allowed physicians to legally provide patients with advice on contraception for health reasons. Sanger, along with other family planning supporters, continued to open clinics around the nation during the 1920s and 1930s. As a result, physicians gained the ability to prescribe contraceptive methods, and eventually a few public hospitals began providing family planning services. Contraceptive devices were expensive, so used mostly by white upper class women. Poor towns like Carter Alabama, populated largely with African Americans and lacking a large public hospital, continued to experience high birth rates and be in demand of medical assistance during the childbirth process.

As medical knowledge and technologies advanced at the turn of the century, physicians began viewing childbirth as a “pathological rather than a natural condition.” Previously, childbirth was an all female process, some enlisting a midwife to aid the mother and baby. However, male physicians felt more medical attention was required. Before he established his practice in Carter, Alabama, Clark stated that “woman were faring no better than animals at childbirth." Compared to midwives, the male physicians were “more likely to intervene, using their hands, drugs, bloodletting, and instruments to ease or hasten delivery.” The promise of a less painful delivery caused many women to request physicians during deliveries.

Male involvement in childbirth was opposed. Social conservatives, health reformers, and feminists all fought their involvement. Many upper class white females feared male physicians, choosing to use traditional midwives. They feared the males would intervene unnecessarily and cause damage to themselves or the baby. It was also a concern of modesty, allowing a male to see them so exposed. The women who used male physicians did so for the promise of less pain. More knowledge of labor, the availability of new technology to handle difficult labors, and the development of anesthesia all held the potential for safer and less painful deliveries, but many medical schools during this time were “at best, haphazard.” Therefore, even with medical professionals involved in childbirth, it was still a dangerous process in the early 20th century.