Midwives 1

Midwives, Yesterday, Today, and Tomorrow

Colleen J. Yurko

Behavioral Health Seton Hill

SSO 390 45 Health and Society

Professor Michelle Rockwell

March 3,2022
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Abstract:

This research is designed to have a clear understanding of the history of the midwives and

the challenges of their early years. This entire class has dealt with health and society. Clearly

the midwives have played an important role since the beginning of time. They have had

challenges proving their worth and need in society. The early history of midwives will be

explained. The early education or perhaps lack of education will be presented. The importance

of the midwife today will be presented as well. Today they still have challenges. As a global

issue, midwives are viewed differently around the world. Comparing the US to other wealthy

nations will be presented. The US midwife workforce is far behind globally. The future of

midwives is promising, and the income obtained can be affected by the area or state in which

they reside.

Introduction

Midwifery has been around since the beginning of time, at least as long as women have been

having babies. Most crucial is how the US stacks up globally. The trend in time is important to

understand. Today, midwives have a grueling form of education and must become a registered

nurse first in most cases. Their high income coincides with their medical education. Statistics

are astounding regarding the number of practicing midwives to the number of practicing

physicians, in the gynecology field. The income presented by demographical area is interesting.
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Body

In the United States, most births occur in hospitals, with physicians, mainly obstetricians,

attending. In 2012, 98.6% of all births took place in hospitals, with nearly 92 percent attended

by physicians.

But in many other wealthy industrialized countries, including the United Kingdom, Sweden,

and Japan, midwives attend to most births and far outnumber obstetricians. The difference has

its roots in history. Midwives attended almost all births in the America colonies, practicing from

their homes and passing the skills they had brought from Britain from one woman to another

informally. West African midwives came to America as slaves and attended the births of both

black and white woman in the antebellum South. After emancipation, African-American

midwives continued to take care of both black and white poor women in most rural parts of the

South, where they were referred to as “granny midwives.” American Indian tribes had their

own birth traditions.

Unlike in Europe and British Isles, where midwifery laws were national, in America,

midwifery laws were local and varied widely. With few midwifery schools, laws requiring

education could not be enforced; with few doctors positioned or willing to attend poor women,

it was not practical to outlaw midwives. Midwives in most states practiced without government

control util the 1920’s. Even today midwifery varies from state to state (Rooks).

Through most of the nineteenth century, midwives remained the people who assisted with

most births. Having little experience with childbirth or training in how to assist with it,
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nineteenth-century physicians (almost all of whom were men) actually knew relatively little,

and generally much less than what most midwives knew, about how to deliver a baby. Despite

this fact, the AMA (American Medical Association) and other medical societies saw an

opportunity to maximize physicians’ incomes by wresting the function of childbirth assistance

from midwives and claiming it as their own. They did so by asserting that they, not midwives,

were most qualified to help deliver babies, and they lobbied state legislatures to require a

medical degree for childbirth assistance (Barkan).

A brief history of midwifery dates way back in time. Listed below are a few of the midwife

highlights

1. 5000 BC: Archeological evidence of midwifery

2. 1513: The first book on obstetrics is published

3. 1862: Florence Nightingale starts a training school for midwives at King’s College Hospital

4. 1864: Ladies’ Obstetrical College founded in London

5. 1925: Frontier Nursing Service is established in the United States

6. 1939: The Frontier Graduate School of Midwifery founded at FNS

7. Mid-1950s: Midwifery services expanded into teaching hospitals

Midwifery practice did not appear in the United States until 1925, when Mary Breckinridge

founded the Frontier Nursing Service. Currently in the United States, there are around 11,400-

15,000 Certified Nurse Midwives (CNMS). Approximately 10% of US births are attended by
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CNMs. Midwifery practice took some time to gain traction in American medical practice, but it

started finding its footage in the mid-1950s. At that time, midwives were formally invited to

enter practice in inner-city teaching hospitals to assist obstetric doctors handle the post-World

War II baby boom.

From that time until the present, midwives grew their practices and influences in hospitals as

well as free-standing birthing centers. According to the “The History of Midwifery “at Our

Bodies, Ourselves, even as their numbers started small, midwives were making big changes in

the science of labor and delivery. Some concepts they introduced include:

1. Family-centered maternity care which included inviting fathers into the birthing rooms and

having newborns “room in” with their mothers until they were discharged to home

2. Developing women-centered childbirth education

As evidence of cost savings and improved outcomes began to surface, the role of nurse

midwives became more accepted and even welcomed by educators, patients, and obstetricians

and gynecologists. Today, certified nurse midwives are highly educated health professionals

who provide holistic women’s health and maternity care (Mangine).

The national midwifery norms we now today were shaped by hundreds of years worth of

history within the US- and they are pretty skewed from the “norm” of other westernize nations.

Around the world, midwives are a commonality. In the UK, more than 50% of births are

facilitated by a midwife and in countries such as Sweden, Denmark, and France mor than 75%
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of women opt for midwife care. By stark comparison, midwives make up less than 10% of

America’s birthing care.

What is most astounding about the US maternal care is the blatant disparities in care for

women of color? In America, black moms are 2-3 times more likely to die during childbirth.

Additionally, less than 5% of certified midwives are colored. The racial disparities tied to

maternal care are obvious and interconnected. In the words of Patricia Loftman, “Midwives of

color protect women in a system that is hostile to them.”

Since the dawn of human history, babies have been delivered by midwives. These women

were viewed as experts and were respected for bringing their knowledge and training to

childbirth. This transition carried on to the states when North America was first discovered and

served as an integral service for both immigrants and indigenous groups. As the US evolved,

midwifery continued tobe a widespread practice, with professionals in the south known as

“granny midwives.” (Vox )

Today the midwife profession is lucrative and income by territory is amazing. Midwives

attended approximately half of all births in 1900, but less than 15% y 1935. By the early 1930s

most practicing midwives were black or poor-white granny midwives working in the south.

Where midwifery declined, the incidence of mother and infant deaths from childbearing or

birth inquires generally increased. A scholar who conducted an intensive study concluded that

41 percent increase in infant mortality due to birth injuries between 1915 and 1920 was due to
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obstetrical interference in birth. Midwives were falsely accused (Rooks). Listed below are the

number of midwives verses physicians globally.

1. Australia 7physicians to 68 midwives

2. Sweden 12 physicians to 66 midwives

3. Norway 12 physicians to 53 midwives

4. UK 11 physicians to 43 midwives

5. Germany 27 physicians to 30 midwives

6. Switzerland 22 physicians to 32 midwives

7. France 11 physicians to 30 midwives

8. Netherlands 10 physicians to 25 midwives

9. US 11 psysicians to 4 midwives

10.Canada 8 physicians to 4 midwives (Maternal Health)

Salary and comparison for midwives and other healthcare providers:

1. Nurse anesthetist $183,580

2. Physicians assistant $115,390

3. Nurse midwife $111,840

4. Physical therapist $91,010

5. Speech language pathologist $79,120

Top paying salary:

California $159.500

Utah $133,680

Mississippi $127,960

New York $125,780

Minnesota $123,600

Conclusion

As Midwives have been around for many many years and their challenges have been great,

with the lack of entry into educational institutions, in the past, they have plunged forward and

have obtained a promising career. They have been falsely accused of being the blame for infant

mortality and maternal death. The midwife has been an awesome individual passing on

knowledge from generation to generation for centuries.

References

Barkane, Steven. 2021 The Rowman & Littlefield Publishing group

Mangine, Dawne Exploring the history of midwifery https://simtalkblog/exploring the

History-of-midwifery

https.//www..allnursingschppls.com/nurse-midwife/salary. How much does a certified nurse

midwife make?

https.//www.cinnatibirthcenter.com/blog/American-midwifery

https://www.ourbodieourselves.org/book-excerpts/health-artile history of midwifery