The year was 1944, and Mary Dieter was about to give birth. To ease her pain, she was heavily sedated with ether. To help her recover, she was confined to her hospital bed for a week. And she rarely got to be with her newborn daughter, except to nurse.

Last month, her great-great-grandson was born into an entirely different world. The baby’s mother remained fully conscious during birth, kept the newborn with her in a cushy hospital suite and was out of the hospital in less than two days.

“Nowadays they just get up and they’re ready to go,” says Mary, 91. “The recovery part is a lot different; well, the whole thing probably is, as far as that goes.”

Spanning five generations born at Memorial Hospital, Mary and her family reflect changes that have transformed childbirth in the U.S. over the past century. It’s not only medical developments such as ultrasounds or epidurals that have altered the experience. Cultural attitudes have shifted, including ideas about where to give birth, who should witness the event and what medications to take — if any.

“You could basically tell when somebody was born by how they came into the world,” says Tina Cassidy, author of “Birth: The Surprising History of How We Are Born.”

Throughout history, almost all women have given birth at home, Cassidy says, and it was still that way in 1917 when Mary’s mother went into labor.

Midwives assisted with many births then, Cassidy said, but their services were waning. Doctors branded midwifery as old-fashioned and dangerous, though their own unsanitary maternity wards provided little improvement. Often sanctuaries for the poor, hospitals began to offer powerful sedatives for upper class women who wanted to avoid the pain of childbirth. The methods became standard practice.

“A lot of times what they did was put patients to sleep when they got close to delivery, and then deliver the baby with forceps,” says Dr. James Steigerwald, an obstetrician at Memorial Hospital North.

Mary’s mother wasn’t particularly rich or poor, but life-threatening complications forced her to Beth-El Hospital, Memorial’s predecessor, for a Caesarean section in 1917. Women were more discreet about their pregnancies back then and rarely spoke of them, so Mary knows few other details.

“They called it their confinement,” Cassidy says. “It was unseemly to be seen outside the house with a large belly.”

By the late 1930s and early 1940s, most U.S. babies were delivered in hospitals, Cassidy says. For servicemen like Mary’s husband, who was in the U.S. Navy, the U.S. government covered the cost of hospital births. Mary was charged 10 cents when their only child, Donna, was born in 1944 at the recently renamed Memorial Hospital.

Twenty years later, in 1964,, Donna Baker was married and back at Memorial, anxiously awaiting the birth of her adoptive son, Scott. Only medical staff were allowed in the delivery room, one of many sanitary measures hospitals had adopted over the years to reduce infections. That concern about germs left husbands to fret outside in the hallway as usual, but it barred women too, even an adoptive mother like Donna.

“That’s only more recent, probably in the last 20 years or so, that the sterility of delivery has been more relaxed, just because there’s no proven benefit to trying to maintain it as a sterile procedure,” Steigerwald says.

In 1989, Donna’s second adoptive child, Jennifer, was the first in the family to have a baby with family present – including her brother, Scott, which broke a long-held custom that birth was outside the realm of men.

“I would say probably even in the ‘60s they weren’t allowed in,” Steigerwald says. “They just felt like it was a woman’s place, and men didn’t belong there. Now anyone that wants to be in the room is allowed in the room with permission of the mother.”

When she gave birth to daughter Jessi at Memorial, Jennifer was also the first in the family to have an epidural, a pain-blocking spinal injection that allows the mother to stay conscious and is now widely used in the U.S. Jennifer’s pregnancy set other family milestones: She was the first to attend at Lamaze class and receive an ultrasound.

Scott, however, took another route. By the mid-1990s, home births were making a comeback, and that’s the option Scott Baker chose when his two children were born. He did it partly to save money: Each birth would have cost $6,000 at the hospital, compared to $1,000 to $1,200 for midwife services at home.

“We also decided to go more natural,” said Scott, 44. “It was obviously ‘no drugs.’”

But when Jessi was pregnant, she chose a hospital delivery — complete with an epidural. On July 18, she gave birth to Tyron Kliewer, the family’s fifth generation born at Memorial. Jessi and her husband, Jon, stayed in the same suite the entire time, avoiding the trips from labor room to delivery room to postpartum room that were common in the past. Equipped with a plasma TV, whirlpool, adjustable bed for the mother, incubator for the baby and another bed for the father, the suite felt like a bedroom to Jessi. She got to wear her own clothes, and Jon brought aromatic oils to set the mood. During their stay they even had room service – and the hospital food actually tasted good.

“They’ve really come around to making it as relaxing and as much like a home environment as possible,” said Scott, who watched Tyron’s birth.

Jon, the first father in the family to witness a hospital birth, didn’t just stand around and watch. He coached Jessi through the delivery, cut the umbilical cord and used special oils to soothe Tyron’s head and backbone.

“In the 1940s it was all a momma thing,” Donna said, “and now it’s a mom and papa thing. I think it’s a really good bonding thing.”

Through it all, 91-year-old Mary has witnessed the changes in birthing practices — and it’s fair to say she’s been astounded by a lot.

“When I was pregnant, they didn’t think of things they think of now,” Mary said. “It was only if you had a problem.”

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Contact the writer at 636-0368.

From left to right: Mary Dieter, Scott Baker, Donna Baker, Tyron Kliewer age 12 days, and Jessica Kliewer represent five generations born at Memorial Hospital. Photo by Kirk Speer, The Gazette