Midwifery

My first home! Davis County Hospital!

       Last weekend I returned to Davis County Hospital in Layton, Utah-- the hospital I was born in!  It was pure accident, I was driving back to Provo from Salt Lake and I got really lost, but I recognized the name from my birth certificate and said to myself "Hey! That's where I was born!" So I had to stop in and pay a visit.

Labor, Delivery, and Recovery suite.

   Three thousand babies are born at Davis County Hospital every year-- nineteen years ago I was one of those! Mothers at Davis County enjoy "private, spacious, Labor, Delivery and Recovery (LDR) suite[s]." Each "LDR suite" is complete with an adjustable bed, jet tub and reclining sleeper. These rooms are designed to give mothers the most comfortable labor experience possible, and all are equipped to facilitate a safe delivery and "outstanding medical care for the first hours of your baby's life."

    Having a baby at Davis County Hospital sounds more like a vacation than "labor," which puts baby delivery and midwifery through the ages into perspective. 

I compare having a baby in a hospital nowadays to having a baby with a midwife in ancient times because for some reason people 5000 years ago didn't have LDR suites (a major over sight of the ancient world). 

  

   A "midwife" is simply a person (typically a woman) trained to help other women during childbirth. Etymologically, the word "midwife" comes from the Middle English word "midwyf" literally meaning "the woman with, the woman assisting." More than just a witness to the birthing process, however, midwives help throughout the pregnancy giving health advice to pregnant mothers and preparing them for parenthood. Midwives held a prominent role in their community because they provided valuable expertise to the entire community on childcare issues and pain relieving practices. 

   Exodus 1 describes the courageous midwives who defied Pharaoh by allowing baby boys to live-- "Therefore God dealt well with the midwives." So we know ancient Egyptian women relied on midwives. (1900-1500 BC)1

    The Roman physician Soranus of early second century AD wrote that only highly competent women could handle midwifery. Soranus wrote, "A suitable person will be literate, with her wits about her, possessed of a good memory, loving work, respectable and generally not unduly handicapped as regards her senses [i.e., sight, smell, hearing], sound of limb, robust, and, according to some people, endowed with long slim fingers and short nails at her fingertips."2 Obviously midwifery was a respected profession. Well-qualified midwives were hired as live-in nurses by wealthy Roman families-- poor mothers in ancient Rome either had to hope that someone with training was available when they had their baby or they would just give birth with the help of another mother. 

    Greco-Roman midwives were trained in a variety of ways. Some simply continued the folk medicine traditions they learned at home or through an apprenticeship. Others became "female physicians" because of their high level of formal training. Obstetric and pediatric books provided some training but most women learned through their mothers or became apprentices to other midwives. All midwives were held to one requirement, however: personal experience with childbirth. 

     When a midwife would come to assist a birth, she would bring two or three assistants usually and a "birthing stool"-- a chair with a hole in the bottom for the baby to come through and handles on the side for the mother to grasp (both midwives and physicians believed the upright sitting position facilitated a more comfortable delivery.) 4 The midwife would face the mother and coach her through the process while the assistants would sometimes push on the mother's belly (ewww). 

    Once the baby was delivered, the midwife would cut the umbilical cord, rinse the baby off, and then sprinkle "fine and powdery salt, or natron or aphronitre” to absorb the birth residue. Soranus advised purring olive oil on the baby's eyelids for further cleansing. The midwife would then determine if the baby was fit to rear by testing its cry and looking for deformities, advising the mother on whether she should keep or expose the infant. 

     Because the process of child birth was a mystery to most people, midwives were believed to have mystical powers. During the middle ages, many midwives were killed in a witch-burning frenzy promoted by church and civil authorities. Women who understood childbirth well enough to help others through the process must surely be in an alliance with the devil!3

     Child birth moving from a physiological event to a medical procedure had a lot to do with the fact that men had access to formal education while women did not. Male physicians educated in  gynecology and obstetrics became the authorities on childbirth and the hospital became the proper setting for labor. 

Mothers today still have the option of giving birth with the aid of a midwife, but it certainly isn't considered the safest or most comfortable way to go. 

    So, as with any other form of folk knowledge, midwifery has evolved over the centuries. Midwifes who learned their art by accompanying another midwife are all but gone-- the process by which modern midwifes learn is much more complicated and formal. http://www.midwife.org/ gives an overview of what standards today's midwives are held to, what training they undergo to be certified.