The Medicalization of Childbirth:
by Lauren Feder, M.D.

Excerpt from Natural Pregnancy

The pregnancy and childbirth experience is considered one of the most coveted experiences in a woman's life.  The diverse and vital ways in which we embrace it has changed since the advent of modern medicine.  Although many aspire for the most natural pregnancy and birth possible, it often does not come to fruition.  

Maternal health is no longer just the domain of physicians, but of expectant parents. This book is about offering women insight into having the most fulfilling experience.   It aims to empower a woman and give her the confidence to make the best, most informed decisions regardless of giving birth at home, birth center, or hospital. 

As a mother as well as holistic physician, I have found myself on both sides of the medical “divide.” During my pregnancies, I was often thinking as a mother-to-be and a holistic physician at the same time.  I realized my background helped me in my journey as an expectant mother.  Often, my explorations took me ‘off the beaten path,’ exposing me to little-known options.  As a result, I learned so much about the holistic approach for pregnancy and birth, which enhanced my own wonderful experience, and ultimately also for others. 

My upcoming book on Natural Pregnancy was born from this dual consciousness—from my desire to bridge the gap between expectant parents and doctors, and to encourage both parties to think more naturally, holistically, and creatively during pregnancy and beyond.   I see hundreds of pregnant women and new parents with their newborns every year, all with different feelings, ideas and expectations. Whether or not they are interested in natural birth, nearly all my patients come seeking an additional approach that honors both the body and the spirit of mother and baby.  

History Overview: The Medicalization of Childbirth
Natural pregnancy and birth are as old as time itself. For as long as we go back to humanity, women have given birth, naturally.  By looking at the past we gain perspective on pregnancy and birth attitudes in the 21st century, as it is only recently that modern medicine has become intricately involved in the birth process. 

Historically, our ancestors lived in small villages where local women, mothers and midwives (with the woman in Middle English) supported the woman and helped her during pregnancy and especially in labor and delivery. Before the 20th century, nearly everyone delivered at home.  Unless a woman was too poor, she had to deliver in the hospital.  In those days, hospitals were unclean places, filled with infections, where the poor went to die.   

By the 17th century, pregnancy and birth became a point of interest by the emerging medical community, starting what is now coined as the ‘medicalization of childbirth.’ By the early 20th century, most births, normal and complicated, became medicalized in developed countries.  Eventually, medical doctors managed the care of women during childbirth, replacing the majority of midwives.  Although, outside of the United States, midwives still play a greater role in labor and delivery.

As a result of the increasing intervention and control by doctors, childbirth became viewed less as a normal natural experience but more as a medical procedure which needed to be orchestrated with pain medications, shaving of pubic hair, and ultimately leaving women no options or choices in the matter.  
In the past, life was different too.  People’s lives were greatly influenced by factors such as food supplies, harvest, weather, war, and infectious diseases. As a result the mortality rate was higher in women and children compared to today. Before the 20th century, 1% of women died from pregnancy-related complications and up to 25% of babies died before one year old.  In the 1800s it came to light that physicians (not midwives) were responsible for the rise in maternal mortality.  According to physician (and writer) Oliver Wendell Holmes, physicians who went from performing autopsies to delivery, spread puerperal fever from patient to patient because of dirty, infected hands. 

Also at that time, the industrial revolution was in full swing leading to crowded unclean living conditions in factories and cities,.  However, eventual improvements in sanitation, healthcare, literacy, nutrition, and standard of living witnessed a decrease in the infant and maternal mortality rates in the United States by over be continued.  

References: Natural Pregnancy