Women have given birth at home with the assistance of midwives since ancient times. The Bible speaks of Egyptian midwives helping Israelite slave women give birth when Pharaoh sought the death of Israelite male infants. Ancient Greek and Roman culture produced various texts that talked about midwifery. In North America, Native Americans and colonists used midwives on a regular basis. They were a necessity because people lived in isolated places, far from hospitals and other medical facilities. Parkland Memorial Hospital says the role of midwives changed in the late 19th century because of the increase in scientific knowledge and medical schools.
Colonial America
In her Pulitzer Prize-winning book "A Midwife's Tale: The Life of Martha Ballard Based on Her Diary, 1785-1812," Dr. Laurel Thatcher Ulrich, a professor of American civilization, wrote about midwifery in colonial America. At this time, midwifery in America was an extension of the practice in Europe. Midwives held such a prominent place in society that they had their own ferry boats to bring them to the Massachusetts Colony.
Dr. William Shippman, Jr.
The University of Pennsylvania archives state that Dr. William Shippman, Jr. played a key role in establishing Penn Medical School and created a curriculum for anatomy, surgery and midwifery. He received a lot of opposition for founding university courses from longtime midwives. Dr. Shippman believed "unskilled old women" led to unnecessary suffering and death. His courses provided scientific knowledge about women's diseases and proper treatment. His midwifery training was rare in the 18th century.
Midwifery Controversy
The Parkland Memorial Hospital Parkland School of Nurse Midwifery article "History of Midwifery in the U.S." says that, during the 19th century, obstetricians began noting the difference between births by midwives and those by medical professionals. Statistics gathered during that time indicated that fewer infants and mothers died from childbirth-related trauma when doctors delivered babies. However, these statistics failed to incorporate other factors such as socioeconomics, sanitation, nutrition and where women lived. The U.S. statistics also did not compare midwifery in other countries.
Certified Nurse-Midwives
The American College of Nurses-Midwives says that, in the 1920s, a nurse named Mary Breckinridge made nurse-midwifery a reputable profession. Breckinridge founded the Frontier Nursing Services in eastern Kentucky. Her program contributed to the reduction of deaths, premature births and low birth rates of women living in poor and rural areas. In the following decade, Hattie Hemschemeyer, a public health nurse educator, founded the first nurse-midwifery school in the United States. The program educated future midwives to help women who delivered babies at home. Her first class graduated in 1933. For the next 30 years, midwifery training improved and became a recognized profession in the medical world.
Growth in Midwifery
The American College of Nurse-Midwives states that in the 1970s and 1980s people began accepting nurse-midwifery as an established medical profession. Certified nurse-midwives cared for women from different backgrounds, not just poor women who could not afford to give birth in hospitals. Wealthier individuals saw the benefit of personalized care provided by modern midwives. In the early 21st century, more than 7,000 certified nurse-midwives worked in the United States and developing countries. The face of midwifery has changed because many of these women work in conjunction with medical facilities, ready to transport women to hospitals if complications occur at home.
Duties of a Midwife
Natural Healers website says midwives, trained for two to four years, provide care, education, counseling and support to women during pregnancy, labor and delivery. The midwifery model of care includes monitoring the physical, psychological and social well-being of new mothers, providing individualized care to mothers, and helping mothers give birth with as little technological intervention as possible. Unlike midwives of the past, certified midwives work with hospitals and obstetricians to help women who want natural, at-home childbirth. Trained midwives can administer medication and recognize medical conditions that require an obstetrician's intervention. The two types of midwives are nurse-midwives and direct-entry midwives. Nurse-midwives have associates or bachelor's degrees in nursing in addition to midwifery training while direct-entry midwives have only professional midwifery training. The American College of Nurse-Midwives estimates that professional midwives make about $76,000 a year.
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