To begin, a midwife is a professional person within the realm of obstetrics, which is the health and medical field that revolves around pregnancy and childbirth. My desire to study this practice more extensively stems from a more personal outlook; I was born with the help of a midwife. I have a lot of respect for the woman who assisted my home-birth. In fact, she has been actively involved in my life since I can remember. But, I did not realize how alternative or bizarre this form child delivery is for so many people. Childbirth is obviously a huge part of what happens in the world and a huge part of women’s lives in general and I believe that the discomfort that many people face with the subject matter comes from a huge lack of midwifery information and an overall misunderstanding of the entire process. From the dawn of time, humans have cast aside things they don’t understand with fear and have replaced those things with negative stigmas that cloud the way the rest of society can see them.
As with many subfields within feminism, midwifery has changed greatly throughout history. I will provide a brief historical timeline of some of these important changes. Around the late 1700s and early 1800s, obstetrics was becoming more popular in childbirth for higher-class people. Midwives were not seen as capable of learning the complex obstetric skill. Cesareans were done, but not successfully. Infection was common because germ theory had not been recognized yet. Women received care from other women in their community and the shift to obstetrics from midwifery started with rich white women in urban settings. During the mid 1800s, the “Popular Health Movement” began and created the idea that there is personal responsibility involved with ones health. Elizabeth Blackwell entered the scene as the first woman to graduate from medical school after applying to dozens of schools and only getting into one, even though she was at the top of her class. Additionally, the AMA (American Medical Association) was founded to enforce standards on medicine and practice. Walter Channing started using ether for women during labor for “humane” reasons, beginning the use of anesthetics for childbirth.
During the second half of the 1800s there was an epidemic of puerperal fever due to uncleanliness in the procedures conducted by physicians. Luis Pastor then coined germ theory, encouraging more people to go to the hospital instead of a midwife. The increased use of phones also began making local midwives less critically needed. As the 1900s began, so did the rise of capitalization. The AMA began passing legislative bills to define medicine and create standard practice laws. Obstetrics became more focused on antibacterial medicines and more conscious of isolating sick patients from others. Hospitals started becoming for-profit businesses, generating more doctors and offering higher pay. Larger cities began opening entire units for obstetrics within their hospitals. Medical associations became affiliated with malpractice insurance availability.
As the century went on, prejudice against the intelligence and capability of women, immigrants, black people and poor people was used to defame midwifery. Midwives were not in a power position. They made very little money and were not seen as professional practitioners. Midwives took care of women who could not afford a doctor. Most women within this time period were more attracted to hospitals because they could offer painless birth, which was not available at home. In 1960, the Flexner Report revealed that ninety percent of doctors were practicing without a college education and almost all of them had attended substandard medical schools. However, their reputation still outweighed that of a midwife.
Historically in early traditions, men were not present in any active role in the birth room, but this dramatically shifted over the course of history. Men used to only enter the birth room after something disastrous had occurred. Their job was to either cut the fetus out of the mother and to bury it separately according to tradition, or to baptize the baby while still inside the mother with “holy” water to assure it’s passage to heaven if it died before it was born. Midwifery is now more common in foreign countries than it is within the US, whose citizens utilize obstetricians more regularly.
Cultural forces began driving a shift in attitude about sexuality and childbirth between 1959 and the present. The 60’s free love and anti-institution ideals influenced the natural childbirth movement as well as women’s liberation movement. In 1963 The Feminine Mystique was published and women began to question their gender roles and believe that they were more than a gender stereotype and that they could be different. Some women started to feel like they were in control of their sexual lives and became present in their bodies. Intentional communities like The Farm in 1970’s helped spread the natural childbirth movement, refusing to use anesthetics. Women there trained themselves to be midwives and wrote books and lectures to help spread the movement.
Misconceptions of midwifery have persisted through centuries. Before the 1940s, our knowledge of their existence simply labeled them as nurturing women assisting each other’s natural life processes, but with no title of legitimate education fueling their action. However, times are always changing and I believe that this is true for the midwife’s practice as well. Ten years ago, midwives delivered 3 percent of the babies in the US and now that number has arisen to 10 percent. I think that as the use of hospitals and antibiotics become less effective, the presence of midwives will become even more necessary. Midwives will become more widely understood and respected for what they are, assistants to the entire birthing process, which has always been more than just the delivery of a baby.