Why did some U.S. medical and nursing professionals view midwifery as unhygienic or unscientific?

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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, the medical and nursing communities increasingly viewed midwifery as unhygienic and unscientific due to its strong association with marginalized groups, including immigrants, African Americans, and Native Americans.1

This perception was driven by several factors:

Social Bias: The medical establishment frequently associated midwifery with superstition and untrained practice, often disregarding the positive birth outcomes achieved by midwives trained in their native countries.1
Attribution of Mortality: High rates of maternal and infant mortality in the U.S. were often blamed on midwife-attended births, regardless of whether such claims were accurate.1
Professional Competition: As scientific medicine gained prominence, it was marketed as a safer alternative that could mitigate risks like hemorrhage and infection. Simultaneously, public health nurses began supervising midwives, further marginalizing the profession.1

Ultimately, these biases, combined with the professionalization of nursing and medicine, led to the systematic displacement of midwives in favor of hospital-based, physician-led births.1