Midwife - Integral to Childbirth History

During ancient history most births were attended to by midwives. There was no such thing as doctors specializing in pregnancy, labor and delivery as there is today. Any doctors in ancient times were considered surgeons and didn't have anything to do with the birthing process. Having babies was considered a woman's domain.

There were a few ancient cultures, like ancient Greek and Rome, where there was some involvement of male doctors in births. But they were usually only called in to advise if there was a problem or concern.

Medieval to 17^th Century

During medieval times, records indicate that this was one of the most conflicting times in the history of midwifery. Births were most often managed by midwives and the midwife was often the most trusted woman in her village. In some areas the midwife was licensed through the local bishop or received training from male doctors. They tended to be paid with gifts and didn't receive a midwifery salary for their work which was considered a public service. In the 17^th midwives were beginning to be paid for their work.

Many midwives used ancient herb concoctions to help a laboring woman. Because of this, conflict arose between these ancient practices and what was considered acceptable by the church. In some places midwifery was associated with witchcraft. Emphasis on labor pain being punishment for Eve's sins also fed into the idea that midwives must be servants of the devil for daring to do anything to relieve a woman's labor pain.

The Decline of Midwifery

In the 1800s there was a rise in scientific studies, knowledge and the perception of childbirth as being dangerous. Many births were still attended to by midwives, but they were rapidly losing respect. They were limited in the amount of education they were permitted to have. They were also limited in learning how to use any new tools related to birthing, like the forceps. In America the transition from midwife to doctor was much faster and there seemed to be a stronger campaign against midwives that presented them as dirty and ignorant.

By the mid-1900s midwife-attended births were almost unheard of. In 1915 Dr. Joseph DeLee wrote a paper for the Association for the Study and Prevention of Infant Mortality that compared childbirth to a disease and not a normal function so must be medically managed. His paper said midwives had no place in childbirth.

This general attitude and the perception that hospitals were the safest, most sanitary places to have a baby increased the number of woman who had their children in hospitals and looked down on midwives. Pain relief treatment was available in a hospital which also made it a popular choice for childbirth. From the 1920s to the 1950s a labor pain treatment that later became known as the Twilight Sleep was popular and medicated women enough so that they weren't quite unconscious, but didn't remember anything of the labor either.

The Return to Midwifery

Midwives still worked, but they worked more along the fringes of society. In 1952 this changed when the National Organization for Public Health Nursing developed midwifery section with a philosophy emphasizing pregnancy and birth as a normal, natural process. In 1960 midwifery training and midwifery courses began to receive modest funding but better funding from the Division of Nursing wasn't available until 1976. In 1970 national certification for midwives was established and in the following years three branches of the American military began to train and use nurse-midwives.

In 1994 the North American Registry of Midwives offered its first written exam to test the knowledge of direct-entry, beginning midwives. Registration is now a crucial part of becoming a midwife in most developed countries.

Today, while there are no specifically exclusive midwifery schools, many post-secondary institutions offer undergraduate degrees or diplomas in midwifery. Besides training in labor and delivery, students also learn how to educate a mother on newborn baby care.