opean study: Compared midwife & physician services at Vienna Lying-In Hospital Physicians & medical students had 4 times death rate as midwives Physician exams limited to non-visual Guidelines: permission from husband 1848 - Boston Female Medical College opened omidwife training oeffort to educate women in the care of women 1874 - forced to close by physician groups Late 1800's Hospitals opunitive, paternalistic control over unwed mothers onewborn must be given up for adoption oadmitted only as primip - labled "first time loser" oadmission refused to multiparous unmarried woman & patients with venereal disease Early 1900's introduction of chloroform - brought more birthing women to hospitals Medical theory was that the ovaries and uterus were the controlling organs and center of all disease in a woman's body Menstruation viewed as a chronic disease 1921 Sheappard - Towner Maternity & Infant Protection Act ogoal to improve maternity & newborn care omidwifery schools were established oopposition from AMA oAMA caused Congress - act expired 1929 1905 - President of the Oregon State Medical Society said, "Educated women could not bear children with ease because study arrested the development of the pelvis, at the same time it increased the size of the child's brain, therefore it's head" Younkgin & Davis, 1998 1915 - present midwives continued to practice oCare is holistic, women focused health oBetter perinatal outcomes oNon-interventionist, supportive approach oCare for poor and under served oFees less, affordable care Mary Breckenridge o1925 founded Frontier Nursing Service o1930 founded New York City's Maternity Center Midwifery school asso. with Columbia U. Early outcomes - 0.9 deaths/live births compared to 10.4/1000Dr. Joseph DeLee (1940's) obelieved that "all births are inherently pathogenic and should be treated as such" ostrongly opposed to midwifery oStandard practice: 1. Lithotomy position 2. Sedation from 1st stage of labor 3. Al...
