Where have all the midwives gone?
In past centuries, only women attended women in childbirth. Birthing women were in control, choosing who should attend them and where and how to give birth. Men were usually excluded unless they were needed for their strength and their tools if labor was obstructed. Eventually, with the medicalization of childbirth, male physicians became involved, introducing new techniques that interfered with the normal birth process and competed with midwives. By the 19th century, midwives struggled to hold onto their profession and advance through education. Midwives survived in Europe, but in America, they were eventually usurped in the early 20th century when birth began taking place in hospitals and as medical science and technology advanced. Midwives eventually rose again as educated nurse-midwives. Technology and obstetric interventions in normal childbirth continue, in spite of lack of evidence of their efficacy. Midwives are again in jeopardy because of rising malpractice insurance costs, women's trust in technology, and, most recently, renewed efforts by physicians to once again prevent midwives from practicing autonomously and outside the hospital environment in the United States.
PHYLLIS BRODSKY has been a nurse for 50 years and an educator for over 20 years, having served as an obstetric nurse and educator in hospital settings and on several university faculties. She taught childbirth education classes for 20 years. She has been a member of the Maryland Nurses Association (MNA) since 1979, Past President of MNA, District 4, from 2002 to 2006, and a member of the MNA Continuing Education Provider Committee since 1992. She is also the author of several articles in journals and other publications. Her most recent publication is The Control of Childbirth: Women Versus Medicine Through the Ages (McFarland & Company).
Phyllis L
PL
Brodsky