The History of the Midwife

Midwives have been assisting with the care of pregnant women for centuries in nearly every culture. The term "midwife" is almost as old as the profession itself. The position did not start out as a paid profession but rather the instinctual need for care of a woman in her most delicate state--when with child. Throughout the ages the position of the midwife has evolved, but the overall function of managing the care of a pregnant woman through birth remains the same.

Earliest References

• References to midwives can be found in the Christian Bible. In the book of Exodus, when the Pharaoh of Egypt ordered the execution of all male Hebrew infants, two Hebrew midwives were noted for refusing to follow the Pharaoh's orders. Passing reference of midwives can also be found in the book of Genesis. Ancient Hindu writing and other papyri also contain references to midwives. In the English language the word "midwife" translates to "with woman" as a supportive connotation. In the French language midwives were called "sage femmes" or "wise women."

Function

• The function of midwives has not changed much throughout history. As it is today, midwives manage the care of pregnant women from prenatal care to delivery and even assist with the care of the newborn while the mother heals. Midwives not only serve as caretakers of pregnant women, they are also responsible for the delivery of the child. This has been common across nearly all cultures throughout many generations. The practice of some midwives delivering the child is still in place today.

Practices

• Education for midwives did not exist before the early 1900s. Up until that point the nature of education for midwives was that of an apprentice where knowledge and skills were passed down from generation to generation. Before modern medicine, midwives used herbs and kitchen remedies to help ease the pain of their pregnant patients.The unofficial licensing of a sufficient housewife in 17th and 18th century England was established through the witnessing of six or more women who could vouch for her experience.

Transition

• Midwifery remained an informal practice well into the age of modern science and medicine. This caused controversy between the more advanced practices of obstetricians and the centuries-old practices of the informally trained midwives from the end of the 19th century to two decades into the 20th century. It was claimed that the midwives were responsible for more infant deaths; whereas, pregnancies under care of physicians fared better statistically. The presence of midwives in homes decreased further during World War I. Government legislatures barred midwives from delivery in hospitals where more pregnant women were going for care.

Evolution

• Because the informal practices of traditional midwives could not coexist with the modernized world of health-care and medicine, a new education for midwives needed to be birthed if the trade was going to survive in the United States. Mary Breckinridge--from her personal struggles with successfully birthing children--began a quest for alternative care for women preparing to give birth. She receiving training for nurse-midwifery in Britain, returned to the United States and founded Frontier Nursing Service (FNS) in Kentucky in 1925.

  Mary Breckinridge eventually established a training program for nurse-midwives at Frontier Nursing Service (FNS) that garnered a resurgence of midwives birthing babies at high success rates.

The Present

• Beginning in the 1930s, several clinics and universities across the nation began midwifery training programs close to the nurse-midwifery model pioneered by Mary Breckinridge.

  Today the midwife is an internationally recognized profession. In the United States, it is managed under the North American Registry of Midwives (NARM) in conjunction with the Midwifery Education Accreditation Council (MEAC), Midwives Alliance of North America (MANA) and National Association of Certified Professional Midwives (NACPM).