This paper argues that looking back to the early history of American nurse-midwifery (1925-1955) can help public health professionals and policy makers to understand contemporary dilemmas in maternal and child health. Based on extensive archival research and oral histories, this paper analyzes nurse-midwifery in three regions. It shows nurse-midwives' problems finding a secure place in American health care and the difficulties in adequately serving the health needs of women and children.
Several issues are especially instructive today:
1. Nurse-midwifery emerged in an attempt to combat alarmingly high maternal and infant mortality rates. The United States's persistently high infant mortality rate, as compared with the rest of the industrialized world, and its continued uneven distribution of maternal and infant health services, point to an ongoing need for nurse-midwives.
2. Public health physicians and nurses created a major structural flaw when inventing the position of the nurse-midwife. From her beginnings, the nurse-midwife was required to be both independent and dependent. This tension is at the root of problems the profession faces today.
3. Internal divisions within the profession also hampered the effectiveness of the nurse-midwife. Questions about the limits of the nurse-midwife's authority, the structure of her training, and her overall role in society prevented the maturity of this profession.
4. Nurse-midwives' emphasis on the environmental and emotional, rather than scientific, aspects of childbirth kept them out of the medical mainstream, but also gave them a special niche. This raises questions about the role nurse-midwives should continue to play in the future.
Learning Objectives: At the conclusion of the session, the participant in this session will be able to: 1. List four issues from nurse-midwifery's past that provide context for making current policy decisions. 2. Explain why nurse-midwifery developed in the United States, and why its growth in the early to mid-twentieth century was limited. 3. Ask questions raised by the study of the history of nurse-midwifery that apply to current maternal and child health issues
Keywords: History, Midwifery
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.