Natural Childbirth - History

History

Historically, most women gave birth at home without emergency medical care available. The "natural" rate of maternal mortality—where nothing is done to prevent maternal death—has been estimated at 1500 per 100,000 births. In the United States circa 1900, before the introduction and improvement of modern medical technologies, there were about 700 maternal deaths per 100,000 births (.7%). (However, natural childbirth advocates recognize the importance of emergency medical intervention, which can avert maternal or neonatal death.)

At the onset of the Industrial Revolution in the 19th century, giving birth at home became more difficult due to congested living spaces and dirty living conditions. This drove urban and lower class women to newly available hospitals, while wealthy and middle-class women continued to labor at home. In the early 1900s there was an increasing availability of hospitals, and more women began going into the hospital for labor and delivery. In the United States, the middle classes were especially receptive to the medicalization of childbirth, which seemed to promise a safer and less painful labor. In fact, the ability to labor without pain was part of the early feminist movement. With this change from primarily homebirth to primarily hospital birth came changes in the care women received during labor: although no longer the case, in the 1940s it was common for women to be routinely sedated and for babies to be delivered from their unconscious mothers with forceps (termed by Dr. Robert A. Bradley as "knock-em-out, drag-em-out obstetrics"). Other routine obstetric interventions have similarly come and gone: shaving of the mother's pubic region; mandatory intravenous drips; enemas; hand strapping of the laboring women; and the 12 hour monitoring of newborns in a nursery away from the mother.

Beginning in the 1940s, childbirth professionals and mothers began to challenge the conventional assumptions about the safety of medicalized births. Physicians Michel Odent and Frederick Leboyer and midwives such as Ina May Gaskin promoted birthing centers, water birth, and homebirth as alternatives to the hospital model. Some research has shown that low-tech midwifery provides labor outcomes as good as or better than those found in hospital settings with fewer interventions, except for a small percentage of high-risk cases.