In the month of July I sat and completed a Lamaze Education course which now enables me to sit for my Lamaze certification exam to become a certified Lamaze Childbirth Education Teacher. It is something I have always been interested in, and finally with my life freeing up, my children getting more independent, and no more kids in the future so I thought, I felt comfortable completing the course to take the dive into one of my dreams.
I learned a lot during the course, but one of the things I was really interested in was the history of childbirth, especially how much it changed in the United States alone since the early 1900′s. I find the racist smear campaigns against midwives especially interesting because it certainly set the tone for the way our modern day midwives are treated in hospitals, and by other medical professionals today, especially Obstetricians.
Before 1700′s : Men were forbidden by law, and custom to attend childbirth
1700′s : Physicians first portrayed the idea that birth is a pathological condition that required medical intervention.
1750 : First recorded practices of medical intervention : Bloodleeting to control hemorrhage.
1847 : Anesthesia first introduced into childbirth. Although it is criticized by colleagues who feared it would have an effect on labor, and the baby. (Hmm… I think they were on to something back then!)
1850 : Oliver Wendell Holmes blamed Doctors for the outbreak of puerperal fever.
1853 : Queen Victoria used Chloroform for the first time.
1900′s : In the United States, most babies were born at home. (90-95%) and most of those births were attended by midwives.
1905 : First Maternity clothes were introduced, and women were no longer confined during pregnancy.
1908 : The American Red Cross starts to offer formal childbirth education. (Later on in the 1950′s they offered information on labor and birth in addition to pregnancy.)
1910′s : Low horizontal cesarean sections significantly decreased infection, and ruptures.
- Births moved from home into hospitals for the well off, and those who would like medication during childbirth.
- “Twilight Sleep” is introduced in the United States, although it has been widely used in Europe for about 20 years. (Scopolomine – Amnesia and a narcotic)
1930′s : Births become split 50/50 between hospitals and home, and the number of births attended by midwives drops to 15%.
- Women labored in large maternity wards where they were told to keep quiet, then give birth alone in sterile delivery rooms.
- Routine enema’s and shaving were the norm.
- Women were kept in the hospital for 10 days, and were not allowed to get out of bed (feet couldn’t touch the floor)
- The Lithotomy position was used almost exclusively and forceps were used frequently.
1944 : Grantley Dick-Read published Childbirth Without Fear.
- Mothers were separated from their babies to prevent infection.
1949 : Elisabeth Bing teaches her first client and goes with her to the hospital for support.
- 95% of women give birth in the hospital, and it is treated like a high risk experience.
- Dr. Lamaze visits a clinic in Leningrad, Nikolayev calling his training psychoprophylaxis : emphasized controlled breathing, abdominal stroking, and pressure points in the back and hips.
1956 : La Leche League has its first meeting, as the breastfeeding rates are at an all time low.
1959 : Thank You Dr. Lamaze is published by Marjorine Karmel.
- Episiotomies became routine.
- During labor, food, or anything by mouth was no longer allowed.
- Elisabeth Bing authored books and founded Lamaze in the United states. (1960)
- The ICEA was also founded in 1960.
1965 : Bradley writes Husband Coached Childbirth and The Bradley Method was formed.
- Fathers were allowed in the delivery room.
- Continuous fetal monitoring was introduced without any kind of randomized controlled studies.
1977 : Spiritual Midwifery by Ina May Gaskin was published.
1979 : 99% of all births took place in hospitals.
- First large scale randomized studies of electronic fetal monitoring were released showing no benefit to EFM.
- Sosa et al published “The effect of a supportive companion on perinatal problems, length of labor, and mother-infant interaction. And uses the term Doula.
1989 : First edition of “The Guide to Effective Care in Pregnancy and Childbirt” is published.
- The Lamaze Philosophy of Birth is adopted, and is no longer considered a method. Childbirth Summit is held and Coalition to Improve Maternity Services (CIMS) is created.
- VBAC increased from 12.6% to a peak of 28.3%
1992 : DONA Doula’s of North America was formed, and started certifying doula’s for labor support.
- WHO Guidelines support keeping baby with mother after birth to support skin to skin contact and immediate breastfeeding.
- Two out of three women have an ultrasound.
- Some hospitals have an epidural rate of 90%
- VBAC Safety is questioned and the rates plummet.
- Many hospitals refuse to allow women the normal biological process of giving birth after a previous surgical delivery.
Now that all of that is out there, while the maternal mortality rates lowered from the start of the timeline, till around the early 1990′s… it seems like the same time that VBAC peaked in 1996, that the maternal mortality rate peaked at the lowest, then started to climb again as the VBAC rate dropped off. I know that there is only a slight correlation between the two, but the rates are back up, and slowly climbing again.
It is certainly interesting to look at the information given, and the kind of ethics that got midwives out of births, and more hospitals, and Obstetricians into birth and form opinions on the subject.