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0 AD - 1760
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From most of human history, childbirth has been an almost exclusively female affair. Midwives, women who help mothers through pregnancy and birth, and female friends and relatives were the people who attended birth and helped deliver babies. Men were rarely involved in the birth process and were often excluded entirely from the delivery room.
Scott, Maiken. “How Did Birth Move from the Home to the Hospital, and Back Again?” WHYY, WHYY, 13 Dec. 2013, whyy.org/segments/how-did-birth-move-from-the-home-to-the-hospital-and-back-again/.
Image: Woman giving birth surrounded by midwives and female relatives.
https://englishhistoryauthors.blogspot.com/2012_09_01_archive.html
1760 - 1900
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Around 1760, some upper-class women began to want to have doctors present during their labour. Over the next few centuries, more and more women began to want to have a doctor present at their birth to help them in the case of complications. Most, if not all, doctors were male. this marks the first time that men were admitted to the delivery room in most cases, transforming a very female process and space, into one where the authority is transferred from experienced women to a man.
The shift from women to men pushed many midwives out of the way and invalidated their experience. This was a problem in the American South where many enslaved or formerly enslaved women had performed essential roles as community midwives were pushed out of the way by white male doctors.
Scott, Maiken. “How Did Birth Move from the Home to the Hospital, and Back Again?” WHYY, WHYY, 13 Dec. 2013, whyy.org/segments/how-did-birth-move-from-the-home-to-the-hospital-and-back-again/.
Image: Male doctors assisting a women through labour, cesarian section imminent.
https://diariodeunmedicodeguardia.blogspot.com/2015/11/la-academia-de-medicina-de-ourense-1880.html
1900 - 1960
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Around the early to mid-twentieth century, as hospitals became safer with the development of antibiotics and medical technology, and the risk of postnatal infection dropped, more and more women began to want and to have hospital births. The shift from home to hospital births was especially seen after the world wars. In the UK, this coincided with the rise of the NHS. As a demonstration of the shift from home to hospital, in the UK, home births went from 35% of all births in 1960 to only 1% of all births by the late 1970s.
McIntosh, Tania. “Pushed into It? Hospital or Home Birth Has Rarely Been a Simple Choice.” History Today, vol. 67, no. 11, Nov. 2017, p. 18. EBSCOhost, search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=ulh&AN=125589498&site=eds-live&scope=site.
1958
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In 1958, the article "Cruelty in Maternity Wards" was published in Ladies Home Journal magazine. The article exposed the ways in which women were being mistreated in maternity wards. Some quotes from women interviewed for the article include: "They give you drugs, whether you want them or not, and strap you down like an animal”. ”I’ve seen patients with no skin on their wrists from fighting the straps”. “My baby arrived after I had lain on the table in delivery position nearly four hours.” These quotes illustrate some of the issues in maternity care at the time.
This article lead to a several movements that aimed for positive change in maternity wards and the care of pregnant women in health fields, It also lead to allowing husbands to be present in the delivery room, something that was not allowed, or was seen as unnatural, for most of history.
Stubbs, Sheila. “Cruelty in Maternity Wards.” Wise Woman Way of Birth, Wise Woman Way of Birth, 10 Mar. 2010, wisewomanwayofbirth.com/cruelty-in-maternity-wards/.
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Professionals, Childbirth. “Do We Still Need a Childbirth Movement?” Childbirth Professionals International, 10 May 2018, thechildbirthprofession.com/childbirth-movement/.
1970 - 1980
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After the mistreatment of women in maternity wards was exposed, there was a conversation about the best way to give birth. For many, this meant a natural birth, that is a birth without pain medication, and for some women, this meant giving birth at home. This was a strong contrast to the "twilight sleep" labours where women were knocked out whether they wanted it or not. Ina May Gaskell was one of the main advocates for natural childbirth in the US.
https://www.nytimes.com/2012/05/27/magazine/ina-may-gaskin-and-the-battle-for-at-home-births.html
1990 - 2020
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Maternal mortality is on the rise in the United States, one of thirteen countries globally that has seen a rise in maternal mortality rates since 1990, putting it more in line with countries like Zimbabwe and North Korea than other wealthier countries like the UK, Sweden, and Australia, all of which have seen a decline in maternal mortality rates in the last few decades.
Maternal mortality in the US is also skewed by race. The article states that "Black mothers are three times more likely to die in childbirth than white women". This relates back to the medical field's unwillingness to take Women of Colour's pain seriously.
Belluz, Julia. “California Decided It Was Tired of Women Bleeding to Death in Childbirth.” Vox, Vox, 4 Dec. 2017, www.vox.com/science-and-health/2017/6/29/15830970/women-health-care-maternal-mortality-rate.
2000 - 2020
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Doulas are people who help women through pregnancy and birth but that are not trained healthcare professionals. They tend to provide more emotional support than medical assistance and have become more popular in recent years.
Having a doula present at birth and throughout pregnancy can have positive impacts on both the mother's health and on the health of the child, including lower instances of low birth weight. The presence of a doula in the delivery room can ensure that the mother's wishes are respected while she is in labour. The study also found particularly good benefits for women of colour when they went through pregnancy with the assistance of a doula.
Gruber, Kenneth J, et al. “Impact of Doulas on Healthy Birth Outcomes.” The Journal of Perinatal Education, Springer Publishing Company, 2013, www.ncbi.nlm.nih.gov/pmc/articles/PMC3647727/.
Image: Doula assisting a woman in labour.
https://en.wikipedia.org/wiki/Doula
2012 - 2020
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The BBC television show Call the Midwife, which has been running since 2012, follows midwives working in the East End of London in the 1950s and 1960s. The show illustrates the tensions and problems that come with moving from home births to hospital births, contrasting the cold and clinical attitudes of male doctors in hospitals with the individualised care that the district midwives could provide. Other than discussing the home to hospital shift, the show addresses issues such as race, sexuality, and class and how they relate to not only society in general, but to the treatment that individuals receive in maternity care based on these factors.
Tricklebank, Annie, et al. Call the Midwife, Season 1-9, BBC One, 15 Jan. 2012.
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Helfrich, Ronald, and Dolly Dastardly. “You Should Watch This: Call the Midwife.” Lady Geek Girl and Friends, 27 Sept. 2017, ladygeekgirl.wordpress.com/2013/03/31/you-should-watch-this-call-the-midwife/.