Brief life of a nineteenth-century obstetrician: 1786-1876
In a career spanning nearly six decades, Walter Channing provided the medical skills and compassionate care women sought as they faced the pain and dangers of childbirth.
Channing was born in Newport, Rhode Island, into a family that boasted a signer of the Declaration of Independence, his grandfather William Ellery, A.B. 1747. He followed two brothers to Harvard, but was expelled in 1807 for his part in the Rotten Cabbage Rebellion. Determined on a medical career, Channing quickly arranged an apprenticeship with James Jackson, A.B. 1796, M.D. 1809, already a luminary on the Boston medical scene and a future professor at Harvard Medical College. Ambition spurred him on to the University of Pennsylvania, the nation's oldest and most prestigious medical school, where he received the M.D. in 1809, and to Edinburgh and London, where he focused on midwifery (as obstetrics was then designated).
American women had by then begun to seek obstetrical care from physicians who had studied anatomy and physiology and seemed to offer safer childbirth than unschooled midwives. When Channing returned to Boston in 1811, the cachet of his European training, his M.D. degree, and his friendship with Jackson positioned him well. In a few years he was professor of midwifery and medical jurisprudence at Harvard, an editor of the fledgling New England Journal of Medicine and Surgery, and an officer of the Massachusetts Medical Society. He was rapidly acknowledged as Boston's leading obstetrician, and also practiced general medicine. When Massachusetts General Hospital opened in 1821, he became assistant physician, though obstetrical patients were not admitted. In 1832, he helped found Boston Lying-in Hospital for destitute women, who had no other safe place in which to give birth.
All other births occurred at home, where Channing might meet his patient for the first time; prenatal care was rare. The expectant mother would be fully clothed in loose garments. Channing paid strict attention to the rules of decorum, avoiding eye contact with his patient during examination and delivery and paying meticulous attention not to say anything that might seem indelicate.
He was most valued for his expertise in difficult cases, especially if instruments were needed, and saved many women and babies without x-ray, fetal monitors, or other modern diagnostic equipment. Keenly aware of the responsibilities of his calling, he annually cautioned his students, "To whom else in the common walks of life does death come double in a single act but to the practitioners of midwifery?" In 1843, when Oliver Wendell Holmes, A.B. 1829, M.D. '36, accused physicians of unwittingly spreading puerperal fever from patient to patient, Channing, like many other doctors, was doubtful. In time he accepted Holmes's demand for cleanliness, though he continued to wonder, "Whence the first case?"
Women often feared pregnancy and childbirth. Many had a close relative or friend who had died of infection or uncontrollable hemorrhage or whose baby had died during labor and delivery. The prospect of excruciating pain during a long labor added to their anxiety. Thus Channing's advocacy of anesthesia in childbirth, despite serious objections from colleagues, ranks as his most significant contribution to obstetrical practice.
Anesthesia was first demonstrated at Massachusetts General Hospital in 1846. No one objected to its use in dentistry or surgery, but that was not true in obstetrics. Many physicians were skeptical of its safety: a prominent Philadelphia obstetrician protested that he could not risk the life of a single patient "in a questionable attempt to abrogate one of the general conditions of man...." Clergy and laymen condemned its use as a transgression of God's judgment upon Eve: "In pain thou shalt bring forth children."
Channing saw no reason for women to "submit to a suffering which is [as] unnecessary as it is...cruel." Having successfully used ether himself, confident that his patients were satisfied, he felt compelled to disprove the critics and free women from pain. His 1848 Treatise on Etherization in Childbirth included data from 45 physicians who had used anesthesia in 581 cases without negative consequences. He quashed religious objections with comments from the Divinity School's George Noyes, A.B. 1818, who provided Scriptural support for the notion that human ingenuity used for the relief of pain is "the use of God-given means by God-given powers."As a physician who witnessed disease and death in Boston's growing slums, Channing actively participated in the temperance movement and programs to relieve poverty. As a deeply religious man and the brother of William Ellery Channing, A.B. 1798, the renowned Unitarian minister, he opposed slavery and was a pacifist. His faith also sustained him through many personal tragedies, including the deaths of two wives and his youngest daughter.
Channing died at 90, still fascinated by the profession he had chosen. Medicine, he wrote, asked perplexing questions: "What is life? What is growth? What is this perpetual motion and how is it sustained?" He never found the answers to those questions, but he thought he knew what living is: "It is action, action of a man's whole nature, the moral, the intellectual, and the physical."
Amalie M. Kass is a lecturer in the history of medicine at Harvard Medical School. Her most recent publication is Midwifery and Medicine in Boston: Walter Channing, M.D. (Northeastern University Press).