The History of Midwifery
Traditionally, women have been the healers in communities. Women held the wisdom of the healing power of herbs, and carried the rich oral history of healing from generation to generation. Older women taught younger women how to care for their own families and neighbors, thus training the next generation of community healers. Women tended to the sick and the dying, as well as to the birthing mothers in their communities.
It has been only recently that healing became the male-oriented, power-driven, hierarchical profession of medicine. When men entered the traditionally female realm of healing, they sought to legitimize themselves by adding more formalized training, and were able to charge more for their services and hold themselves in higher regard. They leveraged this prestige to force women out of the role of community healer and midwife.
There was a huge financial incentive to turn health care into a profession. This financial motivation continues to fuel the fight against midwives to this day. ACOG (American Congress of Obstetricians and Gynecologists), the trade union of obstetricians in the United States, issues policy statements that shape birth practices for women. These standards are frequently not evidence-based; they are based upon protecting the interests of ACOG’s dues paying member obstetricians. ACOG has done a very good job of convincing the public that their policy statements are the gold standard of maternity care, when, in fact, these statements have far less to do with best practices, and far more to do with promoting their members’ profession and protecting them from litigation. ACOG’s deep pockets are a formidable force, and independent midwifery practitioners often feel like it is a bit of a “David and Goliath” battle.
Midwives have been helping women give birth since before recorded history, and most of the people alive today were born into the hands of midwives. Just a little over a century ago, in 1900, midwives attended half of the births in the US, and only about 5% of births happened in hospitals. By 1939, about half of women gave birth in hospitals, virtually all with twilight sleep. By 1960, 97% of births happened in hospitals. Why the dramatic change? Was it because hospital birth was safer?
No. In fact, when doctors first began attending births, and births began their shift to the hospitals, outcomes for mothers and babies worsened significantly. Part of this decline in safety was due to a lack of care taken in prevention of the transmission of infections. Doctors would go from doing autopsies straight to catching babies, without even washing their hands. It was no wonder that infection became rampant. Once the connection was made between hygiene and infection control, outcomes began to improve.
One big reason births moved to the hospital was women’s desire for pain control. The use of “twilight sleep,” where women were given amnesic medications during labor and knocked out for the birth, became a popular option. Doctors would have to use forceps to help the babies be born, because the mothers were unconscious and unable to push the babies out themselves. Of course, these deliveries were risky, causing a lot of damage both to mothers and babies.
Fortunately, as people become more educated about midwifery and about the benefits of the midwifery model of care, they are increasingly seeking the help of midwives for their babies’ births. Modern day midwives are increasing in numbers, especially in out of hospital settings. The Internet, films like The Business of Being Born and Orgasmic Birth, as well as help from organizations like The Big Push for Midwives, MANA, The MAMA Campaign, and NARM have all helped to increase awareness of birth options for families.
The links below are full of historical information about midwifery, and about continuing struggles for the freedom to choose where and with whom a woman may give birth.
A Short History of Midwifery
The History of Midwifery and Childbirth in America: A Time Line, Prepared by Adrian E. Feldhusen, Traditional Midwife
Witches, Midwives, and Nurses: A History of Women Healers, by Barbara Ehrenreich and Deirdre English
Midwife Crisis Why are women being arrested for delivering babies in Maryland? By Bill Gifford (Washington City Paper) on March 3, 1995
The Campaign to Free Midwife and Obstetrician, Agnes Gereb