In 2016, I began reading a lot more about the history of childbirth in the United States and wrote some great summaries as well as an extensive timeline after reading five sources. I hope you enjoy reading this timeline as well as the subtopics of summaries, which are listed under the dropdown menu for “History of Childbirth.”

NOTE: Pink lowercase letters at the end of/in the middle of sentences correspond to the References used (bottom of page). You can also read more about these topics in narrative form by looking at the subpages of this page, using the website navigation. All sources listed here should be assumed to be the same sources on the subpage narratives.

A Timeline of Highlights in the History of Childbirth in the United States from 1750-1950

Before 1750     Childbirth is in the hands of women, childbirth has a social aspect to it, and midwives are mostly passive in their intervention in labor and generally let nature takes its course.a Women looked to family and kin for comfort.b Women expressed their love and care for one another and supported each other in a mutual life experience.b Births usually occurred 15-20 months apart.b Women breastfed for one to two years.b Women would “lie in” for 3-4 weeks, as other women took over house responsibilities.b The mother rested, regained her strength, and nursed without interruption.b It was an occasion for female solidarity.b At the end of the lying-in period, the mother threw a groaning party for all the female helpers.b This was a way to express appreciation and compensation for their help.b The years before 1750 are commonly called “the age of the midwife.”b Birth was usually routinely successful, and colonial midwives were very successful attendants.b Social childbirth rituals continued into the 19th century.b

1750

Pioneer Birthing
An example of women attending other women in childbirth during the pioneer days.
  • Men trained as physicians abroad, including the “new midwifery” in Europe, return to practice in America in colonial towns and cities.a Men began to bring in skills and knowledge that American midwives could not offer.b
  • American had no medical schools, hospitals, or organized medical profession, such as European countries.b

1750-1810        American doctors saw the new midwifery as an enterprise to be shared between themselves and trained midwives.b They believed that natural processes were adequate and that midwives could attend normal deliveries, while they would be called in for more difficult ones.b Midwifery was American medicine’s first professional gambit in America.b

1765-1905    More than 800 medical schools were founded, most proprietary (profit-making focus) and short-lived.b

1765             Medical College of Philadelphia was founded; Dr. William Shippen was the Professor of Midwifery.b

1767            King’s College (later Columbia) Medical school was founded; Dr. Samuel Bard was the Professor of Midwifery.b

IMG_2579
Standing in front of Harvard Medical School in Longwood.

1782            Harvard Medical School was founded. Obstetrics was the first medical specialty at early elite schools, considered to be the keystone to medical practice.b Dr. Walter Channing was a Professor of Midwifery and Medical Jurisprudence at Harvard and later the first Dean of Harvard Medical School.b

 

 

 

Channing (2)
Dr. Walter Channing

1790-1793        Alexander Gordon of Aberdeen, Scotland, writes that childbed fever was spread by medical personnel instead of from noxious elements in the air.b

1794 First successful cesarean in the US performed on Elizabeth Bennett in West Virginia by her husband at their cabin. The procedure was crude and performed by Mr. Bennett after the doctor attending refused to do it on moral grounds.e

1800s            

  • Midwives cease to attend to middle-class women in labor and more so attended to ethnic immigrants, the poor, isolated whites, and blacks.b
  • Several varieties of “doctors” practiced, including empirics, sectarians, botanists, homeopaths, eclectics, and minor sects like hydrotherapists.b Some doctors were “elite” in that they traveled abroad for training, while others went to proprietary medical schools and graduated with no practical medical or clinical knowledge (proprietary schools were primarily profit-making schools owned by doctors who also taught there).b Being a doctor had low professional standing in the eyes of most people.b

1808            Dr. John Stearns of New York state learns about the uses of ergot from an immigrant German midwife.b Ergot stimulates uterine muscles when given orally.b Ergot was a mix of danger and benefit, depending on how it was used.b It could quicken the placenta coming out and stem hemorrhage but it could also rupture the uterus and kill the child.b Critics of doctors said it was often used simply to save time.b Doctors eventually determined it was too dangerous for inducing labor.b

1808            Married Lady’s Companion and Poor Man’s Friend, one of America’s earliest birth manuals, denounced the ignorance of midwives and urged them to “submit to their station.”b

Italian Midwife
Midwives were often the target of criticism.

1810            Midwifery in American towns was unregulated and open-market, with both men and women of varying degrees of experience and training attending to women in labor.b

1820            An anonymous pamphlet published and distributed in Boston said that women lacked the power to act that was essential to being a birth attendant.b The author believed that only men were capable of the detached concern necessary to concentrate on techniques required in birth. Doctors at the time also believed that women suffered bouts of “periodical infirmity” and “temporary insanity” during menstruation that would also make them unfit to attend births.b

1828            The term “obstetrician” was suggested by an English doctor, which took place of calling men male midwives.b

Male Midwife
The Man Midwife.

1832            The Boston Lying-in Hospital was founded c by Dr. Walter Channing of Harvard Medical School.d

1840s            The American Medical Association (AMA) indicates that the hospital is indispensable in providing training for physicians.a

1840            Puerperal fever becomes more common in America, possibly because of increasing physician intervention during childbirth.a It also begins to appear in some home deliveries.b It was spread by doctors carrying staphylococcus aureus from another patient’s wound or abscess or from autopsy matter, the most deadly bacterium, streptococcus group A.b Strep group A could be transmitted by clothes, instruments, or even nasal passages.b Women also received various wounds from birth interventions, which increased the likelihood that an infection would develop.b Some women did survive the fever, becoming very sick, but many died from it.b

1843             Dr. Oliver Wendell Holmes was the first American physician to call childbed fever a contagion spread by doctors in private practice.b He published empirical conclusions in 1843 and encouraged doctors to cease practice when their patients became ill.b Holmes also encouraged certain practices to stem the fever, such as doctors not taking part in a post-mortem exam of a patient who died of the fever.b

Oliver Wendell Holmes
Dr. Oliver Wendell Holmes.

1846-1848        Hungarian doctor Ignaz Philip Semmelwise demonstrates the contagiousness of the fever statistically and proves certain antiseptic means are effective in preventing it.b

Ignaz Philip Semmelwise
Ignaz Semmelweis.

1847           

  • Dr. Meigs, lecturing to an all-male gynecology class, in lecture entitled “Lecture on the Distinctive Characteristics of the Female” said that “she had a head almost too small for intellect and just big enough for love.”b
  • Harriot K Hunt, a woman empiric, applied to Harvard Medical School and was turned down.b
  • Elizabeth Blackwell was admitted to New York Medical College where the class unanimously voted to admit her.b She graduated at the top of her class and had to go to Paris or London to gain clinical experience, as no American hospital would allow her to practice.b
Harriet K Hunt
Harriet Hunt was turned away from attending Harvard Medical School.

1848           

  • American Medical Association was founded to exclude “irregulars” from practice and to set enforceable standards for medical practice.b
  • New England Female Medical College was founded, which eventually merged with the Boston University Homeopathic medical school in 1874.b
  • Dr. Walter Channing first used ether for childbirth and encouraged other physicians to try it.b

 

IMG_2596
Standing in front of the Ether Monument in Boston’s Public Garden.

1850            Harriot K Hunt applied again to Harvard Medical School, was admitted, but published medical students’ objections forced her withdrawal: “We object to having the company of any female forced upon us, who is disposed to unsex herself and to sacrifice her modesty by appearing with men in the medical lecture room where no woman of any true delicacy should be found.”b

1850s            Ether and chloroform begin regular use during labor and delivery.a

Conical Inhaler (2)
Walter Channing’s Ether Cone for ether and chloroform.

1853            Queen Victoria used chloroform for her delivery, increasing the acceptability of it.b

1855            Holmes issues a monograph Puerperal Fever as a Private Pestilence, which responds to American critics who disbelieve the contagiousness of the fever and ridiculed him for his outrageous suggestions that doctors were instruments of death.b Two well-known Philadelphia physicians also rejected it: Dr. Hodge and Dr. Meigs.b Doctors were seen positively and to suggest they could cause death was a scandalous assertion.b Hodge believed Holmes’s belief lacked proof.b Meigs retorted that doctors were gentlemen and that gentlemen’s hands were clean.b

Oliver Wendell Holmes
Dr. Oliver Wendell Holmes.

1860s            Women had to found their own institutions so they could get clinical training.b One such hospital was the New England Hospital for Women and Children in Boston.b

1860            Louis Pasteur demonstrated that the microbial chains he had first discovered in 1860 called streptococci were the major cause of childbed fever and showed that women who had labor injuries were most susceptible.b

 

louis pasteur
Louis Pasteur.

1861-1865        The United States Civil War

1864            Elizabeth Blackwell and her sister opened a medical college for women.b

1870s            Bacteriology was developed as a study.a

1873            Dr. Fordyce Barker of New York declares that puerperal fever has reached epidemic scales.b

 

Dr. Fordyce Barker
Dr. Fordyce Barker.

1875            The Free Hospital for Women was founded by Drs. William Baker, JH Storer, and JP Reynolds across the street from Olmsted Park in Boston.d It would eventually merge with the Boston Lying-In hospital to become the Boston Hospital for Women in 1966.d

 

 

IMG_2588
Standing in front of the exterior of the former Boston Hospital for Women in Longwood.

1879            The President of the newly formed American Gynecological Society suggested that doctors consider using forceps to expedite delivery.b

1880            Physicians become aware of streptococci bacteria that causes sepsis, called “childbed” or “puerperal” fever.a

1880-1904         The number of medical schools starts increasing from 90 to 154.a

1882            Cesarean section revived by a German named Max Sanger and developed into a largely successful method to delivery women with deformed pelves.b He had success in 80% of his operations.b

1883            75% of patients in the Boston Lying-in hospital had puerperal fever and 20% died from it.b This epidemic was caused by prophylactic regimens being in place, except for not disinfecting the syringe used to douche patients with carbolic acid.b Women often lost less patients due to the fever because they exercised more professional discipline, more regularly scrubbed themselves, and used less instruments to hasten delivery.b

1890s       

  • Concern for infant and maternal health begins.b
  • Major reforms link medical education to hospitals.a
  • Case reports in a Boston maternity hospital reveal that interventions were used and justified by moral judgments about the patients as too lazy or stupid to delivery by themselves.b
  • Nearly 50% of all births were physician-attended, though the majority still occurred in women’s homes.a
  • Births in hospitals were mostly for homeless women or women who could not receive in-home assistance.a
  • Southern Black families and immigrants relied heavily on midwives.a

1892 Milk for urban infants was provided under the sponsorship of Nathan Straus, the owner of Macy’s, that was clean, fresh, and tuberculosis-free.b

1893            Johns Hopkins emphasizes science and clinical experience, cementing marriage of education to the hospital.a Their arrangement came to be seen as the model for medical education.a Johns Hopkins was the first coeducational elite school.b

1894            First cesarean section in Boston upon a small women with a tiny pelvis who had previously lost two babies.b

Surgery, undated.
Doctors performing a c-section on a patient.

1900s            Gonococcal blindness had become preventable by dropping a 1% silver nitrate solution in each eye immediately after birth.b

1900-1930s        Hospitals began to increase in number and eventually also in size.b

1900-1930        Absolute number of midwives declined from 7.39 per 100,000 in 1900 to 2.90 per 100,000 in 1930, a trend particularly in larger cities.a The percentage of births attended by midwives decreased from 50 to 12.5%.a

1900           

  • By 1900s, in urban areas, because of ethnic migration, half of women were still being delivered by immigrant midwives.b
  • Less than 5% of births occur in hospitals.a
  • Interventions in birth began to grow steadily.b

1901            Editorial appears in JAMA discussing the problem of “overcrowding” in the doctor profession.a

1904            The introduction of maternity clothes by a young immigrant dressmaker, Lena Bryant, which later became Lane Bryant.b

1910            Lane Bryant offered street maternity clothes, marketing them as “healthful” because women could live normally and go about their usual lives.b

1910-1921        Interventions in labors in one Boston maternity hospital increased from 29% to 45% of all deliveries.b

1910           

  • (Abraham) Flexner Report is published.a This report led to tougher state laws and setting standards for medical education.b The report established that 90% of doctors were without a college education and most had attended substandard medical schools.b Only one women’s medical college, Woman’s Medical College of Philadelphia, survived after the Flexner Report raised standards.b
  • Prenatal care became more meaningful.b Doctors realized women showing signs of eclampsia could be treated to prevent its development.b Blood pressure and urine screenings became more standard.b The Wassermann test was used to detect maternal syphilis.b 10% of married women were actively syphilitic and 5-6% of infants among the poor were congenitally syphilitic.b

1911           

  • J Whitridge Williams, Professor of Obstetrics at Johns Hopkins, surveyed the teaching of obstetrics in medical schools and found it to be deplorably inadequate.b Some professors confessed their students were no more skilled than untrained midwives.b At the time, 120 medical schools gave a four-year course but only half were accredited by the AMA. Most medical schools in 1911 only required a high school diploma.b Most schools were proprietary.b Williams argued that even in the best schools, there was little clinical experience in obstetrics.b Williams said that there should be fewer medical schools, have higher standards of admission, and qualified instructors.b He said obstetrics should be taught as a fundamental part of scientific medicine.b He urged that midwives should be abolished.b He urged the founding of maternity hospitals for advanced training for doctors.b He did urge that general practitioners attend normal home births and leave more difficult births for specialists in hospitals, but this division of labor could was not enforced.b
  • Bellevue Hospital in New York City opened a school for midwives. The public health authorities there believed that midwives were key to reducing maternal and neonatal mortality, but this assertion had many opponents.
J Whitridge Williams
Dr. J Whitridge Williams.

1912           

  • The founding of the Children’s Bureau to investigate infant and maternal health; Julia Lanthrop became its Chief.b She quickly set about to promote birth registration as a means of attacking infant mortality.b
  • The Children’s Bureau does a 1911 study on Johnstown, Pennsylvania and finds a striking correlation between infant mortality and father’s income, making low income a large underlying factor in infant mortality.b A possible correlation that was raised was that women in low-income families had to work and therefore had to bottle feed, which could sicken the infant from unsterilized bottles.b

1913           

  • Director of Sloane Hospital in New York began to gain expertise in performing the cesarean section.b He came up with the dicta “Once a cesarean, always a cesarean.”b
  • 15,000 women die in childbirth, half from childbed fever.b
  • The Harvard School of Public Health opens the first graduate training in public health.c

1914-1918        World War I

1914           

  • Advent of Twilight Sleep.a This involved giving a dose of scopolamine, an amnesiac drug that caused women to forget pain or what happened to her.b  Women went to Germany at the onset of WWI to have a Twilight Sleep delivery.b They returned to start a campaign for it.b
Twilight Sleep
Advertisement for Twilight Sleep event.
  • Dr. Eliza Taylor Ransom, a homeopathic doctor in Boston and a spearhead of the Twilight Sleep campaign, founded her own maternity hospital at 197 Bay State Road in Boston to provide the method.b She eventually attended 3,000 women there.b She began the New England Twilight Sleep Association to force hospitals to offer it.b

 

IMG_2625
Outside 197 Bay State Road in the Kenmore/Fenway neighborhood, site of a former Twilight Sleep hospital in Boston.

 

 

1915           

  • The percentage of births attended by physicians increased, and women are more likely to deliver in hospitals (though this varied widely by income and nationality of the mother).a
  • Rates of hospital births in Baltimore are highest among families where the father reported no earnings and among fathers who reported the highest earnings.a
  • A 1915 Children’s Bureau study found that physicians used forceps (for which they were reimbursed for) in only 4.3% of births in families with fathers earning less than $450 compared to 14.2% of births in families with earnings over $1,850.a
Forceps
A depiction of a forceps delivery.
  • Dr. Eliza Ransom arranges for a showing of healthy babies to a group of “stylish” women in Boston to promote Twilight Sleep.b Propaganda films were for it were circulated to women’s groups.b Twilight Sleep was marketed as a panacea for many illnesses.b Many early pioneers of it were wealthy ladies, such as Mrs. John Jacob Astor.b
  • Popularity of Twilight Sleep begins to fade after death of a noted advocate for Twilight Sleep in childbirth.a

 

1915-1929        Infant mortality rates due to birth injuries increased 40-50%.a

1916            The Children’s Bureau estimates that there was a total of 73,000 infant deaths (including 41,700 stillbirths) in the year 1916 due to syphilis alone.b Pediatricians estimated that 25-30% of adult blindness was due to gonococcal infection at birth, some estimates ranged as high as 50%.b  

1917            Maternal Mortality From All Conditions Connect with Childbirth in the United States and Certain Other Countries Report by Grace Meigs notes that childbirth in 1913 caused more deaths among women aged 15 to 44 years old than any any disease except tuberculosis.a

1918           

  • The Children’s Bureau finds that maternal deaths increased from 1916-1918 and each year 250,000 infants died.b
  • The scarcity of domestic servants made the lying-in period impossible, unless a family could afford help.b
  • Maternity Center Association of New York was founded to provide more complete maternity care.b

1917-1919 Lanthrop proposes that the federal government appropriate funds to promote the “welfare and hygiene of maternity and infancy” through matching grants to states.b It was first struck down but re-introduced in 1919 by Senator Morris Sheppard and Horace Mann Towner.b The AMA came down heavily on the bill, after just opposing national health insurance as a socialist scheme.b

1919 Restrictions on immigration prevented new midwives from arriving.b

1920            American upper- and middle-class accepts hospital as a consumer good.a Births at hospitals dramatically increase in numbers. b

1920s           

  • Women’s magazines made a crusade of making women feel embarrassed about germs at home.b
  • New wards built in hospitals were designed to be pleasant as well as efficient.b There were luxurious features available, such as balconies.b Hospitals in the 1920s were fairly quiet places to rest, too.b

1920            

  • Doctors believed that “normal” deliveries were so rare as to be virtually nonexistent.b
  • Dr. Joseph DeLee of Chicago wrote The Prophylactic Forceps Operation, which became a benchmark for obstetrical practice.b He urged that outlet forceps and episiotomy be made routine in normal delivery.b DeLee believed that tearing the perineum would cause “permanent invalidism,” such as prolapsed uteri, vesico-vaginal fistulas, and sagging perineums.b He said episiotomy would restore “virginal conditions.”b He said that forceps would prevent damage to the baby’s brain caused by contractions pushing the head against the perineum.b He presented a lengthy list of possible injuries caused by “natural, spontaneous labor” and claimed that 4-5% of babies died from such damage.b Long, hard labors were often responsible, he said, for epilepsy, idiocy, imbecility, and cerebral palsy.b He believe such procedures could save a child from a life of crime.b  

1920s-1938        The campaign for Twilight Sleep was successful.b Hospitals adopted the method in 1920 and by 1938 used it in all deliveries.b

1920s-1930s       

  • Hospitals began emphasizing breastfeeding due to bottle-fed infants dying of the “summer complaint” or diarrhea, before women learned to sterilize bottles.b
  • Very few prepaid health plans existed, and birth was a largely out-of-pocket expense.b The cost of birth could range from $50-$300.b A hospital birth could take approximately 25-35% of a middle-income man’s yearly salary.b Costs continued to rise as more specialists came on the scene and the costs of drugs and expensive equipment were accelerating.b Itemized billing began to take rise.b

1921-1929 The passage of the Sheppard-Towner Act in 1921, one of the earliest health acts of the federal government, was meant to benefit poor women and their children.b It was passed with reduced appropriations, after strong criticism from the AMA.b States could figure out how they wanted to use funds to improve women’s understanding of what constitutes good prenatal and obstetric care and also to make adequate community resources available for such care.b The Sheppard-Towner Act money supported 183,000 health conferences, almost 3,000 centers for prenatal care, and more than 3 million home visits by nurses, reaching more than 4 million persons.b Infant mortality fell from 75 per 1,000 in 1921 to 64 per 1,000 in 1929.

1922           

  • Boston Lying-in Hospital moves to 221 Longwood Ave to allow clinical instruction for students at Harvard Medical School.c
  • The AMA announces its opposition to all “state medicine,” including national health insurance proposals.b

1923            A Boston obstetrician says that birth is “subject to variations from the normal which may be disastrous to the mother or baby, or both.”b American obstetrical textbooks began to recommend that second stage labor be allowed to last no longer than two hours.b

1929-1939        The Great Depression in the United States

1929            

  • Harper’s called for more maternity beds and more respect for obstetricians because “childbearing is not a purely physiological process.”b
  • Only two states remained outside the registration for birth, and death registration area was nearly complete.b This made longitudinal comparisons to see if progress was being made on infant and maternal mortality.b
  • Medicine’s opposition and their powerful lobby to the Sheppard-Towner Act forced federal funding for it to end.b They rejected the Children Bureau’s statistics that the US had poorer mortality rates in comparison to other countries and that such rates would only be improved by “cooperation between the individual prospective mother and her doctor.”b

1930s           

  • Anti-infective sulfonamide drugs begin development.a
  • DeLee’s procedures (see above) became normative in many hospitals.b Obstetricians did not ask whether perineal tears resulted from nature or from hospital practices.b
  • 75% of births in various cities were in hospitals.b
  • Nurse midwives emerged from the traditional practice of nursing.b In 1932, the Maternity Care Association of New York began to train qualified public health nurses in midwifery.b Their services helped the poor, who could not afford to pay for care, particularly after the Sheppard-Towner Act ended.b

1930           

  • Ladies Home Journal says that “motherhood is easier and safer due…to the modern hospital and great strides in obstetrics.”a
  • The Papal encyclical Casti Connubi prohibited taking the life of the infant to save the life of the mother, so many cesareans were done to remove an impacted fetus.b
  • The American Board of Obstetrics and Gynecology was established and one of the primary purposes was to provide hospitals with criteria by which to judge the capabilities of staff and general practitioners.b

1930-1932        Study conducted by the New York Academy of Medicine from 1930-1932 found the septicemia death rate to be 1.67 per 1,000 live births in the hospital versus 0.90 deaths per 1,000 live births for infants delivered at home.a

1932            Ladies Home Journal advertises products used by “hospital leaders” and as “hospital-safe.”a

1933            Landmark study by the New York Academy of Medicine called Maternal Mortality in New York City investigated 2,041 maternal deaths between 1930 and 1932.b It determined two-thirds of the deaths could have been avoided if the best medical practice had been applied.b 60% of unavoidable deaths were caused by some issue with the attendant: lack of judgment, lack of skill, or carelessness.b The report also pointed out careless enforcement of aseptic standards in hospitals.b It included favorable comments on the work of midwives and the advisability of home birth.b It urged doctors to educate women to be better consumers of medical care and to know what a proper prenatal and physical examination involved.b It urged better education in obstetrics, prolonged graduate study, and enforcement of requirements for specialization.b It argued that examinations for membership should be held, and those who pass should be on lists as qualified obstetricians and distributed to the public.b Death counts for this study were attributed to midwives, even if a doctor had attended the delivery; still, midwives had a maternal mortality rate of 1.4 per 1,000 while general practitioners had a rate of 2.5 per 1,000.b

Med students with Reid (2)
Medical Students rounding with Dr. Duncan Reid.

1933            The White House Conference on Child Health and Protection issued its report entitled Fetal, Newborn, and Maternal Mortality and Morbidity.b It highlighted that maternal mortality had not declined between 1915 and 1930, despite the increase of hospital delivery, the introduction of prenatal care, and the greater use of aseptic techniques.b The number of infant deaths from birth injuries had actually increased by 40 to 50% from 1915-1929.b The study covered 11 states, not just New York.b The conference estimated that unnecessary cesarean sections were at 75%, and if those were eliminated, maternal mortality would have dropped by 10%.b The Conference also urged a standard fee for all deliveries so as to discourage unnecessary interventions done to earn higher payments.b

Baby Plan (2)
Standard fee delivery plan.

Both reports found two reasons for mortality: one, women either received no prenatal care or receive inadequate care that underestimated or overlooked complications; and two, there was excessive intervention, often improperly performed.b Nearly half of women died after an operation was done unnecessarily, improperly, or with insufficient care for asepsis.b As a result, many hospitals were embarrassed by these findings and set up committees to investigate maternal deaths and to establish hierarchies whose permission was needed before performing certain procedures.b

1935

  • Federal involvement in maternity care is revived by the Social Security Act; these funds were even more generous than the Sheppard-Towner Act.b
  • Nearly 75% of urban births occurred in hospitals.a

1935-1936       

  • National Health Survey of 1935-1936 found that cesareans occurred at 1.3% in relief families versus 3.7% among women with a family income of $2000 or more.a
  • The percentage of hospitalized women undergoing episiotomy ranged from a low of 25% among relief families to nearly 50% among women with family income over $2000.a
  • Forceps were found to be used two to three times more frequently in hospital deliveries when compared to non-hospital deliveries.a

1936-1955        Rates of mortality dropped precipitously.b

1937            Introduction of sulfa drugs in the spring.a Puerperal septicemia is no longer the leader killer of women of childbearing age, due to sulfonamide drugs.a Other things that helped stem the fever were blood transfusions, which helped women maintain their strength; shortening of excessively long labors that gave bacteria easier access to the breaking of the amniotic sac; and general improvement in women’s health.b

1937+            Maternal mortality rate begins to decline after being flat since early 1900s.a

1939-1945        World War II

1939           

  • WWII led to a shortage of hospital personnel, which drastically shortened a woman’s hospital stay.b
  • An Atlantic article argued that no one would consider having an appendectomy on their kitchen table, so a woman should deliver in the hospital because delivery was a “surgical procedure.”b

1900-1940        Maternal mortality rates do not decrease, even as rates of births in hospitals increase.a

1950            Nearly all urban births occur in a hospital.a

REFERENCES

a. Thomasson MA, Treber J. From Home to Hospital: The Evolution of Childbirth in the United States, 1927-1940 [Internet]. National Bureau of Economic Research; 2004 Nov [cited 2016 Mar 15]. Report No.: 10873. Available from: http://www.nber.org/papers/w10873

b. Wertz RW, Wertz DC. Lying-In: A History of Childbirth in America, Expanded Edition. New Haven: Yale University Press; 1989. 302 p.

c. 09 JMGSN, 2014. Tragedies to transplants, the history of Longwood – The Boston Globe [Internet]. BostonGlobe.com. [cited 2016 Mar 15]. Available from: https://www.bostonglobe.com/lifestyle/health-wellness/2014/11/09/tragedies-transplants-history-longwood/5I7WEMXXIcxUx2BbvaoVAN/story.html

d. Brigham and Women’s Hospital: Integrated Residency Program in Obstetrics and Gynecology [Internet]. [cited 2016 Mar 15]. Available from: http://www.partnersobgynres.org/aff-bwh.asp

e. Long T. Jan. 14, 1794: First Successful Cesarean in U.S. [Internet]. WIRED. 2011 [cited 2016 Mar 16]. Available from: http://www.wired.com/2011/01/0114caesarean-first-us/

Some of the images that appear on this page come from the Brigham and Women’s Hospital Archives and the Harvard Medical Library in the Francis A. Countway Library of Medicine.

 

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