As nice as it may sound, the stork is not a central figure in delivering babies—nor do any DIY kits purchased from IKEA come into play. But this isn’t an article about ‘the birds and the bees,’ exactly. As interesting as that story is, what comes next—and how babies actually do arrive on the scene—has its own unique history.
The story of babies coming into the world—like so much of human history—has gone through a lot of permutations through the years, only to wind up in a very similar place to where it started.
Delivery of the Fittest
Childbirth in ancient times (and not-so-ancient times, to some extent) had a lot in common with the Hobbesian view of life in nature: nasty, brutish, and, unfortunately, not particularly short.
Since ancient times, deliveries were attended by midwives, women who either had experience giving birth themselves, or were apprenticed in the profession by other midwives. As with most ancient customs, delivery was steeped in superstition and concern about the presence of good and evil spirits. Rituals around the world called for everything from a thorough scrubbing of the newborn and mother, to the mother laying perfectly still after delivery, to avoid accidentally spilling her insides by getting over-excited.
Men, historically, were nowhere near the scene of delivery, and it has generally been considered “indecent” for a man to have anything to do with the process. When women approached term, they were left to the care and company of the midwives, away from polite society.
Strike a Pose
For hundreds of years, the general outline of the delivery process has been mostly the same—give or take the odd superstition or popular religious flourish. The expectant mother was more or less isolated along with her midwife (or, more often, team of midwives).
At the opportune time (even in primitive eras, it wasn’t hard to tell when the child was due, especially to midwives who had experience in the process), mothers were typically set up in a “birthing stool” for the actual delivery—basically a giant horseshoe with legs, upon which the woman would squat and have her belly massaged until the baby came out and was caught by an attending midwife.
Absent the stool, mothers were left to find the least uncomfortable position for the delivery; walking, stooping, lying down, and the ever-popular bathtub were all in vogue through the years, each with little more medical basis than personal preference and word of mouth.
One or the Other
Of course, that was the routine for a normal, healthy birth. If anything should go wrong—as it does between five and ten percent of the time—attendees would typically be faced with limited options, most of which preserved the life of either the mother or the child at the expense of the other.
High-risk interventions were the only occasion in which men might be called on to participate—and even then, as a last resort.
Forceps could be used to extract the baby (likely in pieces, as they were neither delicate nor precise), or else the mother’s pelvis could be split to allow the baby safe passage out.
The advance of basic hygiene, as well as a better understanding of human anatomy, at least improved survival rates for mother and child through the centuries. The Caesarian method, or C-section, emerged initially out of concern solely for the baby, as a way to extract a child during a difficult delivery to ensure it could be baptized.
By the mid-19th century, with the discovery of germs—and especially penicillin—surgeries were reliably capable of saving the lives of both the mother and the child.
A Woman’s Place in a Man’s World
Throughout the 18th century, women remained the undisputed experts on childbirth. Except in cases where surgical intervention was unavoidable, men remained absent from the scene of the delivery.
Around the early 1800s, however, a general shift away from women in medicine began. This was due in part to emerging middle class notions that women ought to marry and assume a domestic life, leaving bread-winning professions to the men. As medical knowledge and surgical methods became more sophisticated, physicians were able to organize practices and make a better living for their services.
By the late 1800s, for-profit hospitals and similar healthcare clinics were becoming more common, and the relative social status and education of doctors was further elevated.
Women, meanwhile, were routinely denied any access to education, much less formal medical training, leaving the profession of midwifery well in the past, and putting men front and center in the delivery room for the first time. Although many women continued to have home births, these were attended by male physicians.
As medicine and hard science forged a closer relationship, society’s patriarchal forces saw women’s role in healthcare diminished more and more, until midwives and nurses were popularly viewed with little more than disdain by the general public.
The Best Medicine is…More Medicine
Over the course of the 20th Century, general medical knowledge has developed significantly; medical schools have become more rigorous, hospitals have grown larger and acquired ever-more sophisticated equipment, treatments, and pharmaceuticals. More than 90 percent of all deliveries are occurring in hospitals today, under the care of surgically-qualified obstetricians.
Yet even in the sterile, high-tech environment of modern hospitals, childbirth remains a deadly activity, and the 6th leading killer of women in the United States.
The growth of the medical-industrial complex, combined with a general impatience (and, yes, some amount of ignorance) among physicians is seeing unprecedented numbers of C-section deliveries, even among otherwise healthy mothers. Interventions during delivery are being spurred whether or not they are medically necessary, with roughly one-third of all U.S. deliveries involving a surgery.
These interventions, despite being sold as a “safety-first” precaution, can actually increase the risk of death and injury to both mother and child, especially when they are not explicitly necessary.
Once More, Into the Breach
The hard shift toward surgery and interventions has led to a quiet shift both in the medical community and among mothers. Once again, as in centuries past, midwives are assuming the role of the lead attendee for delivery. This time, however, it is not due to paternal attitudes toward pregnant women, nor toward women practicing medicine.
Modern mothers are simply seeking more choice and personalization in their delivery, and midwives—more than obstetricians—are providing an alternative to the modern model. While home births still make up less than 10 percent of all U.S. deliveries, that is nearly a 30 percent rise over just a few years ago. Combining the best of modern medicine with an old-fashioned, let-nature-take-its-course mentality toward childbirth, midwives are seeing a renewed demand for their services, working alongside obstetricians or even attending deliveries as the primary caregivers.
While midwives are unlikely to replace obstetricians altogether (they are not typically certified as surgeons, after all) the slow shift back toward the labor-room of old shows the cycle of history never stops turning.
Edgar Wilson is an Oregon native with a passion for cooking, trivia, and politics. He studied conflict resolution and international relations at Amherst College, and has split his time between New England and the Pacific Northwest ever since. He has worked in industries ranging from international marketing to broadcast journalism, currently serving as a marketing consultant and freelance writer. He can be reached via email or on Twitter@EdgarTwilson.