The Rise of the Male Obstetrician: Childbirth as a Medical Procedure

Clara Kirkpatrick is a Senior Art History major at Grinnell College who specializes in 20^th Century European Art. She intends to study Graphic Design on a graduate level and eventually work as a designer in New York City.

Contemporary discourse surrounding childbirth reveals a great deal about the transformation of birthing practices over the past 300 years. Because females give birth and men do not, we might imagine the historical discourse surrounding pregnancy to be female-centric and perhaps dominated by womanly concerns. Instead, the discourse surrounding birth has quite remarkably transformed into a highly medical conversation that seems to ignore the female’s role in birth.

Today, a Google search of the word “childbirth” results in a series of articles that resemble instruction manuals and advertisements for the “newest” and “safest” ways to deliver your baby. Articles with titles like “Car Mechanic Invents Technology to Ease Childbirth” litter the web, further solidifying the idea that birth cannot occur naturally but must be directed by (usually male) medical personnel. What is arguably the most natural process in the world has been transformed into a kind of technological, medical competition. Natural childbirth is considered abnormal, and birth outside of the hospital is considered masochistic.[1]

Until the 18^th century, birth was an entirely female process. Female family, friends, and midwives gathered around the bed of the childbearing woman before, during, and after birth, comforting and helping her through the trying and often dangerous process.[2] The past hundred years has seen the majority of women perform the subservient role of patient or nurse while the male doctor dominates the birthing room. Only in the past two decades have women obstetricians gained a significant presence in the field. Most women in the United States no longer feel comfortable laboring at home—instead, new mothers generally feel safer and better cared-for in a hospital maternity ward. How did birth become a medicalized, male-dominated event? What caused this essential shift?

Historian Jacqueline Wolf explains in Deliver Me from Pain: Anesthesia and Birth in America that despite the support women provided to each other during and after labor, the process of childbirth remained a source of extreme fear and panic for most women until the twentieth century. This fear was not without reason—many women fell ill or died due to complications sustained during birth. The widespread perception of women (mainly white and upper class) as weak and fragile creatures contributed to this fear as women were considered unable to bear the stress of daily life in a modern environment, let alone the incredible pain of giving birth.[3]

This widespread fear of giving birth created an environment conducive to the rise of male obstetricians and hospitalized births. Women’s fear caused them to search for safer, easier, and more comfortable ways of giving birth if they had the means. Many poor women and women of color continued to give birth at home as they were either unable to afford the hefty hospital fees or were unaffected by the fear of home birth. [4] Judith Walzer Leavitt notes that, because of intellectual insecurity, many women decided to follow male birthing advice, despite the fact that these men could not understand birth the way a midwife who’d given birth could. The incredible anxiety surrounding birth at this time outweighed women’s desire for social births. Thus, hospitalized, male-led birth was the new trend.

Though women increasingly delivered their babies in hospitals under the care of a male doctor, survival rates did not improve as quickly as expected. A 2006 article in the New Yorker entitled “The Score: How Childbirth Went Industrial” cites a 1933 study from the New York Academy of Medicine. Of 2,041 maternal deaths: “There had been no improvement in death rates for mothers in the preceding two decades; newborn deaths from birth injuries had actually increased. Hospital care brought no advantages; mothers were better off delivering at home.” Women’s belief that they would be safer giving birth in a hospital under the care of licensed, experienced male doctors (as opposed to in the home with female midwives) proved to be largely untrue.

Nevertheless, women increasingly bestowed their unwavering faith on male doctors, undergoing experimental treatments during birth, such as taking opium in order to avoid pain and fear.[5] Once childbirth was in the hands of obstetricians, there was no turning back. Though obstetrics today improved exponentially since the opium days, the history of the field reveals a disturbing rise to power that initially did more harm than good and cemented childbirth in the medical realm.