How did birth move from the home to the hospital, and back again?

Margaret Marsh, professor of history at Rutgers University takes us through the timeline of home birth. 

WHYY’s Taunya English took an in-depth look at the issue of home birth for “The Pulse.” It’s a choice that increasing numbers of women are seeking out, but critics say that home birth is not safe.

The fight over where birth should take place, and who should be present to assist the process is not a new one.

Margaret Marsh, professor of history at Rutgers University, gave us a quick tour of birth history, and discussed the age-old tug of war between midwives and doctors.

“In the colonial period, all the way up to 1760 or so, there was no real challenge to midwives delivering babies,” explained Marsh. When a woman was ready to give birth, her female relatives, and friends would help her through the process, along with a midwife.

“But, it was a scary process, babies died, women died, having a baby was a frightening thing,” added Marsh. She says that around 1760, upper class women started to want to have doctors at their births. They thought that because the doctors had more education they could deliver a safer birth. Doctors delivered babies in women’s homes, and doctor-assisted births became more popular over time. “In 1900, about half the babies were delivered by midwives. By 1935, only fifteen percent were delivered by midwives,” said Marsh.

“Over time, there developed a rivalry between doctors and midwives, ” she added. “Doctors would say ‘we know more about anatomy, we are better suited to do this.’ Midwives said ‘we are women, we have experience, we know how we do this.'”

For many decades, the tug of war over approaches broke down along the gender lines; all of the doctors were male, and all of the midwives were female.

The shift to hospital births started in the 20th century. “What happened in the beginning of the 20th century was anesthesia for delivering children, and they wanted to have pain-free childbirth.”

But Marsh says the outcomes for women weren’t that great. “Lots of complications, lots of infections, it didn’t have the effect that women desired. They wanted safer, less painful childbirth, but in the first third to half of the century, it was not always safer childbirth.”

Marsh explained that in the 1930s, most of the midwives were practicing in rural areas, and were often called “granny midwives,” people who learned their trade on their own. “It did seem for a while as if midwives were going to become obsolete. The 1940s, 50s and 60s, you get doctors, especially obstetricians delivering all the babies.” Marsh says the feminist movement of the 1970s revived women’s interest in midwives. “Women once again wanted to control their own childbirth experience.”