Day 9: Historical & contemporary comments by physicians about midwives ~ 1820 to 2014

by faithgibson on April 9, 2016

in Contemporary Childbirth Politics, Historical Publications

Day 9 ~ 1931 to 1934

1931 ~ A report published by the White House Conference on Child Health and Protection by the Committee on Prenatal and Maternal Care, noting the wide disparity between safe care provided by midwives and highly risky care of many physicians.

The report’s physician-authors concluded that the care of midwives was safer than the care of MDs, saying that:

“... that untrained midwives approach and trained midwives surpass the record of physicians in normal deliveries has been ascribed to several factors. (emphasis in original)

Chief among these is the fact that the circumstances of modern practice induce many physicians to employ procedures which are calculated to hasten delivery, but which sometimes result in harm to mother and child.

On her part, the midwife is not permitted to and does not employ such procedures.  She waits patiently and lets nature take its course.” 

Midwife-attended normal birth

Midwife-attended normal birth, husband present and supportive

waterbirth_babe_arms02

baby girl 10-15 seconds after birth, just taking her first breath

Tiki & Grace DWtub

Mom & baby 5 minutes after the birth


1933 ~  Study by the New York Academy of Medicine of 2,041 maternal deaths in physician-attended childbirth*

The investigators were appalled to find that many physicians simply didn’t know what they were doing: they missed clear signs of hemorrhagic shock and other treatable conditions, violated basic antiseptic standards, tore and infected women with misapplied forceps.

Insertion of forceps in anesthetized mother

Insertion of forceps in anesthetized mother

to follow the natural 60-degree curve of the pelvis, the obstetrician has to pull up, towards the ceiling to delivery the baby's head

In order to follow the natural 60-degree curve of the pelvis, the obstetrician has to pull up, towards the ceiling to delivery the baby’s head

At least two-thirds [of the maternal deaths], the investigators found, were preventable. … newborn deaths from birth injuries had actually increased.

Hospital care brought no advantages; mothers were better off delivering at home. … Doctors may have had the right tools, but midwives without them did better. [reported by Dr. Atul Gawande*in his 2006 New Yorker article “The Score“]


1934The Committee on Maternal Welfare of the Philadelphia County Medical Society

…. expressed concern over the rate of deaths of infants from birth injuries increased 62% from 1920 to 1929. This was simultaneous with the decline of midwife-attended birth and the increase in routine obstetrical interventions, due in part to the influence of operative deliveries.  

DeLeeTxtbk_cutAway_forceps_edit

Excerpt, Dr. Neal DeVitt, MD, a 1975 doctoral thesis: “The Elimination of Midwifery in the United States — 1900 through 1935


 Day 10 ~ 1937

Obstetrics and Midwifery

“not until the third decade of the twentieth century with the advent of sulfa drugs that infections related to medical intervention during childbirth ceased to be the leading cause of maternal death.
“http://www.faqs.org/childhood/Me-Pa/Obstetrics-and-Midwifery.html

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