INFOGRAPHIC: History of Childbirth in the United States

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INFOGRAPHIC History of Childbirth in the US [ssbp]

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The experience of childbirth is dramatically different than a century ago – and much has changed even in the last 50 years. The location for deliveries shifted from the home to hospital maternity wards with pain medications available, and more recently to birthing centers. Starting in the 1970s, expectant women began seeking more control and a more natural childbirth and some of the accepted modern practices began being reexamined. Midwives (nurse midwives) and breastfeeding made a comeback and new technology was introduced to monitor the health of the mother and child.

Early 1900s: Childbirth at home was still quite common in rural and remote areas in the early 20th century. Two-thirds of women gave birth at home with no painkillers and attended by family doctors.

1920:   An article in the first issue of the American Journal of Obstetrics and Gynecology outlined a series of medical interventions to save women from the “evils” common to childbirth. Dr. Joseph DeLee, author of a widely used textbook on obstetric care, proposed that specialist doctors should sedate women at the start of labor, allow the cervix to dilate, provide ether during the second stage of labor, perform an episiotomy and use forceps to extract the baby.  Medical intervention by doctors during childbirth became the trend and the rate of hospital births began to increase.

1936: Dr. Gertrude S. Nielsen of Norman Oklahoma, a child specialist, questioned the use of painkilling concoctions such as gas and twilight sleep during childbirth during debate at an American Medical Association convention, according to a Time magazine article. Dr. Nielsen said the pain of childbirth had been exaggerated and that going through delivery in an unconscious state deprived a woman of the experience of giving birth. She urged prenatal education to reduce fear of the unknown.

1930: A year into the Great Depression, 2.6 million babies are born in the United States. The most popular baby names of 1930 are those perennial favorites, Mary and John.

1945: The first babies who would come to be known as members of the baby boom generation are born. The post World War II surge in the birth rate continues through 1964.

1952: The number of infants born in hospitals continues to increase in Oklahoma and across the U.S. In Oklahoma, 87 percent of babies born in Oklahoma are delivered by physicians in hospitals in 1952 compared to only 40 percent in 1940 – 12 years earlier.

1952: The idea that pregnancy and childbearing are a normal process is promoted by the Midwifery Section of the National Organization for Public Health Nursing.

1956:  La Leche League is founded to promote breastfeeding as an important part of the healthy development of the baby. At the time, the prevailing pediatric practice is to give baby’s formula and only about one of five new mothers breastfed their baby.

1959: The publication of Thank You, Dr. Lamaze, an engaging bestseller written by Marjorie Karmel about giving birth in France using techniques pioneered by Dr. Fernand Lamaze including relaxation, breathing and emotional support from the father, popularized the Lamaze Method and inspired many women to approach childbirth as an event for both mother and father to share. It is part of a movement toward natural childbirth.

1960s: Ninety-seven percent of deliveries occur in hospitals.

1965:  The childbirth bookshelf gains another important book. Publication of Husband-Coached Childbirth by Robert A. Bradley, M.D., introduces the Bradley Method of natural childbirth to a wider audience, encouraging a focus on diet and exercise throughout pregnancy and the use of patterned deep breathing techniques and the support of a partner as a coach during labor. Expectant dads are invited into the delivery room.

1970s: Trained nurse midwives start to reappear at bedsides during deliveries as part of the renewed interest in more natural childbirth.

1972: Rates of breastfeeding increase about 3 percent a year through the decade of the 1970s.

1980s: Electronic fetal monitors become more widely used, allowing doctors to detect changes in the heart rate of the fetus during labor and delivery that may signal distress.

1995: Breast feeding rates increase to approximately 60 percent.

2009: The portion of expectant mothers in the U.S. who have cesarean sections, including elective cesarean sections, peaks at 32.9 percent. Four years later, the American College of Obstetricians and Gynecologists warns against the overuse of unnecessary elective cesarean procedures without a strong medical reason.

2014: The general fertility rate in the U.S. increases for the first time since the Recession, suggesting a post recession baby bounce. For every 1000 women of childbearing age, 62.9 babies are born. More than 53,000 babies are born in Oklahoma.

2015: Today, nearly 99 percent of babies born in the U.S. are delivered in hospitals.  Obstetricians delivered about 86 percent of these babies. Certified nurse midwives attended about 8 percent of births and doctors of osteopathy attended 6 percent of deliveries.