History of pregnancy and childbirth | Rebecca Jo Plant's Teaching Website

I. Why is childbirth so hard?

II. Changing birthing practices

Before 1760, birth was a female affair
- “social childbirth”
- Overseen by midwives—non-interventionist
Late 18th century, doctors enter the birthing chamber – elite women only
“Medicalization” of childbirth
- Two big steps; gradual, uneven process
  - Shift from midwives to doctors; and from home to hospital (1920s)
    - 1900: half of all American women still attended by midwives
    - 1930: Physicians attended 85 of all births
      - BUT, even in the mid-1930s, more than half of all births occurred in private homes
        
        Maternal death rates remained high
        
        Move to hospital did NOT initially lower death rate
- Emphasis on pain and suffering persists

III. Historical interpretations of the history of childbirth

Pre-1960s: Seen as one of modern medicine’s greatest triumphs
- These histories were often written by obstetricians
1970s: New feminist reinterpretations
- Perceived as attempt by male physicians to wrest control away from women
- This interpretation reflected women’s frustration with modern birthing practices
- Emerged in tandem w/a revival of midwifery and home births
Some truth to feminist interpretation
But misleading on two counts
- Women themselves actively sought male doctors’ assistance in birth
- At first, men did not aim for total control of the birthing process
  - Doctors and midwives often cooperated
  - Doctors seen as necessary only in difficult cases (about 5-10%)

IV. William Shippen

First physicians to teach midwifery/obstetrics—University of Pennsylvania (1762)
“male midwife”
First taught both female midwives and male physicians; soon limited lectures to men

V. Anesthesia