Midwife and Businesswoman
Romana Rios de Ramos and her daughter Agapita Ramos Bonilla became two of the most well-known midwives (parteras) in the Westside. They offered vital support for this community. Romana delivered between 11,000 to 15,000 babies during her career. The maternity home that she operated, La Casa de Maternidad, also provided a refuge for single mothers and their newborn babies. Agapita followed her mother’s footsteps. She practiced as a midwife for over fifty years and delivered about 4000 babies in her career.
Romana was born on February 28, 1881. Her birth certificate notes that she was born in Selma, Texas, though some city records note that she was born in Guerrero, Tamaulipas, Mexico. Her father was Evaristo Rios and her mother was Valentina Castillo. She moved to San Antonio with her family when she was three. She married Isidro Ramos and they lived at 308 ½ South Santa Rosa Ave. Little else is known about her older relatives, except that there were also family members in Monterrey. Romana had three daughters: Agapita (born in 1897), Carolina Garza and Gloria Muñoz. She was a faithful member of the San Fernando parish.
Romana became a midwife in San Antonio circa 1908-1911, and continued her practice until eight years before her death in 1961. Like many parteras, she engaged in other kinds of work as well. In 1913, she travelled with her daughters to China and spent three months there learning how to become a skilled seamstress. She also ran a restaurant/grocery store and managed a business making clay figures to sell for the city’s downtown carnivals. For some time she managed a taxi business as well. Unlike many women of the time, Romana regularly drove her Model T, travelling around the San Antonio area and making regular trips to Chicago and Monterrey. While Romana’s formal education is unknown, she read and wrote in both Spanish and English, as evidenced by the birth registers she kept.
Midwifery has a long history as a respected occupation for women (primarily) in many parts of the world. For much of the history of the United States, midwives attended most childbirths. Midwives continue to practice in the United States, but the practice is not as common as it once was. Much of this has to do with changes in obstetrics as a medical field. By the early twentieth century, medical professionals considered childbirth a medical event. Physicians increasingly advised families to have their children delivered by obstetricians rather than lay midwives. Between 1900-1930 individual states also began to enact various regulations to limit the practice of midwifery. Some states like Massachusetts outlawed the practice, while others began to issue licenses. Texas was one of the most lenient states, with a “common law” arrangement because no regulatory agency existed, but the practice declined significantly in this state as well. In the last several decades, though, midwifery has become more popular. One study estimated that eight percent of childbirths in the United States were attended by midwives in 2009, a significant increase from the late mid-twentieth century. Today, most midwives receive formal training and certification, but they define childbirth as a natural process that should occur within the context of family and a nurturing community. Midwives rely primarily on vitamins, herbal teas and other natural substances, rather than prescription medicines. They cultivate close relationships with their clients before and after delivery. They are also often hired from word of mouth, rather than through formal advertisements.
Midwifery persisted among mexicanos longer than in the Anglo community, partly because of a lack of medical resources, but also due to these differing cultural beliefs about childbirth. Midwifery provided an alternative to medical care that was seen by many as highly technological and impersonal. Giving birth at home with a partera was a well established cultural practice in the Westside through about 1950. Parteras were well-respected members of mexicano communities in the United States, much as they were throughout Latin America. They also at times served as general health practitioners (healers). Midwives have also contributed to lower rates of infant and maternal mortality.
At some point during Romana Ramos’s career, she took a series of classes to become certified in delivering babies. Her certification was probably part of an effort by the city health department to curb the high infant mortality rate in the 1920s and 1930s. The goal was that midwives would work more closely with physicians, consulting with them about complications and prenatal care. The first classes in San Antonio were offered by Dr. David Cerna around 1926, and held in a small house. Cerna was a Mexican physician who came to San Antonio in the early twentieth century, possibly during the Mexican Revolution. Many midwives credit him with their training. Later classes were held at the Robert B. Green hospital, supported by Dr. Austin E Hill, Dr. Eugene R. Chapman, and Elvira Oetkin, R.N. They were advertised in local newspapers including La Prensa, and attracted many women. Some of the women had already established practices; others were young women drawn to a potentially lucrative job. Approximately 200 midwives were in San Antonio during the 1930s. These classes would continue for the next couple of decades.
Midwives who went through the program were often very proud of their certification, but much of their training was also based on working with other midwives in the community, and this knowledge was valued by physicians, especially when many physicians had little expertise on matters relating to women’s health and childbirth. Descendants of midwives report that physicians often attended home births along with midwives. Romana’s granddaughters noted that Dr. Carl Walker asked Romana to come and assist on difficult cases. At the time, it was fairly common for midwives to deliver breech babies and attend to other complications that were considered manageable. Romana was known for never losing a mother or a baby, and would even be called to deliver twins. Once she delivered a set of triplets to Lorenzo and Geneva Favela of 610 W. Evergreen Street, a case which was reported in La Prensa on November 13, 1928.
She delivered babies for families in many area small towns and neighborhoods, including Cementville, Somerset, Lytle, LaCoste and Elmendorf, and was well known and regarded in the community. Initially she travelled by horse and buggy, and eventually drove her Model T Ford to attend home births.