Archive | April 2023

Brief overview of midwifery in early America through today

(I would like to state that I wrestled for some time with writing this “blog post,” as I am a writer and I have a great interest in midwifery history. This time around with this topic, I became dissatisfied about how much midwifery is usually presented and defined by its opposition to doctors, the medical system, etc. Midwifery has its own glorious, stand-alone history, our own errors and mistakes that we rarely own up to, and I eventually decided to leave out almost entirely the history of medicine, doctor’ persecution, childbirth under early doctors’ (purpureal fever, etc.), and instead just make it a simple, brief actual overview only of midwifery. It is intentionally very brief, and doesn’t go into much detail about the arguments for nurse- or direct-entry midwifery, for example. I was thinking mainly of clients who would only like an overview, not a selective piece of swaying writing highly critical of the medical model nor a deep overload of information about direct-entry midwifery.)

A very brief overview of midwifery in early America through today:

America has a rich history of midwifery care, though much of it is not recorded. The colonists brought midwives among themselves, and later, midwives were also brought among the slaves and immigrants. Knowledge and skills surrounding helping women in childbirth were passed on orally and in hands-on apprenticeship training. Few women were taught to read and write.  Some midwives we know about (because of extant writings) are Bridget Lee Fuller, Anne Hutchison, and Martha Ballard.

In the 1800s, male involvement in medicine and formal training for doctors rose, licensing for doctors became formalized, and along with this, doctors openly promoted the view that childbirth is an inherently dangerous process that requires routine interventions. Midwives, being female, were often illiterate and not trained to write, or they were immigrants and didn’t know English very well, so they could not compete with the growing social and legal power of doctors.  

Wealth and social status are also large factors in childbirth. Wealthy and middle-class women still birthed at home but using a doctor became more accepted. Doctors organized into what became long-standing, powerful, legal organizations like the American Medical Association. Gradually, childbirth moved into hospitals where drug pain medications and many medical interventions could be practiced.

In many countries, midwifery developed as an integrated part of the medical system. However, in the U.S. and Canada, in the first half of the 1900s, midwives were more and more sidelined, put out of practice, or allowed to serve only poor communities. The “granny midwives” of the South are remembered during this time and several well-known biographies are written about their unwavering service to women. Midwives often skillfully and sacrificially served poor communities that were unable to pay for doctors’ services.  Some famous midwives of this time are Mary Breckinridge, Mary Coley, Etta “Granny” Nichols, and Onnie Lee Logan.

Particularly in the mid- to late-1900s, there was a resurgence of middle-class women wanting home birth and midwifery care. Midwives organized as both nurse-midwives and as direct-entry midwives. Each developed their own standards for education and licensing. Some well-known midwives of this era (who also authored popular textbooks and books) are Elizabeth Davis, Ina May Gaskin, Helen Varney, and Anne Frye.

Resources

Connerton, W. C. (2012, May 25). midwifery. Encyclopedia Britannica. https://www.britannica.com/science/midwiferyhttps://www.ohsu.edu/womens-health/brief-history-midwifery-america

Feldhusen, A. E. (2000). The history of midwifery and childbirth in America: A time line. Midwifery Today. Retrieved April 19, 2023, from https://www.midwiferytoday.com/web-article/history-midwifery-childbirth-america-time-line/

Hanna, C. (n.d.). A brief herstory of midwifery and childbirth in America . Happy Mama Healthy Baby Alliance . Retrieved April 19, 2023, from https://motherbabysupport.net/professional-education/history-of-midwifery/

Hill, H. (n.d.). Five black American midwives you should know: The history and impact of black midwives in the U.S. . Hanna Hill Photography. Retrieved April 19, 2023, from https://www.hannahillphotography.com/hanna-hill-photography-blog/5-black-american-midwives

Rooks, J. P. (2012, May 30). The history of midwifery. Our Bodies Ourselves Today. Retrieved April 19, 2023, from https://www.ourbodiesourselves.org/health-info/history-of-midwifery/

The story of the granny midwives, who birthed untold numbers of babies in the rural South. (n.d.). Vimeo. Retrieved April 19, 2023, from https://vimeo.com/211012543.

Varney, H., & Thompson, J. B. (2015). Chapter one: The early voices of midwives. In The midwife said fear not: A history of midwifery in the United States: (pp. 4–19). essay, Springer Publishing Company. (accessed: https://connect.springerpub.com/content/book/978-0-8261-2538-5/part/part01/chapter/ch01)

Update on my studies

I’ve been in school for almost 7 months now.

For academic studies, I’m enrolled in the National College of Midwifery’s program, and I completed several Antepartum classes (Basic Skills, Provision of Care, Risk Screening, Diagnostic Lab Tests and Procedures, Observation & Charting).

I’ve completed several other classes (Family Planning), just waiting for grading.

I’m currently working through History of Midwifery and we’re finishing up Lactation and Perinatal Education.

For my clinical studies, I’ve assisted the midwife at about 80 prenatals, 17 births, 4 newborn exams, almost 20 postpartum exams. I’ve learned venipuncture and soon we start our IV class. Checking vital signs, palpation to determine fetal position, listening to FHTs, evaluating labs, charting–these are all things I regularly practice.

My three philosophical thoughts from this time: 1) I hope the world tires soon of all. the. research. and realizes the limits of what is actually measurable. Reducing these experiences to numbers is a major weakness of the allopathic system.

2) How on earth did the legal system become such a chokehold to good care?!?!

3) I continually remind myself that clinic midwifery has it’s pros and cons. Pros: amount of experience, multiple teachers and input, ability to leave it until the next shift. Cons: lack of the emotional synergy, freedom, and physiology of home birth.