Historically, laboring was left to the women as men knew very little of how children were born. Men believed it to be a hellish experience as back then, not every mother or child made it out alive. Medicine, drugs, surgery, and other advancements have changed that perspective.
Midwifery (literally translated to “with woman”) is the name given to female birth attendants. Unfortunately, there was a period in time (around the 14th-17th centuries) where midwives did not communicate or share with one another their birthing experiences and in some cultures midwives were considered witches – they were hunted and hanged! Midwives were self-taught till about the mid 1800’s.
| In the 1800's Male physicians began to convince women that it was much healthier to have a doctor deliver a baby |
Home births continued through the end of the 1800’s. Around that time men became hungry for business and started attending births, promising pain relief and safer deliveries. Male physicians stated that it was much healthier to have a doctor deliver a baby, even using trashy pictures of old, gnarly women to scare expecting mothers into their offices. Midwives were losing their status and income as a result.
The introduction of male physician birth attendees soon after led to the use of sedatives and other interventions to ease the pain of birthing.
The following is a brief history of some of these interventions:
1600s – Forceps were first created in Europe. Later (early 1700s) they were re-invented by Dr. Smellie. Smellie was London’s most famous man-midwife. He set up a midwifery school in London and in doing so, began to change history. Women were not permitted to study in universities at the time. Soon word spread that it was safer to deliver a baby in a hospital setting with a doctor, not a midwife or female healer. Propaganda was spread and women of wealth began to labor and deliver in hospitals. Not long after, women began to receive chloroform and other pain killers to numb the experience. Women were no longer birthing in the natural squatting position but rather, flat on their backs. There are reports of women being strapped down to a gurney for periods of up to 8 hours so as not to hurt themselves during labor.
1742 – Episiotomy was first used in Ireland. It was in the 1870s that Dr. DeLee began to use the cut along with forceps whenever delivering. Dr. DeLee created the bed with stirrups where a woman would lie flat on her back to deliver.
1898 – A German doctor, Karl August Bier, originally injected cocaine as an early form of an epidural. As late as 1970, epidurals were still imperfect. Today it is better as levels of anesthesia can be adjusted. 90% of births in America today involve an epidural. Other countries use epidurals only minimally. Japan’s epidural rate is about 1%. In the Netherlands home births are the most popular route of delivery.
1914 – Twighlight Sleep was a drug that combined morphine and scopolamine as an amnesiac that caused women to have no memories of giving birth.
1915 – Dr. Joseph DeLee said it was better to prevent the pains associated with labor rather than to deal with issues or problems as they arose. He was very influential and soon all doctors were using sedatives, ether, episiotomies, and forceps. He taught that birth was a malady, something to be treated, and treated by a doctor only.
A cesarean section is the act of cutting open a woman to retrieve the unborn child. Records of a successful C-section date back over 500 years ago with survival of both the mother and son. However, most cases had a 50/50 survival rate due to infection and knife cuts. 1794 is the year of the first successful cesarean section in the US (opium was the sedative of choice). In today’s world, the Brazilian City of Rio de Janeiro has a 90% cesarean rate amongst their wealthy women. It has become a common surgery in the last century as seen by the following numbers: 40% in Chile, 36% in Mexico, 35% in Italy, 29% for America, and 22% in Canada and England. Women today are having larger babies due to current diets, not genetics. The problem has been that women’s bodies have not evolved to carry larger fetuses, perhaps causing more C-sections. Women today may choose a C-section ahead of time if they are carrying multiples, have preeclampsia, diabetes, placenta issues, or if the baby is in a breeched position. Female genital mutilation is another cause for a cesarean section, as is common in Somalia where 95% of women there undergo pharaonic circumcision (inner lips of vagina are removed and outer lips are sewn together). Somalia is one of the deadliest places on earth to give birth.
Grantly Dick-Read was a young obstetric trainee that found birth to be more of a natural occurrence. He believed that women needed to relax and less pain would be experienced and laboring would be shorter. He was criticized by his colleagues and soon after left the hospital atmosphere for a practice in the English countryside where he found women to be more accepting of his ideas of childbirth. He later wrote a book in 1942 titled Childbirth without Fear, which received positive feedback and became a bestseller. His teachings were brought to the US where many obstetricians were turned on to the natural child birthing process.
By 1910 midwives in America were only delivering 10% of babies and by 1973, less than 1%. Today we’re back up to 10% with a resurgence of the natural childbirth movement (a return to a kinder and gentler delivery).
Up until the 1960’s it was common for men to wait outside of the delivery room whereas today a woman can have present whomever she wishes for the birth of her child. The 60’s and 70’s also brought about the establishment of birthing centers. These centers were located near hospitals but cost less than half the price of a hospital delivery. However, the birthing centers did not give out epidurals or anesthesia, and therefore, no Cesarean sections. Mothers-to-be wishing for a natural childbirth could opt for a homelike setting at the birthing center. Such centers brought competition to hospitals that stepped up their game plan by offering new maternity wards with mother being allowed to labor, deliver, and recover in the same room. Hospitals also offered to follow along with a mother’s birthing plan. This has been a great show to expecting women and has driven birthing centers to closing (along with astronomical malpractice insurance the birthing centers are required to carry).
With all of the options available today, women can decide where, when, and with whom to deliver their baby. Sometimes, these attempts fail and fate steps in. A mother may unexpectedly go into labor on an airplane or while traveling underground. At times, mothers may have to make a decision to have an emergency cesarean section if she finds that her baby’s health is at risk. The best attitude to have when it comes to labor is to have an open mind and an open heart. No matter the method, in the end, the mother will be joined by her child, and how he got here will hold little value.
