History of midwives
ST. LOUIS POST-DISPATCH
01/19/2008
In the 1930s, maternal mortality rates began to decline in hospitals in the U.S. thanks to the use of more sterile surgical conditions and techniques. Medical advances in antibiotics and blood transfusions accelerated declines. Around this time, medical doctors began campaigning against midwives in the media, courts and legislature. They cited poor outcomes, though some research suggests they were ridding their competition.
Technologically intensive childbirth, however, has become the norm. The rate of labor induction has doubled since 1990, which studies show increases the chances of having a Cesarean section. The C-section rate has jumped within the past 10 years to over 30 percent, the highest ever. The major abdominal surgery involves risk to the mother and also increases risk of complications in subsequent pregnancies.
A comprehensive survey of women’s childbearing experiences released last year shows most mothers experienced each of the following during labor and delivery — continuous electronic fetal monitoring, one or more vaginal exams, intravenous fluids, epidural or spinal analgesia and a catheter. Most had little understanding of the side effects of these interventions. The survey also showed that many received interventions, such as episiotomies, without their consent.
National health statistics show that while over 4 million women give birth a year, obstetric procedures number nearly 7 million.
Today, more than 7,000 nurse midwives practice in all 50 states and attend almost 10 percent of all births, mostly in hospitals.
But natural birth advocates decry the loss of non-nurse midwives. As a result, they say women have lost the knowledge and confidence in giving birth. Advocates are pushing for the legalization of non-nurse midwives with specific training in home births. These "direct-entry" midwives learn midwifery through apprenticeship or a midwifery school that is distinct from nursing.
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