The Facts of Life: Examining Reproductive Health

Childbirth

The History of Childbirth

Women have always been healers. While they practiced as unlicensed doctors for much of Western history, they were frequently the only healers for women and the poor. However, during the middle ages, women's healing powers were strongly associated with witchcraft and thousands of women across Europe were burned at the stake during the 14th through the 16th centuries for the "crime" of attempting to heal others. Their true crime however, was the threat they posed to the church and state by providing an alternative to the traditional healing practices controlled by men. In centuries past, the majority of births were attended by midwives, rather than by male practitioners. However, the male medical establishment and the Church were threatened by the fact that women were being assisted and supported by other women during childbirth and illness. Consequently, much retaliation against these women occurred in the form of witch-hunts, even though their methods were successful.

25. Delivery of a German woman in a birth chair by a midwife (1513) (Ploss-Bartels.) Neufeld & Henis

26. A Dutch Birth Helper of the seventeenth century giving help to the woman while covered with a sheet. (Ploss-Bartels.) S. Janson

Midwives often knew more about herbs, remedies and anatomy than many trained male healers. Although some doctors acknowledged and adopted the collected wisdom of midwives, others worked hard to limit their healing activities. By the 18th century, obstetrical forceps came into widespread use in England, making it possible for male practitioners to make serious inroads into midwifery. Since forceps were considered surgical instruments, women, having been legally prohibited from practicing surgery, were unable to use them. New technologies and breakthroughs continued throughout the 19th century, "professionalizing" medical education and further excluding less "scientific" women.

27. Medieval C-Section

28. Trotula (circa 1050 A.D.) A matron of Salerno, Italy, through her contributions to the literature of obstetrics and gynecology, became the most famous woman in the early medical history. She was one of many midwives to contribute dignity and proficiency to her profession. Davis & Geck, Inc.

29. The Japanese woman in labor supported by an assistant. (Witkowski.) G. Steinheil, Paris

Midwifery continued to thrive, however, and despite the increased scientific knowledge of doctors by the 1900s, midwives practiced widely in the United States, especially in rural areas. A 1912 study by Johns Hopkins University established that most midwives were better trained than most American doctors. This fact, however, did not stop the organized opposition to midwifery. Many European countries acknowledged the importance of midwives, offering them greater educational opportunities and a place in the medical hierarchy. Meanwhile, numerous state laws were passed that outlawed the practice of midwifery in many areas of the United States.

Recently in some areas, the midwife has resumed her place on the childbirth team and the profession of midwifery has grown. Some hospitals, including The University of Iowa Hospitals and Clinics, offer the option of delivery by midwife or obstetrician.

Currently there are two categories of midwives in the United States- certified Nurse-Midwives and lay midwives. Nurse Midwives must have a bachelor's degree in nursing and then attend a midwifery training program for which many receive a master's degree in nursing. They typically use less technology than obstetricians, but are trained to work in conjunction with physicians and to involve physicians and technology in the birthing process when necessary. Lay midwives learn through apprenticeship, and may receive some training, but have no certification or licensing procedure. They are community-based, and can not be affiliated with a hospital or clinic.

Midwives offer a service to women and their families in an unhurried and relatively relaxed environment. They are able to offer continuous support to the mother and family during pregnancy, labor and birth and are willing to leave the timing of the birth to the infant, rather than intervening with medical procedures. Many women give birth today with the help of midwives, whose goal it is to enhance both the emotional and physical well-being of mothers and newborns.

30. Drawing of woman with newborn in Medieval times