When I look  at birth certificates, I focus on names and dates and 
places--information I can add to a family tree. When I look at hospital 
records, I come face to face with the realities of giving birth. I think
 the records from the Chicago Lying-In Hospital and its satellite 
clinics provide fascinating and important family history details and I 
believe they merit a closer look.
The hospital records are listed in the Family History Library Catalog (FHLC) as 
Chicago, Illinois birth records, 1896-1933. The added author is Northwestern Memorial Hospital and I think the originals are most likely held by the 
Northwestern Memorial Hospital Archives.
These hospital books document services provided by four 
clinics connected to Dr. Joseph Bolivar DeLee, the physician who founded
 the 
Chicago Lying-In Dispensary
 at Maxwell Street and Newberry Avenue in 1895. D
r. DeLee was interested
 in improving birthing conditions and his clinics offered care to needy women while providing training opportunities for 
doctors and nurses in the emerging field of obstetrics. The
 primary clinic was Maxwell Station but others included Northwest 
Station, Stockyards Station, and the Chicago Maternity Center. The history of the Lying-In Hospital intertwines with other Chicago medical institutions and some related historical records, 1913-1943 can be found in the University of Chicago Library's Special Collections Research Center. Photos can be found here.
There are three types of clinic records 
available on the 14 microfilms--application books, birth books, and 
case books--and I will take a look at each of them in turn.
Application Books
Application books are available on 11 microfilms (1315895 to 1315905)  and
 the FHLC identifies them by volume number and year range. However, some
 years are covered by more than one book (because the books are from 
different clinics) so it would be hard to know which film(s) to view 
without more information. I've created a key which can be viewed as a 
PDF 
here. The application books cover the following clinics:
- Maxwell Station, Dec
1896 – Jun 1932
- Northwest Station, Sep
1903 – Nov 1907
- Stockyards Station, Aug
1923 – May 1926
- Chicago Maternity
Center, Sep 1932 – Aug 1933
There
 are two kinds of application books. The standard books, with the 
exception of the first one, have entries made on pre-printed forms. They
 are organized by the date of the woman's first visit to the clinic 
(births often happened a few months later) and recorded information 
generally includes name (either the woman's given name or her 
husband's), address, nationality, how the woman was referred to the 
clinic, information on previous pregnancies, and expected date of 
confinement. If the woman gave birth the birth date, sex, and weight of 
the child are noted. Beginning with Vol. 49, the forms asked for the 
birthplaces and ages of parents, but sometimes that section was left 
blank.
Eight
 of the earliest application books log house calls and I've indicated 
that on the key linked above. Entries in those books include name, 
address, including notations like "1 Floor Rear" to help the doctors 
locate apartments, the names of the physicians sent to assist, and the 
number of the bag that they carried. Time called, time started, and time
 returned are also noted along with the "nature of the case." In some 
instances the notes are detailed but if a birth was without 
complication, the entry might simply read "normal delivery."
Birth books are available on 3 microfilms 
 (1315995 to 1315997) and they are included on the key linked above. 
It's difficult to determine the exact coverage because the volumes 
include birth books, case books, and birth and case books and some 
aren't labeled with a clinic name. As a group, they appear to go from 
November 1898 through July 1933 with the bulk of them being from the 
Maxwell clinic.
Birth Books
The entries are 
chronological by birth date and span two pages. Information includes spouse with the 
patient's name to the right, for example, "Gold, Sam Tillie," the names of the intern and student assigned
 to the patient, an application 
number, a case or confinement number, and the diagnosis which usually reads something like "Normal L.O.A. Female 8#."
The birth and case book from February of 1900 gives 
detailed instructions for how to determine whether to assign a case or a
 confinement number. For example, full confinement cases received a 
confinement number, hospital cases received no number, and false alarms,
 abortions, midwife cases, postpartum cases, and treated pregnancy cases
 received a case number.
The later birth books include 
obstetrical terms that were unfamiliar to me. In the example below, the word that begins with "ceph" is "
cephalic" which, according to Wikipedia, means the head enters the pelvis first. "Para" refers to "
parity,"
 the number of times a mother has given birth. Comparing the notation 
for one of the births to the information on the corresponding birth certificate, it appears that this 
number refers to previous births. In other words a "I" would mean that 
the woman was giving birth to a second child. The 
abbreviations refer to the way the babies are facing. R.O.A., for example, means "right occipito-anterior."
|  | 
| Example: Page from a birth book showing delivery details. | 
It's possible to use 
the application number from a birth book to find the corresponding entry
 in the application book and following up in this way provides 
additional information, address, for example.
I think it's likely that the
 children listed in the birth books had birth certificates created and 
those records should be easily accessible at FamilySearch's 
 Illinois, Cook County Birth Certificates, 1878-1922  database.
 Conversely, if you've found a birth certificate stamped "Chicago 
Lying-In Hospital," it should be easy to find the matching entries in 
the application and birth books.
Case Books
The birth book films include four "birth and case" books and five separate 
case books. The case book entries cover clinic visits that didn't result
 in confinement. Information generally includes names, application 
numbers, case numbers, and a diagnosis, "False Alarm," and "Precipitate 
Mid wife on case," for example.  These books include numerous entries 
for miscarriages.
Observations
So, here's what I've learned so far from and about these application, birth, and case books:
- If a family had enough resources to pay a doctor, you
 probably won't find a birth or clinic visit listed in these records. 
For example the Maxwell 
Station book for 1900 has a notation that says, "Not case for dispensary – can afford to pay doctor." 
- Some of the poorest women in Chicago had access to innovative medical 
care from the late 1890s forward. Even if a child was born at home, the 
birth might have been assisted by a skilled physician. 
- Many of the entries in the early Maxwell Street books are for Jewish women 
from Russia but other neighborhood women used the clinic, too.  
- The Stockyards Station books list religion. Notations
 include things like "Amer Cath," "Amer Prot Col," and Amer Prot"  and 
this information might prove useful in looking for baptismal records. 
- Comparing hospital record information with birth 
certificate information I notice that there are sometimes minor 
variations. Name might be spelled differently, for example. 
- Sometimes the doctors recorded remarks about the 
health of an infant. For example, I saw notations such as "Upper lip 
shows imperfect union" and "Birthmark."
- Sometimes the doctors were called to the home only to
 find they weren't needed. One note said "Met husband who said he had an
 other doctor & did not
need us.”
- In the 1920s, the Stockyards book begins to mention 
payments. Notations include things like "Will try to give $5" and 
"$16.50" (I saw amounts ranging from $5 to $20) but some patients are 
listed as "Free Care."It's possible that these payments or donations 
were used to fund the construction of the new hospital.
What use might these records be? Here are some ideas that come to mind quickly:
- Birth
 records are available for public searching up through 1922. If you want
 quick confirmation of birth without obtaining an actual birth record, 
these records might help. 
- A mother's medical history might provide some interesting insights into the makeup of a family. Was there a medical reason, for example, that there were large gaps between siblings' births? 
If you've read to this point and find yourself 
thinking, "I wonder if my ancestor appears in the records?" post a 
comment. I'll gladly take a look at the records, time permitting, for 
the first person to ask.
____________________________
Related Links Collected while Researching this Post   
 
Caroline Benoist Collection at University of Virginia School of Nursing
Caroline studied in-home delivery at the Chicago Lying-in Hospital and her papers include some publications from the same.
Syphilis in Pregnancy and Labor
Report of a study done at the Stockyards Station published in American Journal of Syphilis; follow the link and search the book for "chicago lying-in."
American Child Hygiene Association Annual Meeting Report
Search for "chicago lying-in"
Directory of History of Medicine Collections
A tool for finding the locations of archived hospital records.
Numerous additional references can be found by searching for "chicago lying-in hospital" at Google Books.