Academic journal article Pre- and Peri-natal Psychology Journal

An Historical Overview of Midwifery in the United States

Academic journal article Pre- and Peri-natal Psychology Journal

An Historical Overview of Midwifery in the United States

Article excerpt

ABSTRACT: This article provides an historical overview of the history of midwives in the United States from the seventeenth century to the present. Brief background information on the period prior to 1600 is included. The article shows how a profession that was traditionally considered to be "women's business" came to be dominated by a predominately male medical establishment. Special attention is given to the early twentieth-century "midwife debate." The origins of nurse-midwifery and the major factors which have contributed to the recent midwidfery renaissance are also considered.

For centuries, the practice of midwifery was considered to be the almost exclusive province of women. The definition of midwife, "a woman who assists other women in childbirth," implies the existence of this female monopoly (Oxford English Dictionary, 1971). References to the work of midwives can be found in the Bible (Genesis 35:17, 38:28; Exodus 1:15-22). The writings of classical Greek and Roman physicians, such as Hippocrates, Galen, and Celsus, provide further information about the regularity with which midwives served as birth attendants (Goodell 1876, p. 381).

Throughout the Middle Ages, midwives continued to officiate at births for both the rich and poor alike. Most midwives were empirically trained and learned their skills through personal experience and training with older, more established midwives. The monopoly which women held over midwifery was reinforced by the fact that it was generally deemed inappropriate for men, be they husbands, physicians, or surgeons, to be present in the lying-in chamber.

Europeans who settled in North America in the seventeenth and eighteenth centuries brought the profession of midwifery with them. Colonial American midwives, like their European counterparts, dominated the practice of midwifery and were considered to be the recognized experts in the conduct of childbirth. Indeed, most colonial midwives were held in high esteem by their communities.

The colonial American midwife usually subscribed to a noninterventionist approach of letting nature take its course. She may have offered herbal teas, wine, or perhaps hard liquor to help ease the birthing pains. Her chief duty was to comfort the pregnant women during the often long and arduous hours of labor (Wertz and Wertz, 1977; Donegan, 1978; Scholten, 1977, 1985; Ulrich, 1988).

Although the vast majority of midwives in colonial America, as well as in Europe, were empirically trained, the invention of the printing press around 1440 paved the way for the publication of instructional materials for midwifery. By the early seventeenth century, when the first European settlers arrived in America, several midwifery manuals had appeared in print. Among the most significant of these were Thomas Raynolde's Byrth of Mankynde (1540), Jane Sharp's The Midwives Book (1671), and Elizabeth Nihell's A Treatise on the Art of Midwifery (1760).

It is difficult to determine how widely these and other midwifery manuals were circulated or how carefully midwives followed their instructions. However, it is quite likely that midwives in colonial America found the works by Sharp and Nihell of special interest. Both of these authors expressed disdain for the emergence of man midwifery and forcefully argued that midwifery was rightfully "women's business."

The idea of man midwifery did not begin to take root until the early 1600s. Prior to this time, the presence of men in the lying-in chamber was so rare that there was little cause for debate or discussion of this subject. No record is even known to exist of a man attending a normal birth until 1663. It was in that year that Louis XD7 of France engaged Julien Clement to attend the labor of his mistress (Goodell 1876, p. 382).

The first men midwives were usually surgeons who were called upon to deal with especially complicated or difficult labors. Over the next two centuries, as the taboo against men in the lying-in chamber was gradually relaxed, men midwives were increasingly called upon to attend normal, uncomplicated births. …

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