American Childbirth History
Attitudes towards pregnancy, labor and childbirth have changed significantly over the last one or two hundred years in American history. During the colonial period anything associated with the biological experience of giving birth was considered to be the domain of the female. Men were excluded from the experience and a group of female relatives, neighbors and midwives took care of the laboring woman. Birth was considered a natural process and midwives provided a supportive, noninterventionist role while handling slow labor process, poorly positioned babies or excessive pain.
The Role of Doctors
It wasn't until the second half of the 18th century that doctors began to play a significant role in childbirth. In American history of giving birth, the first man who began a steady practice of midwifery was William Shippen. In 1793 the formally educated doctor serviced well-off women in urban areas.
The official practice of obstetrics in the United States began in the early 19th century. It was considered a new and innovative medical field where opium was used to help with labor pain and the use of forceps became more common than before. Unlike midwifery where practical application was important, the male doctors of obstetrics rarely witnessed an actual birth even after years of practice. Pelvic exams and birthing took place under sheets without the male doctor looking at the woman's genitals.
By the mid-19th century obstetrics was promoted as managing of the childbirth experience by doctors and the experience became more interventionist. Traditional midwives promoted more of a supportive role while doctors were able to interfere in the birthing process with medical advances like drugs to ease pain or positions that made delivery easier from a doctor's perspective. Chloroform was first officially used in the American history for easing childbirth pain in the 1840s. Forceps were standardized. Horizontal birth was encouraged which often made labor more difficult or painful than the upright positions traditionally used by midwives. For this reason, episiotomies became more common.
Some studies indicate that the US birth rate history in regards to mother or infant mortality statistics was sometimes worse when a doctor attended the birth. Often mortality statistics were equal to midwives even though traditional birthing techniques and the women who promoted them were considered uneducated and dirty by the medical community at this point in American history.
The Shift to Hospital Births
In 1900 only about five percent of American women delivered in hospitals. By 1920 the numbers rose to as high as 65 percent in larger US cities. In 1955 95 percent of births were in hospitals. The reason for the rise in hospital births was to because doctors wanted to create a more sterile environment and reduce the chance of infection in both the mother and the new infant. Hospitals also provided more pain management options as well as x-rays (in later years) and c-sections for difficult or complicated deliveries. Some argued that hospital births made it easier to keep birth records. Papers could be filed right after the birth of a child eliminating the need of the parents to make an extra trip to the church or courthouse to file birth records.
More Medical Advancements
The more medical focus on childbirth and the birthing process led to the beginning of the history of birth control in America. Medical research led to the synthesis and isolation of female sex hormones and the birth control pill was developed in the 1950s. Over the years it has been refined to contain only the minimal amount of hormones necessary to reduce the chance of pregnancy.
Other medical research led to the earliest form of the modern reproductive technology of in vitro fertilization by the late 1970s. In the 1980s new reproductive technologies like surrogacy, cloning, genetic engineering and embryo transfer were developed.