Medicalization of Childbirth
In the 1700s, Barber-surgeons, predecessors of the obstetricians belonged to a low social standing, similar to that of carpenters and shoemakers, members of the arts and trade guild. In an attempt to create social mobility and improve social status, barber-surgeons saw the opportunity to expand their expertise and redefined the perception of their skill as life saving, a higher moral order. Soon, barber-surgeons gained a competitive edge over midwives to practise at difficult home-deliveries, through manual non-medical-instrumental extraction of fetus from the birthing woman (Dundes, 1987). Contrary to lay belief that fetal life began only at the point of “quickening” when expectant woman felt fetal movement (20 weeks), Obstetricians utilized their bio-scientific knowledge from the expertise of the microscope to claim that the start of perinatal life begins from the point of conception (Costello, 2006). This Interprofessional rivalry sparked resistance from the displaced midwives. However, English midwives succeeded in certifying midwifery practice through the 1902 Midwifery act (Costello, 2006). This was an important step in establishing midwives not as physician-rivals, but as para-medical subordinates. In the same year, 1902, the Journal of Obstetrics and Gynecology of the British Empire was published (Drife, 2002). Early physician Mosher observed inverse relationship of declining birthrate and increasing abortion rate. He hypothesized that women opted for “criminal abortion” to avoid childbirth pain. This sparked widespread attention from society to reduce the disincentives of childbirth. Hence, obstetricians made claims to be able to alleviate childbirth pain, creating a market for obstetrics. In 1900s, only 15% of deliveries were in hospitals (Jones, 1994), after the ministry of health expanded maternal hospital facilities, hospital deliveries sored from 60% in 1925, to 70% in 1935 and 98% in 1950 (Loudon, 1988).
This sharp increase also