The Herstory of Childbirth
"Even though most American practitioners had not attended medical school and were themselves apprentice trained, physicians carried with them the status advantages of their gender and of the popular image of superior education."
Judith Walzer Leavitt in Brought To Bed-Childbearing in America 1750-1950
Historically women were attended in birth by other women, namely midwives at home. They laboured and birthed, standing, sitting or squatting.
1484-the Malleus Malefic arum or The Hammer of the Witches became a best selling book; it caused a mass hysteria that lead to the inquisition, where midwives were burned at the stake. It stated (among other foolish ideas) "….midwives, who surpass all others in wickedness" and "midwives cause the greatest damage, either killing children or sac religiously offering them to devils".
1500- The earliest recorded C-section (although there were other accounts that are not recognized by medical historians) Jacob Nufer a Swiss pig gelder put his gelding tools to good use, by operating on his own wife after the doctors had given up on her. By the way she and her baby lived and she went on to have 4 more children vaginally! Subsequently, the very first C-section was accompanied by 4 VBAC’s!
1588-Forceps invented by Barber Surgeon (as the name implies, they were barbers who brought their skills of adeptness with sharp tools to enter into the birth scene through bloodletting), Peter Chamberlain.
1585-By this time, two villages in the Bishopric of Trier, were left with but one woman inhabitant each. (It has been estimated that between 50,000 to a million or more, illiterate peasant women who served their communities as midwives and healers were executed during this horrific time.)
17th Century- the Hotel Dieu in Paris was set up as a hospital where women could obtain free care, but it was initiated to medicalize birth, a place where women of working class and the destitute, would become real life experiments or demonstration material. In America, black women often suffered the same fate.
17th Century- Madame de Monte span, the mistress of King Louis XIV, lay down to give birth so her lover could watch the event from behind a curtain.
17th and 18th centuries, the ability to touch and learn through touch, formed the essence of obstetrics because male doctors were not allowed to look at the female patient's vagina.
During the 17th and 18th centuries, the Colonization of North America began. Women became quite isolated from each other, but they still came from neighbouring farms to assist each other in birth. However, as colonization continued from New England to California, from the deep South to the Canadian border, women became so far isolated from other women that they began to call for their husbands to assist them in birth. This opened the door for male doctors to become more involved in childbirth.
1742-Episiotomy was first written about by Sir Fielding Ould, Master of the Rotunda in Dublin. In those times it was an emergency operation that was rarely performed.
1760's and on-the North American continent began to really prosper economically and in turn the demand for doctors grew. It became a sign of social status to be able to afford to hire a doctor to attend your birth. (It is interesting to note that when doctors first attended these births, women actively negotiated with the doctors along with friends, neighbours and husbands who were also present at birth. It was also taken for granted that women would labour upright and move around. The women used rafters, ropes, window ledges and furniture to get comfortable. However, in time doctors began to complain that nothing could be done without a women's consent, and began to urge everyone out of the room, thus foregoing accountability to the community).
1773-This is when puerperal fever appeared in the lying-in ward of the Royal Infirmary of Edinburgh. Almost every women who gave birth there, was seized with it and all of them died. Since none of the women who gave birth at home with midwives in the town "contracted" it, an incorrect assumption was made. The assumption was that since no-one in the town got it, they believed it to be a contagious disease running rampant through their hospital. However, it turns out that it was passed on from the doctors to the patients. The doctors didn't wash their hands after touching dead corpses and they themselves inflicted the women with the fever.
19th Century- Immobility was imposed on women by doctors who wanted to be able to examine them more easily; they were now instructed to birth lying on their backs. At this time, the notion that only women could become hysterical, was perpetrated by the medical establishment; they believed that hysteria was the consequence of a malfunctioning uterus.
19th Century- middle class women were instructed with strict rules by male physicians about how they should breastfeed. They were told to put the baby in a separate crib (as they had never done before (in the past mothers slept with their babies); mothers were instructed to wash their babies' mouths out with boracic lotion after each feeding.
From 1845-1849 a doctor named James Marion Sims began to specialize in disorders of the female organs. He was drawn to 'cure' vesico-vaginal fistulae, which are tears in the wall between the vagina and the bladder (causing continual leakage from the bladder, leaving them to become invalids and social outcasts because the smell from the seepage was intolerable). It often occurred during childbirth as the result of a poorly implemented forceps delivery. In the pursuit of a cure, Sims bought several black afflicted female slaves, whom he housed in a hut in his backyard. For four long years he operated on these women without anaesthetic.
1847- Dr. James Young Simpson discovered the anaesthetic properties of chloroform, but the church resisted his discovery and he doubted that chloroform would ever catch on because of the church's influence on societal acceptance.
1850's- Dr. Ignaz Semmelweis discovered the cause of puerperal fever. It was that doctors and medical students were coming directly from the morgue where they performed autopsies on victims of the fever and then would go straight to the maternity ward and place their fingers into the birthing woman's vagina. The cure was to wash hands in chlorine water. The 'cure' was found and the death rate plummeted where he practiced. Dr. Semmelweis was eventually driven out of his post at the Vienna Lying-In Hospital, by a vengeful and envious superior. Many doctors ignored his findings and continued to challenge him; they were too arrogant to believe that they themselves could be the conduits of disease. Finally, he fled to his native Budapest where he died in an insane asylum after he eventually went mad.
1853- Chloroform goes mainstream. Apparently Queen Victoria had more pull than the church and in 1853 when she used it to birth her 8th son by the age of 33, chloroform became all the rage and soon crossed the Atlantic to America.
1863- By this time 123 deaths of women had been attributed to chloroform.
1880-Before this time, maternity wards were rightly considered to be "hellholes of infection and death".
1882- The first modern version of the caesarean section was performed by a German doctor named Max Sänger. He performed them on women with deformed pelvises who had been malnourished and developed rickets as a result. He had a success rate of 80%.
20th Century- artificial milk was introduced. Babies suffered vitamin deficiency resulting in rickets.
Simultaneously in the earlier portion of the 19th Century in England; most women were still attended in birth by midwives. However, by the end of the 19th Century, birth also became medicalized in England; and just as in the U.S., birth became dangerous. 70% of the women were delivered by GP's with much interference by chloroform. In the 1930's, doctors in England were applying forceps in 50% or more deliveries. At the time, the maternal death rate was 500-600 maternal deaths per 100, 000 births!
1910- the breastfeeding "anti-embarrassment device" was patented. It was a harness which confined the breast, with rubber tubes passing over them and out through the clothing and ending in artificial nipples for baby to suckle on.
1912- Dr. J Whitridge Williams, sent out a questionnaire to all the medical schools in the United States that offered 4 year courses. He discovered that 1/3 of the professors had no special obstetric training. He concluded that labouring women were just as safe in the hands of "ignorant" midwives as they were in the hands of poorly educated doctors (although this statement, he thought to be contrary to reason).
By 1913-1/2 of the women who died in childbirth, still died from puerperal fever, even though the cause was discovered in the 1850's. Doctors still refused to wash their hands. Women continued to die of postpartum infection (as doctors continued to busy themselves with interventions), birth in the U.S. became increasingly dangerous until the 1930's when antibiotics were discovered.
In the beginning of the 20th Century- European midwives began to emigrate from Europe to North America. At this time doctors attended more than 50% of births and the midwives attended the rest of the women; those who could not afford doctors.
1920's-Hyoscine in the form of scopolamine or "twilight sleep" was introduced. This is a hypnotic drug that makes women unable to remember what happened during childbirth. Upon injection, women became restless, excitable and at a loss for mental control, she became in danger of harming herself. Birthing women were placed in barred, high-sided, padded cots and eventually delivery tables were designed with handcuffs, ankle cuffs attached to lithotomy stirrups and shoulder restrainers. According to Sheila Kitzinger, a social anthropologist, scopolamine is still used in some American hospitals today.
1920's- Some doctors began warning others about the dangers of X rays in pregnancy.
1920's -1930's breastfeeding was reintroduced, but rather militantly. Rigid schedules and clock watch feeding became the norm.
It is also interesting to note that in every society, mortality rates are greatest among the poor. However, due to poor obstetrical practices as late as 1934, the risk of death in childbirth was highest in the middle and upper classes. These women were twice as likely to die in childbirth than women in the poorest area of London, England, in the east end where women were still being attended by midwives and a strong social support network of other women in their communities.
By 1939, more than 75% of births in the U.S. had moved from home into hospital and by 1960, it became close to 100%. Birth did not become safer. Infection was still a major cause of death.
1940's Doctors routinely starved pregnant mothers by prescribing low protein diets sheets to keep babies small and therefore to supposedly avoid complications.
1950's Dr. Alice Stewart revealed that radiation exposed to the fetus led to an increased risk of cancer before the child reached the age of 10. X raying finally stopped after 50 years of use and the 30 years it took before the scientific warnings were heeded.
1970's- Fathers were finally welcomed into hospital delivery rooms, although he was likely to be sent out for the pushing stage.
On why Midwives ought not to attend births…
"They (women) have not the power of action or that active power of mind,
which is essential to the practice of a surgeon. They have less power of
restraining and governing the natural tendencies to sympathy and are
more exposed to yield to the expressions of acute sensibility……Where
they become the principal agents, the feelings of sympathy are too
powerful for the cool exercise of judgement."
-(Anon., in Wertz, R.W. & D.C., op. cit., p57)
HISTORICAL QUOTES
On the pathogenic nature of childbirth…
"Labour has been called, and is believed by many to be, a normal
function……and yet it is a decidedly pathologic process. If a women befalls
a pitchfork, and drives it through her perineum, we call that pathologicabnormal,
but if a large baby is driven through the pelvic floor, we say that
it is natural, and therefore normal…labour is pathogenic, disease
producing, and anything pathogenic is pathologic or abnormal…So
frequent are these bad effects, that I have often wondered whether Nature
did not deliberately intend women should be used up in the process of
reproduction, in a manner analogous to that of a salmon, which dies after
spawning." Joseph De Lee (oversaw the birth of modern obstetrics in the
U.S.)
On the disposable nature women…
"If women get tired and die in childbearing there is no harm in that; let them
die as long as they bear; they are made for that." -Quoted in Jacques
Maritain, Three Reformers: Luther, Descartes, Rousseau, Scribner, New
York, 1950, p184
On "Twilight Sleep"…
"When these women thought they were "out" they were awake and
screaming. Made crazy from the drug, they fought, they growled like wild
animals, they had to be restrained, tied by hands and feet to the corners of
the bed (with straps padded with lambs' wool so there would be no injury,
no tell-tale marks) or they would run screaming down the halls. Screaming
obscenities, they bit, they wept, behaving in ways that would have
produced shame and humiliation had they been aware. Doctors and
nurses, looking at such behaviour induced by the drug they had
administered, felt justified in treating the women as crazy wild animals to
be tied, ordered, slapped, yelled at, gagged." -Dr. Michelle Harrison (when
writing about her training experiences becoming a doctor)
OUR REFERENCES:
Arms, Suzanne. Immaculate Deceptoin - Myth, Magic and Birth. California: Celes-tial Arts, 1996.
Davis-Floyd, Robbie. Birth As An American Rite of Passage. Berkeley: Uni-versity of California press, 1998.
Davis-Floyd, Robbie & St. John, G. From Doctor to Healer. Rutgers University Press, 1998.
Kitzinger, Sheila. Rediscovering Birth. London: Little Brown Books, 2000.
Leavitt, J.W. Brought to Bed-Childbearing in America 1750-1950. New York: Oxford University Press, 1986.
Mitford, J. The American Way of Birth. New York: Dutton, 1992.
Simonds, Wendy et al. Laboring On: Birth In Transition in the United States. New York: Routledge, 2007.
Want More Info on Childbirth History?
The History of Midwifery and Childbirth in America: A Time Line by Traditional Midwife, Adrian E. Feldhusen, click here to read article in Midwifery Today!
