Evolution of Childbirth in the US

Childbirth is a universal experience that has undergone significant changes throughout history, including the evolution of childbirth practices in the United States. From the humble beginnings of home births to the rise of hospital births, and the medical management of uteruses.

In early American history, homebirth was the norm. As was the norm, literally all over the world. Midwives, often experienced women (aka elders) from the community, provided care and support during labor and delivery. Families valued the comfort, privacy, and familiarity of their own homes, viewing childbirth as a natural and family-centered event. However, as medical advancements gained momentum, attitudes towards childbirth began to shift.

In the late 19th and early 20th centuries, childbirth underwent a significant medicalization process (like SIGNIFICANT). The rise of obstetrics as a medical specialty led to a shift towards hospital births. Advances such as forceps and anesthesia allowed for greater control over the birthing process, but they also introduced interventions that were not always medically necessary.

In the early 20th century, twilight sleep made it’s rounds. People in labor were given an injection of morphine and scopolamine to induce a drugged sleep while giving birth. In 1920 in the first volume of The American Journal of Obstetrics and Gynecology, was considered a “pathologic process” from which “only a small minority of women escape damage during labor” (Leavitt, 1986, p. 179). This was the start of the hardcore push to remove midwifery everywhere so that doctors and obstetricians could “take over” and make more money. That’s literally what it comes down to, it’s always about money.

The development of medical technologies, such as fetal monitoring, ultrasound, and cesarean section, just further reinforced the dominance of hospital births in the mid-20th century. Hospitals became the primary setting for childbirth, with doctors assuming the lead role in managing pregnancies and deliveries. They were successful in the shift of perception of hospitals as safer and more equipped to handle emergencies (which we all know hospitals are fantastic for emergencies, but not low risk pregnancies).

In the latter half of the 20th century, a growing number of women/people began questioning the medicalized approach to childbirth and sought alternatives. The natural childbirth movement emerged, advocating for a more personalized, empowering, and holistic approach to childbirth (aka Ina May Gaskin is a problem in learning/stealing information/knowledge from black community midwives and not giving them credit). Birth centers and homebirths with certified nurse-midwives gained popularity as women/people sought to reclaim control over their birthing experiences.

In recent years, there has been a renewed focus on maternal-centered care and collaborative models that prioritize the well-being and preferences of expectant parents. This shift recognizes the importance of informed choice, shared decision-making, and personalized care. Midwifery-led models, birthing centers, and the integration of doulas into the care team have become more widely accepted options for low-risk pregnancies thankfully.

The United States continues to face challenges in maternal and infant health outcomes, including racial and socioeconomic disparities. The US literally has an increasing maternal mortality rate year after year. It has the WORST maternal mortality outcomes of ANY developed nation in the world. Let that fucking sink in. And although efforts are being made to address these disparities through increased access to quality prenatal care, community-based support programs, and advocacy for equitable healthcare services, it’s still slow to change.

The evolution of childbirth in the United States reflects a dynamic interplay between medical advancements, cultural shifts, and the changing needs and expectations of expectant parents. From the dominance of home births to the rise of hospital births and the recent resurgence of personalized, collaborative models, childbirth practices continue to evolve. As we move forward, the focus on informed choice, evidence-based care, and addressing disparities remains paramount to ensure safe, respectful, and empowering birthing experiences for all families.

References:
Leavitt J. W. 1986. Brought to bed: Childbearing in America, 1750–1950. New York: Oxford University Press.