As Mother's Day approaches, it's a time to celebrate the women who nurture, and guide us and reflect on the history of the over-medicalization of birth and the female body anatomy. In our modern age, where medical interventions often dominate the birthing process, it's crucial to acknowledge the rich tradition of midwifery and its significance in women's healthcare.

The Evolution of Birth and Female Body Anatomy

Traditionally, midwives were revered as guardians of the birthing process, entrusted with guiding women through one of life's most profound experiences. Across cultures and centuries, midwives have been the unsung heroes, offering support, wisdom, and compassion during childbirth. However, the path of midwifery in the United States has been fraught with challenges, stemming from the rise of Western medicine and pervasive societal attitudes.

In colonial times, midwives were the primary attendants for childbirth, carrying on a tradition from England. Birth was viewed as a natural, social rite, and midwives were respected for their expertise in guiding women through this sacred journey. Yet, the 18th century marked a turning point, as a push for medical professionalism led to the marginalization of midwifery. Sexist beliefs about women's emotional capacity and ability to learn new obstetric methods began to erode trust in midwives, particularly among the elite.

The decline of midwifery in America was further exacerbated by social pressures that confined women to domestic roles and discouraged their participation in the medical field. Despite the emergence of midwifery training programs, the majority of students were men, signaling a shift towards male-dominated obstetrics and gynecology. 

This shift was accompanied by a disturbing legacy of mistreatment, exemplified by figures like American Gynecologist J. Marion Sims widely known as the father of modern gynecology. Lesser known is that he performed his first experiments on slave women without anesthesia. He also carried a cruel and racist belief that black women have a higher pain tolerance than white women. With this being the basis of modern gynecology, it's no surprise that obstetrics and gynecology carry a long history of mistreating women, especially black women.

In 1914 the invention of “twilight sleep” allowed women to not feel the pain of childbirth. In fact, they didn’t feel it at all. Women would seemingly go to sleep and wake up with no recollection of the birth. “Twilight sleep” was viewed as a sign of medical progress even though mothers were completely removed from the birth experience and often the anesthesia negatively affected the newborns. However, the serious problems associated with “twilight sleep” were ignored for years and the practice continued into the 1970s.

After the invention of twilight sleep, in 1915 Dr. Joseph DeLee described birth as a pathological process, one that wasn’t a normal function for women, and therefore, midwives had no business in it.  Sit with that one a minute. Can you imagine telling a modern mother that her birth is a ‘pathological process’?!

It’s astounding to see the lying propaganda peddled in the medical community and blindly accepted as truth.  Obviously, a woman’s body has evolved for the process of pregnancy, birth, and post-partum, and yet false theories to the contrary would persist until the 1950s. 

The Midwife Movement: Embracing Female Anatomy

In 1952 the midwifery section of the National Organization for Public Health Nursing affirmed that pregnancy was a natural process, and a family-centered event (gee really? Thanks!) With this attitude change, more women began entering the medical field as nurses, midwives, and OBGYNs. By the 1970s women accounted for only 9 percent of medical students, but this would jump to 25 percent by the end of the decade. During this time, women’s groups began learning how to care for their own vulvas, and shortly after these groups called for medical care to be demystified and for the female body to be de-medicalized. They argued that since birth was a natural process, there wasn’t a need for births to take place in hospitals over the constant supervision of obstetricians. Furthermore, in the 1980s, the medical community came under fire, while women’s groups demanded the same access to medical care for all women. The disparity in medical care started becoming obvious to women of color, who were far more likely to have limited access to effective care. With this in mind, midwifery started to be viewed as a profession again, and one that should be standardized and regulated. In 1994 the North American Registry of Midwives offered its first written examination to certify midwives. Sadly, however, midwifery is still illegal in many states as of 2020, and regulations on what’s required to become a certified midwife vary from state to state.

Expanding Midwifery and Medical Birth Practices

Today, the majority of births still occur in a hospital. Even with midwives and doulas becoming more widely accepted, there’s still a mistrust of the profession. But when you look at the history, it’s clear to see midwifery decreased in popularity because of sexist, racist, and classist views. Midwives were discredited by the medical community for being women, lower class, and women of color, even though they carried on long-standing and effective traditions.  

As a vulva superhero, I believe medical birth practices and midwifery can come together, each with the unique and vital value they provide. In fact, The word obstetrics is actually the Latin word for midwife and is taken from the root word obstare, meaning to stand before, because attendants stood in front of the mother to “catch” the baby.

As we celebrate Mother's Day, let's remember that midwifery and obstetrics don't have to clash. They both share a common goal: helping mothers safely bring their babies into the world.