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How did immigration shape attitudes toward midwifery in the United States?

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Midwives assisting a birth while astrologers consult sky charts; woodcut relief print from Jakob Rueff's De conceptu et generatione hominis (1554; The Expert Midwife). — midwifery Midwives assisting a birth while astrologers consult sky charts; woodcut relief print from Jakob Rueff's *De conceptu et generatione hominis* (1554; *The Expert Midwife*).

In the early 20th-century United States, immigration played a significant role in the decline of midwifery. During this period, midwifery became closely associated with immigrant communities, as well as African Americans and other marginalized groups.1

This association negatively influenced the medical and nursing community's perception of the profession. Despite many immigrant midwives having received formal training in their native countries, the U.S. medical establishment frequently characterized midwifery as unhygienic, superstitious, and unscientific. These biases often overshadowed the positive birth outcomes achieved by these practitioners.1

Furthermore, while midwives served as essential links for immigrant families adjusting to life in the United States, their influence waned as these populations assimilated into mainstream American culture and moved away from traditional midwifery practices. This shift, combined with the rise of public health nursing and the increasing dominance of hospital-based, physician-led births, contributed to the near-disappearance of midwifery in the United States by the mid-20th century.1