“The Living Mother of a Living Child”: Midwifery and Mortality in Post-Revolutionary New England

Abstract

ORTY-ONE years ago, Richard Harrison Shryock could summarize the history of early American midwifery in a few sentences. history of obstetrics and of pediatrics, he wrote, affords other illustrations of the way in which inadequate medical science affected the public health. Maternity cases were left, in English-speaking lands, almost entirely to midwives.... And since midwives lacked any scientific training, obstetrics proceeded on the level of folk practice, and with consequences which may be easily imagined.1 The consequences could be imagined because few persons in I 948 doubted the superiority of medical science over folk practice. The advent of natural childbirth, culminating in recent years in the revival of lay midwifery, has changed historical judgments as well as obstetrics. In revisionist histories of childbirth, the pleasant story of scientific progress has been replaced by a darker tale of medical competitiveness and misplaced confidence in an imperfect science. Medical science did not on the whole increase women's chances of surviving childbirth until well into the twentieth century, the new histories argue, and may actually have increased the dangers. As Richard W. and Dorothy C. Wertz explain, puerperal fever, the dreaded infection that killed so many women in the nineteenth century, is probably the classic example of iatrogenic disease-that is, disease caused by medical treatment itself.2