**NOTE** Medical advancements have saved the lives of women and babies at risk for injury or death during pregnancy and birth. This site is not about the doctors who properly use interventions to save lives; it is about those who use them unethically for profit or convenience. Improperly used interventions have led to harm and death of women and babies and obstetrics is the only field in which mortality rates are rising and non-medically needed interventions such as c-sections are related to 66% of maternal deaths.
**NOTE** This site is designed to share valid evidence for those working to change the maternal healthcare system who do not have access to databases of peered research.
**NOTE** Chronological order allows users to find new data. It also begs the question of why, when we have known for decades that such practices are harmful, do they not only continue to be used but are increasingly used.
HISTORY OF MEDICALIZATION OF PREGNANCY AND BIRTH
WHAT DOES THE LITERATURE SAY?
2021
University of Houston Digital History (2021). Childbirth in Early America. Accessed https://www.digitalhistory.uh.edu/topic_display.cfm?tcid=70
- In recent years, a reaction has occurred against the sterile impersonality of modern hospital delivery. Women today are much more likely than their mothers or grandmothers to want a “natural childbirth.” Beginning in the l960s, a growing number of women elected to bear their children without anesthetics, so that they could be fully conscious during childbirth. Many women also chose to have their husbands or a relative or a friend present during labor and delivery and to bear their children in special “birthing rooms” that provide a home-like environment. In these ways, many contemporary women have sought to recapture the broader support network that characterized childrearing in the colonial past, without sacrificing the tremendous advances that have been made in maternal and infant health.
2018
History of American Women: Women in Medicine. (2018). 19th Century Midwives. Accessed https://www.womenhistoryblog.com/2014/06/19th-century-midwives.html
- The substitution of doctors for midwives and of hospital delivery for home delivery did little in themselves to reduce mortality rates for mothers. It was not until around 1935, when antibiotics and transfusions were introduced, that a sharp reduction in the maternal mortality rate occurred. In 1900, maternal mortality was not much lower than it had been in the mid-nineteenth century.
2017
Holland, B. (2017). The ‘father of modern gynecology’ performed shocking experiments on enslaved women. Accessed https://www.history.com/news/the-father-of-modern-gynecology-performed-shocking-experiments-on-slaves
- But because Sims’ research was conducted on enslaved Black womenwithout anesthesia, medical ethicists, historians and others say his use of enslaved Black bodies as medical test subjects falls into a long, ethically bereft history that includes the Tuskegee syphilis experimentand Henrietta Lacks. Critics say Sims cared more about the experiments than in providing therapeutic treatment, and that he caused untold suffering by operating under the racist notion that Black people did not feel pain.
2016
Oakley, A. (2016). The sociology of childbirth: an autobiographical journey through four decades of research. Sociology of Health & Illness, 38(5), 689–705. https://doi.org/10.1111/1467-9566.12400
- CONCLUDED: “What I identify here as separate strands in the development of the sociology of childbirth – the heritage of medical sociology, the arrival of a new respect for qualitative research, the impact of the women’s movement, the energies of consumer organisations, the drive for evidence-based practice and policy – jostle next to one another in the documentary records. They cannot be separated from one another, except arbitrarily, for the purpose of analysis. The analytic process suggests a need to probe more carefully the interconnections between personal lives and networks, on the one hand, and professional concerns and enterprises, on the other.”
Thompson, & Varney, H. (2015). A history of midwifery in the United States: the midwife said fear not. Springer Publishing Company. eBook is accessible for online reading or download at
- CONCLUDED (from introduction: “The historical evolution of midwives as respected, autonomous health care workers and midwifery as a profession can be depicted by several important characteristics that are highlighted throughout this text. Th ese characteristics include the close link between midwives and the communities where they live, their shared view of pregnancy and birth as normal life events that sometimes result in less-than-optimal outcomes, midwives’ desire to promote health and prevent sickness whenever they could, and their willingness to be “with women” wherever those women are and whatever the sacrifice for the midwives themselves. However, the midwives’ desire to promote the health of women and families was often threatened and/or undermined by the increasing medicalization of childbearing care (medical monopoly) along with the midwives’ lack of a common identity based on education and practice standards, the lack of legal recognition to practice, and, more recently, reimbursement for autonomous midwifery services”
2014
Al-Gailani, S., & Davis, A. (2014). Introduction to “Transforming pregnancy since 1900”. Studies in history and philosophy of biological and biomedical sciences, 47 Pt B(Pt B), 229–232. https://doi.org/10.1016/j.shpsc.2014.07.001 Accessed (journal in which published may be accessed at https://www.sciencedirect.com/journal/studies-in-history-and-philosophy-of-science-part-c-studies-in-history-and-philosophy-of-biological-and-biomedical-sciences/vol/47/part/PB
- CONCLUDED: (from article) “The most influential writing on pregnancy from a historical perspective during the 1970s and early 1980s focused on struggles for the control of childbirth. These accounts presented late twentieth-century maternity care as the consequence of a historic power grab that had transformed obstetrics and gynecology into privileged and
powerful professions at the expense of female midwives (Arney, 1982; Donegan, 1978; Donnison, 1977; Ehrenreich & English, 1973). This perspective emerged in a political context in which not only feminists but also non-feminist patient consumer organisations were campaigning for the redistribution of power between medical specialists and pregnant women, and for greater choice in childbirth (Oakley, 1984, pp. 236–249). Critics of maternity care—especially in the United States and Britain—argued that by redefining the ‘natural’ process of childbearing as inherently risky, obstetricians had deceived women into accepting hospital and medical interference as the rule for all births (Arms, 1975). Despite their different approaches these authors shared an understanding of the medicalisation of reproduction as a process that was, a priori, imposed upon women to their detriment;”
2010
Benoit, C., Zadoroznya, M., Hallgrimsdottir, H., Treloar, A. and Taylor, K. (2010) Medical dominance and neoliberalism in maternal care provision; The evidence from Canada and Australia. Social Science and Medicine. 71(3) 475 – 481 Accessed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4445451/
- CONCLUDED: “This neoliberal rhetoric of consumerism provides the justification for the continuing hegemony of medicine over maternity care in Canada and Australia. It would be beneficial to investigate the recent history of medicalisation of maternity care in other high-income countries using our analytical perspective, as well as to explore counter-neoliberalizing forms of regulatory restructuring in these countries and their impact on medical hegemony.”
2009
Schram, C. (2009). Maternal History. Accessed https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2726092/
- The New York Maternal Mortality Study was funded by the Commonwealth Fund and conducted by the New York Academy of Medicine from 1930 to 1932. The study found that home births attended to by midwives during this time actually had the lowest maternal death rate and that approximately two-thirds of the maternal deaths that occurred in hospital were preventable.
2008
Brodsky, P. L. (2008). Where Have All the Midwives Gone? The Journal of Perinatal Education, 17(4), 48–51. https://doi.org/10.1624/105812408X324912
- ICONCLUDED: (from article” “In response to the small but growing demand for midwifery care and home birth and to the success of the documentary film The Business of Being Born (Lake & Epstein, 2007), the American Medical Association, in three separate resolutions in 2008, seeks to limit the scope and practice of midwifery, insure physician and regulatory oversight of midwives, and promote legislation to insure that all births take place in hospitals or birthing centers (American Medical Association House of Delegates, 2008a, 2008b, 2008c). Childbearing women need to be made aware of the evidence that now exists on the risks of the routine use of interventions during labor and birth and be thoroughly informed about the pros and cons of all obstetric interventions.”
Thomasson, & Treber, J. (2008). From home to hospital: The evolution of childbirth in the United States, 1928–1940. Explorations in Economic History, 45(1), 76–99. https://doi.org/10.1016/j.eeh.2007.07.001
- CONCLUDED (from article) “An intuitively appealing explanation for the sudden growth of hospitals is that they offered superior outcomes compared to alternative home-based medical care. With respect to childbirth, it is not obvious that hospitals necessarily led to better outcomes; as birth shifted to hospitals, maternal mortality rates (measured as the number of maternal deaths per 100,000 live births) did not decline. Fig. 1 shows total, urban (places over 10,000) and rural maternal mortality from 1915 to 1940. Fig. 2 shows the death rate among women for tuberculosis and all causes related to childbirth (puerperal causes) from 1900 to 1940.”
2001
Cahill. (2001). Male appropriation and medicalization of childbirth: an historical analysis. Journal of Advanced Nursing, 33(3), 334–342. https://doi.org/10.1046/j.1365-2648.2001.01669.x
- CONCLUDED (from abstract) “Male justifications of female inferiority have been developed and nurtured through professional discourses and socialization processes inherent within medical education and practice (Cahill H. 1999 MA Thesis, University of Keele). These assumptions are internalized and reproduced to shape quite profoundly, the nature of doctors’ interactions with women in their care. Perhaps more fundamentally, such discursive explanations of women’s bodies as inherently defective continue to shape women’s position in society. Maternity care is a key area in which women’s ability to exercise real choice and make informed decisions is limited and where doctor±patient interactions are themselves constructions of existing gender orders; women’s autonomy continues to be violated through both quite subtle and overt discourse and practice.”
2000
Cahill, H. (2000). Male Appropriation and Medicalization of Childbirth: A Historical Analysis. https://doi.org/10.1046/j.1365-2648.2001.01669.x
- CONCLUDED: “Male justifications of female inferiority have been developed and nurtured through professional discourses and socialization processes inherent within medical education and practice (5 MA Thesis, University of Keele). These assumptions are internalized and reproduced to shape quite profoundly, the nature of doctors’ interactions with women in their care. Perhaps more fundamentally, such discursive explanations of women’s bodies as inherently defective continue to shape women’s position in society. Maternity care is a key area in which women’s ability to exercise real choice and make informed decisions is limited and where doctor–patient interactions are themselves constructions of existing gender orders; women’s autonomy continues to be violated through both quite subtle and overt discourse and practice.”
1996
Tone, A. (1996). Controlling Reproduction: An American History. BOOK accessed https://rowman.com/ISBN/9780842025751/Controlling-Reproduction-An-American-History#:~:text=Controlling%20Reproduction%20is%20an%20informative,%2C%20business%2C%20and%20social%20change.&text=The%20breadth%20of%20Andrea%20Tone’s%20project%20is%20its%20greatest%20strength.
- Few topics stir stronger interest than birth control and abortion. Divisive opinions abound. This informative, detailed text contains 39 writings on the history of reproduction in the U.S. The historical path of reproduction control is viewed in the contexts of politics, law, medicine, sexuality, business, and social change. Because birth control has been construed chiefly as a female responsibility, Controlling Reproduction stresses the centrality of gender in the history of reproduction and explores how and why reproduction-as a biological, social, and economic function-became a gender-assigned issue.
1987
Leavitt. (1987). The Growth of Medical Authority: Technology and Morals in Turn-of-the-Century Obstetrics. Medical Anthropology Quarterly, 1(3), 230–255. https://doi.org/10.1525/maq.1987.1.3.02a00020
- CONCLUDED: (from abstract) ” Before 1880 bortjomg wp,em amd tjeor fe,a;e attemdamt dominated decisions concerning labor and delivery. Between about 1880 and 1920; however, the medical profession gained control of obstetrical care and birth increasingly took place within hospitals. Using the specific example of the debate about performing craniotomies (the surgical mutilation of the fetal head to permit vaginal extraction) on live fetuses, the paper analyzes how technological innovations, changing medical theory, moral and ethical considerations, and professional interests interacted to make physicians more powerful arbiters in America’s birthing rooms.”
1982
Arney, & Neill, J. (1982). The location of pain in childbirth: natural childbirth and the transformation of obstetrics. Sociology of Health & Illness, 4(1), 1–24. https://doi.org/10.1111/j.1467-9566.1982.tb00245.x Accessed https://onlinelibrary.wiley.com/doi/pdf/10.1111/j.1467-9566.1982.tb00245.x
- CONCLUDED (from abstract) “In the post-World War II period obstetrics transformed the nature of its work, partly in response to the challenge of natural childbirth. The transformation is traced by focusing on obstetrics’ understanding of pain in childbirth. In reformulating its field of power obstetrics reconstituted its patient-object to take into consideration the patient’s subjectivity which, as a result of the natural childbirth movement, had asserted itself, escaping from the confines in which obstetrics had tried to contain it, and reclaiming for a fleeting instant the pain which signalled a woman’s active participation in birth.”