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Why was midwifery pushed out of much of the United States and Canada in the early 20th century?
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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, midwifery was largely pushed out of the United States and Canada due to a combination of professional, social, and cultural factors.
The decline was driven by the following key influences:
- Professional Marginalization: The medical and nursing communities collaborated to displace midwives. Physicians promoted scientific medicine, emphasizing their ability to provide safer deliveries through the use of obstetric tools and pain relief, while public health nurses began supervising midwives and providing maternal education.1
- Social and Cultural Bias: Midwifery was frequently associated with immigrants, the poor, African Americans, and Native Americans. The medical establishment often perceived these practices as unhygienic, superstitious, or unscientific, regardless of the actual birth outcomes achieved by midwives.1
- Public Perception: High rates of maternal and infant mortality were often attributed to midwife-attended births, which fueled the push toward hospital-based deliveries. As populations assimilated into mainstream culture, many families moved away from traditional midwifery in favor of physician-led hospital care.1
By the 1950s, these shifts resulted in approximately 88 percent of births in the United States occurring in hospitals under the care of physicians.1