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How did public health nurses affect the work of untrained midwives 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 first half of the 20th century, public health nurses played a significant role in the decline of traditional, untrained midwifery in the United States. As part of a broader shift toward scientific medicine, these nurses were tasked with supervising untrained midwives and providing mothers with education on the proper care of infants and children.1

This intervention was driven by a medical and nursing community that increasingly viewed traditional midwifery—often associated with immigrant, African American, and Native American populations—as unhygienic and superstitious. By monitoring these practitioners and promoting hospital-based births, public health nurses helped marginalize the role of the untrained midwife, contributing to a transition where the vast majority of births in the United States eventually took place in hospitals under the care of physicians.1