Table of Contents
What does a midwife do?
Midwifery during Colonial times
Mary Breckinridge
In my paper, I decided to explore the history and impact of nurse-midwifery on the United States. Mary Breckinridge was a pioneer in both nursing and childbirth. This topic was chosen because I’ve worked with nurse-midwives over the last year. Each time I work with these women, I’m amazed at their knowledge and how much they accomplish. What childbirth practices existed before nurse-midwives were formalized, what Mary Breckinridge did to influence the change, and how she influenced those who were trained in assisting in birth.
What is the role of a midwife according to WHO? “Skilled, compassionate and knowledgeable care is provided by midwives for pregnant women, infants and families… through pre-pregnancy pregnancy, childbirth, postpartum or in the early weeks after birth.” A midwife’s role goes beyond delivering babies. It also includes assisting women in conceiving a child. Even though it seems simple, conceiving a child can be affected by many factors we don’t expect or didn’t think would happen. Respecting the opinions, choices, and circumstances of women while under your care is also part of being a professional midwife. As a medical professional, a midwife must also respect the views, decisions, and circumstances of each woman while she is in your care. The Mayflower was the first ship to bring midwifery to America. Martha Ballard accompanied by Bridget Lee Fuller endured a two-month trip to America. The women continued to journal their experiences and assisted with multiple births during this time. Fuller continued her midwifery work in Plymouth for an additional 44 years, until she passed away in 1664. Many women offered midwifery as a free service to their community for many years. However, in 1660, New Amsterdam became America’s first town to pay a woman for her services. A midwife was paid 100 guilders (52 dollars) to provide care for the poor in a community for a year. Even though women didn’t have to go to school to be a laymidwife, they spent considerable time working and shadowing a more senior and experienced midwife. As soon as a woman was on her feet, she would work under the supervision of an older Protestant bishop. This was because infant mortality at that time was more than 50%. The midwife could have baptized the baby sooner if she worked under a bishop’s supervision.
Early 1900s, in large communities there was often a midwife to help the women deliver their babies as far as they were physically capable. There was little health care in rural America. This meant that many women delivered their own babies with the assistance of untrained relatives and neighbors. The lack of training was responsible for the high number of maternal deaths in rural areas. In fact, there were 800 maternal deaths per 100,000 births, and 100 children out of 1,000 died before they reached their first birthday.
Mary BreckinridgeMary Breckinridge is a Kentucky native born in 1881. She was born to a wealthy family and studied in Europe and America. Breckinridge’s father and two children died shortly after she decided to go to school in New York. In 1910, she became a registered nursing after dedicating her life to improving women’s and children’s lives. Breckinridge was a nurse-midwife in Britain during World War II. This experience sparked Breckinridge’s interest, and she came to believe that “nurse-midwifery would be the best solution to rural America’s needs”. Breckinridge was inspired to pursue public health studies at Columbia University, since nurse-midwifery had not been formally established in the United States. She thought that if the plans she had developed could work in this secluded region, then they would be successful elsewhere in America. Breckinridge rode on horseback to determine the needs of families and lay midwives in this vast area. She discovered that there were many families with nine children on average. Farmer’s wives were the ones who attended births during this time. They were often self-taught and relied heavily on folklore and holistic measures. Mary Breckinridge, a midwifery trainer who was overwhelmed by the need for midwifery in the community and the lack of training in the field, founded the Frontier Nursing Service in 1925. After the Frontier Nursing Service was established in 1925, Breckinridge wrote an American Journal of Public Health article stating the FNS nurse-midwives had made Appalachia Ky one of regions with the lowest rates of maternal mortality.
Frontier Nursing University has become one of the top institutions for nurse midwifery education. Changes in Practice Women have been seeking pain relief for centuries in various forms. For centuries, women saw childbirth pains as another hurdle to be overcome during childrearing. Women relied exclusively on nonpharmacologic ways to relieve pain for centuries. These included hydrotherapy techniques, patterned breathing and visualization. Anesthesia wasn’t used as a pain reliever during childbirth until the 1850s. The term anesthesia, back then, was applied to any type or amount of drugs that could cause unconsciousness. A new type of pain-relief became popular in the U.S. only around 1920.
Twilight Sleep is a type of pain management that uses a medication to ease pain during childbirth and also erases the memory. Twilight Sleep is created by combining two drugs: Scopolamine (a neurotransmitter-acting medication) and Morphine (a narcotic). Women were attracted to the idea of “painless” births, but the decision to have one was not without its consequences. Women were more likely to experience extreme behavioral effects, including thrashing and banging against walls, as well as clawing and screaming at staff and themselves. Due to these behaviors, women were restrained in their beds with their wrists or ankles, to avoid harming them, the staff, or their child. Twilight Sleep also had effects on unborn babies. These medications were able to cross the uterus and cause babies to have a central nervous system that was depressed.
Twilight Births popularity started to wane after Francis Carmody’s death, who was one of Twilight Births most famous supporters. She gave birth while Twilight Sleeping to her third son. Despite the fact that medical professionals attempted to deny the drug’s involvement in her death, the demand for Twilight Sleep continued to decline. Twilight Sleeps became increasingly popular after women started to remember the experiences they had during them.
The safety of pain relief has improved dramatically in recent years. Women often use pharmacologic as well as nonpharmacologic techniques to reduce pain during pregnancy. Women use a variety of techniques including hydrotherapy, relaxation methods, rhythmic respiration, etc. Women today prefer an epidural to relieve pain during childbirth. This form of anesthesia works by reducing pain in lower parts of the human body. The anesthesiologist places the catheter in the epidural area of the spinal cord, where it stays for the duration. Spinal blocks are another type of spinal anesthesia. A spinal block is another form of spinal anesthesia.
