When I ask someone whether they’ve considered having their baby at home or at a birth center, I often hear them respond with something like, “I decided to have a traditional birth in the hospital.” This generally makes me smile, because giving birth in a hospital is hardly the traditional way to give birth! Traditionally, women have been the healers in communities. Women have traditionally held the wisdom of the healing power of herbs, and carried the rich oral history of birth and healing from generation to generation. Traditionally, 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 women in their communities. The experimental way to give birth is this relatively new idea of giving birth in the hospital with doctors. It has been only recently that healing became the more male-oriented profession of medicine.
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 for a while. The experiment was a horrible failure! 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. It was an attractive option for those who could afford it, which made hospital birth a show of affluence and status, as well as a desirable choice for women who were afraid of the pain of childbirth. 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.
Now, we have generations of people in the United States who have only known hospital births for their family members. Looking at my own extended family, I believe I may have only one living relative (other than my own children) who was born at home, and she will be 104 years old this year. Most people’s reference point for birth is that it is a medical procedure. In the media, we see hyped up shows like “Maternity Ward” and “A Baby Story” that show highly interventive, medicalized, often scary births. Most people see that as traditional, normal, and oddly somehow safer than an out-of-hospital birth, rather than what midwives know as the truth of birth: birth with midwives is traditional, normal, and safe, emergencies are rare, and birth almost always works or there wouldn’t be so many people on the planet. Midwives, and more specifically midwives who attend out-of-hospital births, are the birth practitioners who are guardians of traditional, natural, physiologic birth. We’re the only health care providers who ever see births that are truly natural.
Hospitals have made huge improvements over the years in trying to make birth more family-centered, but even the most natural-minded hospital-based practices don’t come close to a home birth or freestanding birth center experience. When was the last time you heard of a hospital birth where a woman with no IV (or saline lock) gave birth attended by the midwife she’d seen for all of her prenatal visits, birthed her baby in a quiet, dimly-lit room, and caught her own baby in a birth pool in whatever position she wanted to be in? We home birth and birth center midwives see that kind of stuff all the time. Fortunately, as people become more educated about midwifery and about the benefits of the midwifery model of care, the tide is beginning to turn. People are increasingly seeking the help of midwives for their babies’ births, and are returning to traditional care. 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, and NARM have all helped to increase awareness of birth options for families. The links below are full of historical information about midwifery, traditional birth, and about continuing struggles for the freedom to choose where and with whom a woman may give birth. Something to think about the next time says they want a traditional hospital 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
- The Disturbing, Shameful History of Childbirth Deaths