Prior to the 1920s, midwives attended almost all the births that occurred in America. The majority of births took place at home, with little pain relief and no formal aftercare program for mother and baby. It was in the 1920s, however, that childbirth was transformed into a "pathology-orientated" practice that would set the tone for the modern era.
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One of the biggest changes to childbirth in the 1920s was the move from home to hospital. Giving birth in a hospital came to symbolise economic prosperity and social status for middle and upper-class families. It also offered women the opportunity of a lying-in period to recover and the support of nurses to help care for the baby in the first few weeks. By 1921, for example, between 30 and 50 per cent of women gave birth in a hospital.
The 1920s was also characterised by a dramatic increase in childbirth interventions. Such interventions include the use of forceps, inflatable balloons to induce labour, episiotomies and caesarean sections. 65 per cent of the women who gave birth at the Chicago Lying-In Hospital between 1918 and 1925 had some kind of birthing intervention. There was also greater choice in pain relief drugs for women and this contributed to women choosing to give birth in the hospital. Anaesthesia, like ether and chloroform, for example, was widely used to combat the pain. Many women also took stronger drugs, like Twilight Sleep, a combination of morphine and scopolamine.
Alongside the shift to giving birth in hospital came an increasing desire to be attended by a doctor. Where midwives had once attended nearly all births, there was now an almost 50/50 split in deliveries. When the rules of asepsis prevented husbands and families from attending the birth, many women felt that they were in safer hands in the presence of a doctor, as opposed to a midwife. For women in the hospital, fully-trained obstetric nurses were also on hand to attend during and after the labour.
Despite an increasing number of women giving birth in hospitals under the supervision of a doctor, the problem of maternal mortality continued during the 1920s. According to Midwifery Today, between 600 and 700 women died for every 100,000 births. Puerperal infections, for example, were especially deadly for women and could not be properly treated until sulphonamides were introduced in 1934. Recognising the problem of infection, the medical profession sought to encourage more women to give birth in hospital as a preventive measure.
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- Our Bodies, Ourselves; The History of Childbearing Choices; Judith Rooks; 2006
- "Enduring Issues in American Nursing;" Ellen Davidson Baer; 2002
- "Mothering the New Mother;" Sally Placksin; 2000
- Midwifery Today: The History of Midwifery and Childbirth
- University of Houston; Childbirth in Early America