The Amazing Mechanised Mom

We mums take it for granted nowadays that medicine will look after both us and our babies. We fetch up at the door of the maternity hospital, with the glow of new life about us, and hand ourselves over to an array of medical professionals. While the care of pregnant women is a very old medical discipline, the idea that babies should also be cared for is surprisingly new. For centuries, doctors treated pregnant women, delivered their babies, resuscitated them if necessary, and moved on. The care of the new tiny person was entirely in the hands of the mother. And this practice, along with many others, was the cause of terrible infant mortality rates even in very wealthy societies. It had long been understood that tiny premature babies needed warmth for their survival. Contrivances operating on the same principle as an incubator had been around for a long time. Infants were often placed in padded baskets warmed by hot water bottles. Or they were placed in the drawers at the bottom of ovens. In the 19th century, it became apparent to doctors that something had to be done to improve medical outcomes generally, including those for babies.

In this, as in much else, we owe a huge debt to the French.There began a national crusade in the late 19th century to increase the population – Zut alors! France was in danger of being outdone by their German rivals!  This led to an interest in reducing infant mortality rates. An obstetrician at Paris Maternité Hospital, Stephane Tarnier, wanted to find some way to warm the numerous premature infants who died in huge numbers of hypothermia. He found his solution in the most unlikely of places. While visiting the Paris zoo, he saw chickens housed in an incubator display and realised this was exactly what he needed. He had one installed in the hospital in 1880.Housing several babies together, much like the chicken enclosure on which it was based, it warmed them over a hot-water reservoir attached to an external heating source. Later models broke free of their roots in the poultry industry by accommodating babies individually. In Nice, Alexandre Lion, made considerable modifications to Tarnier’s design, creating a large metal apparatus with a thermostat and an independent forced ventilation system. And the incubator we know today was born. The medical profession welcomed its arrival but there was strong opposition from mothers.  Who can blame them – they were being asked to surrender their role in caring for their children to whacky strangers, who wanted to put babies into bizarre, new-fangled boxes. Like many of us, I have stared at a tiny baby through the glass of an incubator, suppressing a primal need to care for him and having to trust others to do so, and so I can understand this early resistance. Unfortunately, then as now, the incubator was expensive. At the time, the care of infants was largely in the hands of charities and they did not have the money for this new technology. However, Lion was not just a talented physician; he was also something of an entrepreneur if not a showman.He set up his incubators as public shows and charged people admission to come and marvel at the way these tiny babies were cared for. It seems mad to us now – who among us could imagine strangers gawping at our precious babies? But at the time all sorts of live human shows were common entertainment. The incubator was advertised as The Amazing Mechanised Mom and the accompanying publicity campaign showed chubby babies who had graduated from the incubators.This increased public knowledge of what this technology could do for them. The crowning glory of Lion’s career was taking his baby show to the Berlin Exposition in 1896. Through setting up his show, Lion came into contact with Martin Couney, an American physician who was also taken with the potential of these new machines and brought his own incubator shows across the Atlantic. Couney was adamant that he was not just a showman but was advancing understanding of proper care of the premature infant. It was an era of huge technological innovation – Thomas Edison filed his first patent application for “Improvement in Electric Lights” in 1878 – and there was a growing public awareness of the potential of new inventions to change lives. Certainly, Couney’s shows boasted a standard of care not matched in any hospital at the time, along with a huge staff of doctors and nurses. However, it was not plain sailing. There was an out break of gastroenteritis in the show at the Louisiana Purchase Exposition in 1904 and in 1911 the Coney Island Show was destroyed by a fire, from which the infants were narrowly rescued. But, more damningly, there was a growing unease about these shows and a sense that they were nothing more than the freak shows that were often found at county fairs. The Coney Island show closed in 1941 because of falling numbers and the opening of facilities to treat premature infants at local hospitals. This show and others like it had done their job and now had outlived their usefulness.

We have many reasons to be grateful for incubators, aside from the nature of the technology itself. For centuries, medicine felt it had little responsibility to save premature or ill babies because it had little capacity to do so. Or maybe it was the other way around? Either way, these Amazing Mechanised Moms planted in the minds of medical professionals the idea that tiny babies, previously referred to as weaklings, could be helped and therefore that effort should be expended to do this. Nonetheless, incubators, and the almost space-age quality of modern neon natal care, bring unease to bereaved parents. For some of us, technology made no difference as our babies did not live long enough to get to an incubator in the first place. Many others did but still could not be saved. And this is a hard truth to grapple with. Because it is not a huge mental leap from  babies can now be saved to the notion that all babies can now be saved. And if your baby was one of the ones who could not, that can fester in your heart. This is not to denigrate the effort in caring for those babies. I just wish more than anything that it could have been available to us too.

Despite these tensions, many bereaved parents have good reason to be grateful to these high tech boxes with their roots in the care of chickens. The capacity to save babies, which is now the cornerstone of paediatric medicine, stems from them.  So too does the more general view that babies are deserving of not just top notch medical care but also respect and dignity at their most vulnerable time. For many families, an unhappy outcome was perhaps inevitable but the incubator meant they had some precious time with their baby, giving treasured memories that sustain them on their journey. But most of all I feel that even when the outcome for families is sad, there is some comfort to be had from the idea that your baby’s survival mattered and from how much effort was employed, sadly all too briefly, to bring it about.

This post first appeared as a column in Moments, the magazine of A Little Lifetime Foundation