![]() ![]() Until the 20 th century, the majority of US births occurred in the home, attended by female midwives and numerous female family and friends. From a home-based event managed by female midwives and other birth attendants without formal training to a hospital-based, standardized encounter managed by formally trained male and female physicians and other healthcare practitioners, this complete paradigm shift resulted from women’s determination to have a safe and painless delivery, a new scientific foundation, innovations in medicine, and changes in the social landscape. ![]() But the introduction of standard physician training accompanied by an emphasis on infection control eventually led to substantially decreased morbidity and mortality in the mid-20 th century. Initially new medical interventions, such as forceps and anesthesia, caused as many issues as they seemed to resolve as they emerged in burgeoning medical school obstetric programs. However, starting slowly in the late 18 th century and accelerating into the late 19 th century, labor and delivery radically changed. From Histoire des accouchements chez tous les peuplesįor most of American history, pregnancy, labor and delivery, and post-partum have been dangerous periods for mother and child. ![]()
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