The Midwifery Era
High Touch, Low Tech
Since time immemorial, women have traditionally given birth surrounded by trusted females and overseen by a midwife-healer-herbalist. Amazingly, we can date colonial birth history back to 1587 when Virginia Dare, the first American-born child of English parents was born. Fortunately, birth in America was safer than in England due to healthier living conditions and abundant food. But pregnancy continued to be overshadowed by a gray cloud of puritanical shame and guilt, and religious doctrine cursed women with painful birth blaming her for the fall from grace. Society was patriarchal (male dominated), as it continues to be today, but men were not regularly involved in childbirth. In labor, women were nurtured by loving relatives and friends and often for weeks following the birth.
Midwives were highly valued for making birth safer. They were skilled in empathizing and reassuring women, turning breech babies, a variety of delivery maneuvers, herbal medicine and some midwives occasionally used opium for pain relief. One successful midwife observed, though, that opium could slow labor progress and cause breathing problems in babies, so she would not use it. This same midwife was unusual in that she kept records of all 816 babies she delivered with the last being born in 1812. Interestingly, her infant and maternal mortality rates were as good as any in the U.S. before the introduction of antibiotics in the 1940s.
Midwifery knowledge was commonly passed down from an experienced midwife to her daughter. Some communities provided a midwife with housing in exchange for her commitment to attend all labors regardless of the women’s ability to pay or if they occurred at night or on holidays.
Era of Doctors
High Touch, Higher Tech
By 1750, doctors called “man midwives,” began attending home births providing opium more commonly for pain relief, but women continued to be surrounded by nurturing women. Welcomed advancements came with European influences of greater knowledge of anatomy and forceps to assist with difficult deliveries. If a woman was happy with the doctor’s birth services, she would call him for her family’s other needs so women became the gatekeepers for a successful medical practice. Competition between doctors and female midwives began, but doctors were not as well suited for the long, inconvenient hours of labor. Doctors began using forceps and a drug called ergot to speed up normal births, which introduced dangers. Though doctors were using many dubious techniques, they accused midwives of not being scientific and began a public campaign against midwives.
The U.S. government would not support public midwifery or medical education, as in Europe, and private medical schools were out of the reach of most women. Overseas the midwifery profession advanced along with the medical profession. American women, who had the means, applied for admission to U.S. medical schools but were rejected. It wasn’t until 1849 that the first woman received her medical degree but she faced many professional challenges and prejudice because of her gender. Meanwhile, American midwives continued to learn their art from other midwives. The man midwives changed their title to “obstetrician” and gradually laboring women were encouraged into hospitals where midwives were not allowed. Once in hospitals, nurses, who the woman often did not know, were assigned the “labor-intensive” care of women with doctors arriving for the delivery.
High Tech, Low Touch
Hospital births continued to increase but birth did not automatically become easier or safer. By the early 1900s, care now routinely included many strange interventions that made birth more challenging and complicated, such as isolating women from their families and community, positioning women on their backs with feet in stirrups, heavily drugging women who could no longer push their babies out thus requiring the use of forceps, painful episiotomies (vaginal incisions), delivering in operating rooms, separating mother and baby, and bottle feeding.
By 1940, more than half of American deliveries were in institutions. Antibiotics and improved cesarean surgical techniques began to make birth safer. But over the decades, physician’s growing reliance on “delivery by scalpel” led many physicians to lose expertise in turning breech and “back labor” babies and other essential skills that were once commonly used.
Then our patriarchal paradigm gave birth to the problematic:
Triplets of our Modern Age:
- Most pregnancies are now treated as an illness and birth as a disaster waiting to happen.
- The American healthcare system is intertwined with the profit and power-driven agendas of “Big Business.” This includes insurance, pharmaceutical and medical supply companies as well as physician organizations.
- Normal births are overwhelmed by technological interventions and a dangerous rate of unnecessary caesareans.
New Era of Holistic Birth
High Touch, Tech as Needed
The birth of an exciting new paradigm is gracing our culture. The holistic paradigm maintains the benefits and advances brought by the techno-medical approach while correcting the wasteful and dangerous imbalances. This new thought system strives to empower women, create healthier, gentler and more welcoming arrivals for the sweet newborn and strengthen partners/families while also making maternity care affordable for all. Awakening Birth Now is encouraging and nurturing this new paradigm to thrive so the U.S. will reach the following goals:
- All hospitals will become mother and baby-friendly.
- Prevention, nutrition, wellness and health education will be high priorities.
- The many benefits of “birth as nature intended” will be understood and valued.
- Technological interventions and cesarean deliveries will only be used when clearly beneficial.
- Normal childbearing will be honored as a profound transformational rite of passage for the woman, partner and their baby.
- The entire family will be deeply supported through the psychological, social, emotional, physical and spiritual changes take place.
- Advancements will continue based on scientific research.
- All pregnant women in the U.S. will be able to choose either an obstetrician/physician or an educated midwife who has medical back-up available as their care provider.
- Doctors and educated midwives will increasingly work together for the good of childbearing women and their babies.
- Midwives will be able to practice independently and consult, collaborate and refer to obstetricians as appropriate.
- The medical domination and control of the midwifery profession to protect physicians own interests at the expense of families will no longer be tolerated.
- More independent birth centers and professional homebirth services will be safely integrated with our medical system as in some other countries.
- Private corporations will no longer be allowed to gouge the American family and taxpayer to accrue huge profits.
- The U.S. will have lowered its caesarean rates to rational levels.
- America will see improvements in international rankings in regard to infant/maternal mortality.
- Finally, greed will be removed from the equation and the USA will have national health care for all.
Wertz, R. Lying-In: (1977). A history of childbirth in America. New Haven/London: Yale University Press.
Wikipedia. Martha Ballardhttps://en.wikipedia.org/wiki/Martha_Ballard
Davis-Floyd, R. (2001). The Technocratic, Humanistic, and Holistic Paradigms of Childbirth. International Journal of Gynecology and Obstetrics, Vol 75, Supplement No. 1, pp. S5-S23
Vanita Lott, Certified Nurse-Midwife, Pregnancy Coach
Awakening Birth Now.com, Awakeningbirthnow@gmail.com