Catching Babies: The Professionalization Of Childbirth, 1870-1920

Catching Babies: The Professionalization of Childbirth, 1870-1920

Childbirth is a quintessential family event that simultaneously holds great promise and runs the risk of danger. By the late nineteenth century, the birthing room had become a place where the goals of the new scientific professional could be demonstrated, but where traditional female knowledge was in conflict with the new ways. Here the choice of attendants and their practices defined gender, ethnicity, class, and the role of the professional.Using the methodology of social science theory, particularly quantitative statistical analysis and historical demography, Charlotte Borst examines the effect of gender, culture, and class on the transition to physician-attended childbirth. Earlier studies have focused on physician opposition to midwifery, devoting little attention to the training for and actual practice of midwifery. As a result, until now we knew little about the actual conditions of the midwife's education and practice.Catching Babies is the first study to examine the move to physician-attended birth within the context of a particular community. It focuses on four representative counties in Wisconsin to study both midwives and physicians within the context of their community. Borst finds that midwives were not pushed out of practice by elitist or misogynist obstetricians. Instead, their traditional, artisanal skills ceased to be valued by a society that had come to embrace the model of disinterested, professional science. The community that had previously hired midwives turned to physicians who shared ethnic and cultural values with the very midwives they replaced.ReviewIn other accounts of the decline of midwifery, historians have focused on the competition between physicians and midwives, suggesting that elitist physicians undermined the credibility of the midwife. Borst presents her own fresh and innovative view of the causes of this gradual change in birth attendants. She proposes that the inability of midwives to develop a truly professional approach to their craft contributed to their decline over these years, when both medicine and nursing began to develop as professions rather than vocations. The cultural, ethnic, and sex-based causes for this are well explored in the book...Catching Babies is clearly laid out, progressing from an analysis of midwifery to an evaluation of the changing training and focus of physicians. The arguments are easy to follow, well researched, and well substantiated by the depth of material presented. Borst's analysis of the influences of sex, class, and ethnic background is illuminating. The lessons she extracts from the Wisconsin experience can easily be extrapolated to the larger community. Catching Babies is a thought-provoking book, raising many questions about how we reached our present structure of care. Furthermore, it makes us consider how these same factors may influence the changes we are now struggling with in the fields of obstetrics and gynecology. This book is good reading for anyone interested in medical history, midwifery, or obstetrics, or anyone who simply wants to consider the influences of background, sex, class, and culture on our futures. (Elizabeth J. Buechler, M.D. New England Journal of Medicine)One of the strengths of Catching Babies is the opportunity it offers the reader to examine the experience of childbirth for lower class, immigrant, and rural women