A Peek Into the Past: A History of Birth Choices and Practices

Once upon a time, Miriam and I wrote a book. And in that book, we had over 400 pages of material. Our vision, however, was to give new and expecting moms a nursing companion–a book they could hold in one hand. We had to face it: four hundred pages is awkward.

So we snipped. And trimmed. And cut. (Miriam was the better cutter. I acted as if my limbs were being torn from me every time she suggested a section for the chopping block.) It’s hard to say no to hundreds of hours of work, but thankfully, all’s not entirely lost. We’re bringing you some of our largest unseen sections from TOBB, in a series of blog posts.

“A Peek into the Past” is a pithy round-up of our societal evolution of parenting practices, mostly in the U.S. You’ll learn about the history of birth, breastfeeding, potty training, co-sleeping and more–eight posts for our eight chapters. Enjoy, ask questions, and share with friends!

~Megan

A Peek Into The Past: Birth
Just 100 years ago, American childbirth was considered a normal, natural process. Our great-grandmothers didn’t need to enroll in childbirth education classes; they were supported by their mothers, sisters, cousins, and neighbors. Since women attended other births as a regular life event, like weddings and funerals, new mothers were often well-versed in labor and delivery. Babies were born at home with the help of family, friends, and often a skilled midwife.

Toward the end of the 1930s, male Obstetricians (OBs) launched a crusade marketing campaign to glamorize hospital births. For extra oomph, they ran a smear campaign to put fear in the hearts of birthing women. Cities were plastered with posters featuring photos of ugly, dirty and ragged women–“midwives.” Middle and upper class women soon jumped ship. Hospital births, along with complete anesthetization (read: mamas were knocked out!), became the norm. Women were often strapped down and given narcotics like morphine and scopolamine, which erased all memory of the experience. Expectant fathers passed laboring hours in waiting rooms, and when babies were delivered, nurses whisked them away to nurseries.

But not everyone joined this bleak birthing bandwagon. In 1944, Dr. Dick-Reed, author of Childbirth without Fear: The Principles and Practice of Natural Childbirth, coined the phrase “natural childbirth,” reintroducing labor without anesthesia. A decade later, the work of Dr. Fernand Lamaze began bringing fathers back into the delivery room. Labor and delivery began to be seen again as normal processes, and though hospital births still accounted for an overwhelming majority, the days of intense maternal disempowerment, ended.

Ina May Gaskin was another player who helped us reclaim birth as a normal, natural process. After attending out-of-hospital births of women in her community, Ina May and several midwives founded The Farm Midwifery Center, one of the first birthing centers in the U.S. She went on to author Spiritual Midwifery and Ina May’s Guide to Childbirth. Editor of Midwifery Today Jan Tritten dubbed Ina May “the mother of modern midwifery.”

The debate over homebirth heated up in the 1970s; the American Congress of Obstetricians and Gynecologists opposing, and the women’s movement demanding a return to midwifery and demedicalizing birth.

Birthing centers began popping up on America’s east and west coasts in the 1970s, allowing moms a more flexible birth experience not restricted to a hospital bed. Unfortunately, in the 80s and 90s, many health insurance companies streamlined their support of OB-facilitated hospital births by reducing coverage of midwife-related costs, and ditching support of certified nurse midwives altogether. Their decisions reduced out-of-hospital options for moms.

Today, the U.S. birthing system leaves much to be desired. No central set of licensing standards governs midwives, and independent practitioners of midwifery aren’t legally allowed to practice in several states. Despite these barriers, homebirth rose a dramatic 20% from 2004 to 2008, with almost 30,000 mothers opting to give birth at home in 2008.[i] In the same year, former talk show host Ricki Lake produced The Business of Being Born, a frank examination of the politics behind birthing in our country, followed by other documentaries advocating home births. While it’s too soon to tell, we suspect these educational films have increased the number of women considering home or natural births. As concern about high rates of interventions persists, more women are reclaiming birth as a normal, natural process.

For a deeper look at the history of birth, check out these sites:

Birthologie

Digital History: Childbirth in Early America

Midwifery Today: A History of Midwifery and Childbirth

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[i] MacDorman, M. F., Declercq, E. and Mathews, T. J. (2011), United States Home Births Increase 20 Percent from 2004 to 2008. Birth, 38: 185–190.