Returning Birth Choice to Women

By Darlene Oakley

Definition of Midwifery

Midwifery is the traditional practice of having a trained woman rather than a doctor, deliver babies. A midwife is a trained professional who specializes in supporting women during pregnancy and birth by providing one-on-one attention and care, education, counseling and support throughout the childbearing cycle.

In the United States, there are nurse-midwives, who are also registered nurses, and "direct entry" midwives who are trained in pregnancy care and birthing techniques, but are not nurses. While obstetricians focus on the difficulties of pregnancy, midwives operate according to the belief that pregnancy and birth are normal life processes.

Advances in Giving Birth

Midwifery was widely practiced until the "enhanced" medical knowledge and discoveries of the 17th and 18th centuries emerged, which included the discovery of pain-relieving drugs. Along with drugs and male physician-attended deliveries also came anesthesia, delivery by forceps, enemas, no food or drink for the mother prior to labor, episiotomies, the on-the-back position for birth, and by the end of the 20th century, cesarean section and induction.

It was thought that doctor-attended births could reduce maternal and infant mortality rates. During the "obstetrical revolution" between 1900 and 1930, however, mortality rates actually increased. The discovery of sulfa-based drugs (after 1935), treatments for toxemia (preeclampsia) and post-birth hemorrhaging, safe blood transfusions, and better antiseptic and hygiene practices brought mortality rates down again.

Holland and Sweden continue to be the world leaders in midwifery. In Holland, one out of every three births is a home birth and the mortality rate in 1992 was the tenth-lowest in the world (6.3 deaths per 1000 births). The United States ranked twenty-second.

"Swedish midwives ... administer 80 percent of prenatal care and more than 80 percent of family planning services in Sweden. Midwives in Sweden attend all normal births in public hospitals and Swedish women tend to have fewer interventions in hospitals than American women." (4)

Going Back to Tradition

From the 1940s through the early 1960s, women knew very little about what happened to their bodies during pregnancy and childbirth. As women have learned more about their bodies, birthing practices have become a lot more humane and less institutional. They include conscious relaxation techniques for laboring mothers and more relaxed, less surgical surroundings for the birth.

As women become more empowered in their birthing decisions and decide to return to more traditional birthing practices, midwifery has surged and quickly become a welcome option for new mothers.


1) Frequently Asked Questions about Midwives and Midwifery. Citizens for Midwifery. Web. Nov 20, 2012.

2) Midwifery. World Health Organization. Web. Nov 20, 2012.

3) "A Brief History of Midwifery" Hanna-Cheruiyot, Cordelia. Wholistic Birth Resource Center of Southern California. Web. Nov 20, 2012.

4) Obstetrics and Midwifery. Encyclopedia of Children and Childhood in History and Society. Web. Nov 20, 2012.

Reviewed November 21, 2012
by Michele Blacksberg RN
Edited by Jody Smith