Well, here we are in the year year 2000, two hundred of those years is literally a sneeze! And 200 - 300 years or so, is what is being referred to here, from about the mid 1700s to 1999. ( Please read page 29 in your book ) What book?
The turn of the 19th century was in a flurry of discovery and the discoveries were many! To name a few: The camera, telephone, the automobile, medical and surgical practices, and the growth of hospitals as the "safe" place to go for treatment of illnesses and childbirth. As our society changed and advanced technologically, so did our lifestyle and where we chose to have our babies.
Up until the late 19th and early 20th centuries, women were at home, birthing their babies, attended by midwives, family, neighbors, and at times by a doctor. New mothers held "Grunting" parties to thank neighbors, family and friends for their support and help. No medication to relieve discomfort was available, like it is today.
Midwives did the deliveries at the turn of the century and began to disappear as doctors took over this role. But, midwives have remained, quietly, but actively interwoven in the fabric of our nation's history, and are making a strong comback. Today, they are just as important, if not more so, than at the turn of the century.
The advances in medicine decreased maternal mortality to the point where it is a very rare incident today. It took several years for this fact to be acknowledged: That doctors themselves could actually infect their own patients with transmitted germs, from new mother to new mother! Thank heavens they finally accepted what could no longer be denied, and as a result maternal mortality was reduced.
Today, most births take place in hospitals, where the natural event is clouded with technology: monitors, IVs, machines, and isolated with little contact with family members. There is also a high rate of epidural anesthesia for discomfort. However, today we live in the age of information. Information and education lead to choices, and there are many options for the expectant couple to choose from ranging in where to have a baby to options in medications...or NONE! Perhaps the greatest choice is to birth at home the way women did a century ago, with technology at arms distance if needed, but in a family supported environment.
Listed below are just a few highlights in history that have made an impact in our country and as a result in childbirth......who knows what the future will bring. Maybe more homebirths with midwives
as THE way to deliver.
Resourses: Encarta Encyclopedia; Penny Simkin, Signifigant Twentieth Century Developments and Associated Changes in Maternity Care; Lying-in, A History of Childbirth in America, by Richard W. Wertz; Manual of Obstetric Anesthesia, by Gerald W. Ostheimer.
1751- The first hospital established in the USA, in Philadelphia
1865- After the Cival War in America, about 200 or more hospitals were opened in the northern states to respond to the amount of war casualties.
1800- Surgeons operated in street clothes, never washing hands. Patients survived the surgery, but would die from infections.
1800s- Ether introduced by Dentist William Morton for pain
1845- Chloroform and ether used to relieve discomfort in childbirth. Also, Childbirth Fever, or the Puerperal Fever, a bacterial infection of the female genital tract after childbirth, took the lives of up to 30% of the women giving birth in lying-in wards, whereas most women who gave birth at home remained unaffected.
1850s- Louis Pasteur and Robert Koch establish the Germ Theory- bacteria is in the air, can be transmitted, and assists in tissue decay.
1868- Joseph Lister, based on studies by Louis Pasteur and Theodor Schwann, discovered and implemented antiseptics in medical practice- washing hands and the use of carbonic acid in cleansing hands and instruments.
1865- Ignaz Philippe Semmelweiss, a Hungarian Obstetrician, showed increase rate of mortality in women after childbirth was attributed to infectious agents transmitted by unwashed hands. This was rejected by the medical community at the time.
1873- Begining of the radio.
1876- First telephone transmission by Mr. Bell
1888- George Eastman introduced the 1st Kodak Camera.
1890- Rubber gloves first used in surgery.
1893- First car designed by brothers Frank and Charles Duryea. Henry Ford would create his first experimental car that same year. This created the opportunity for women travel to hospitals.
1896- Cloth masks first used in surgery.
1900- Increased rate of women going to hospitals to have babies for pain-free childbirth."Twilight Sleep" introduced to women as a method to reduced discomfort in childbirth. Morphine was given first followed by scopolamine. Ether or Chlorform would follow on the delivery of the baby's head, and amnesia for the new mother was a side effect. This was used up to the 1920s with variations up to the 1950s.
1904- First line of maternity clothes designed by Lena Bryant, now known as Lane Bryant.
1920- Women get the right to vote! Bottle feeding is dominant.
1930s- Increased infection prevention. Obstetrics/Gynecology develops as a specialty.
1935- Sulfa Drugs discovered !
1939- 50% of women were having babies in the hospitals
1940s- Penicillan discovered !
1940-49- Improvements in maternal and infant mortality.
1945- First computer data base created.
1950-60s- 95% of births in the hospitals. Lamaze introduced to women as "natural childbirth", childbirth without medication, as well as other oganizations such as La Leche League, and the International Childbirth Education Association.
1960s- Dr. Jess B. Weiss started the first clinical laboratory devoted to studies in obstetric anesthesia. The initial investigations of epidural anesthesia emanated from this laboratory.
1970s- A return to "Natural" childbirth at home: homebirth with midwives and family, interest in breastfeeding increases. Childbirth education seen as essential to natural childbirth. Platform shoes... :) Womens Liberation movement.
1980s- Hospitals take an interest in family centered care: birthing rooms, birth plans, interest in the psychology of mother and baby well-being.
1990s- A new member of family centered care-the Doula, although around for years, makes an important contribution to laboring women by providing physical and emotional support with reseach to support a Doula's importance. How about this: research shows Doulas reduce cesarean rates by 50% ! Hospitals renovate OB wards to accomodate "Family Centered" Care by creating LDRPs (labor, delivery,recovery and postpartum) rooms. An increased rate of epidural anesthesia used for discomfort management in childbirth.
2000- ??????? Who knows.
To be continued..........
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