History of Midwifery in the Commonwealth of Virginia

The focus of this paper is to document the changes the midwife has undertaken since 1900 in the Commonwealth of Virginia. While these changes can be taken as part of national trends (Antiabortion, anti-immigrant, anti-African-American, and increased availability of medical doctors) the research is confined to Virginia due to the recent decriminalization of midwifery law.

Since the turn of the century the medical community has continued to gain control over private practices. Midwives became unnecessary simply because the filled a role that was being claimed by physicians. The medical community, especially specialists in obstetrics and gynecology, had much to gain from removing the completion.

Midwife as the Scapegoat

Instead of addressing larger social problems in society governments, physicians, and special interest groups all mounted campaigns against midwives. This was a national trend focused on demanding conformity to gender roles, which require heterosexual marriage, women to bear children, and men to support the family (Reagan 1997). Doing away with them all together would have not have met the States or physicians needs. They needed a target to focus social ills on, plus people simply did not have access to doctors in a lot of areas. The state decided to educate the midwives until they could be done away with (Craven 2005). The "education" was based on the assumption that the midwives were uneducated, which may or may not have been the case. Had the state had any interest in women's health or desires they would have set up a testing program and supported midwives who could perform deliveries.

The States role in all of this was simply intervention in sexual and family matters (Reagan 1997). Authority over pregnancy is what concerned the medical community to raise the specialty status for obstetrics and gynecology (Reagan 1997). The midwife was rolled into a large collection of social fears: female sexuality, premarital sex, and abortion. Combined the State and doctors make it seem that doing away with midwives will solve these problems. Now midwives answer to the state and must meet regulations. The state being able to dismiss those they deemed unfit to be midwives. This control would continue to tighten until a complete ban in 1977.

The Nail in the Coffin

"What was demanded as a "right" for the privileged came to be interpreted as a "duty" for the poor" (Davis 1981). The poor had no choice whether or not they used a midwife no matter how restricted it became. It just became harder for them to find the care they needed. In the 1950s it became mandatory to see a doctor who decided if you could have a midwife delivery (Craven 2005). Physicians are not only usurpers, but they also decide if a midwife in even acceptable. The medical community has displaced their completion and now decide if midwives can even deliver. This is a wonderful system for doctors, but completely unfair to the consumer. The switch from midwives to physicians is all in marketing: safer, less painful labor through the use of forceps, drugs, and anesthesia (Dye 1980). There was no actual fact based research to see who could deliver babies the safest and most effective. This is a continuing trend in women's work, simply assuming that it is flawed or imperfect without actually doing empirical work.

All these restrictions finally came to a head in 1974 when, by law, only Certified Nurse-Midwives (CNMs) could get a permit to practice (Craven 2005). Direct-Entry Midwives (DEMs), who train directly as midwives and specialize in out-of-hospital birth could no longer practice in Virginia (Craven 2005b). Putting all debate to a close in 1977, you can deliver at home if you want, but it is illegal for that person to receive compensation. Any DEM is operating illegally if they deliver a child and are accept payment. Homebirth options have become very limited in most areas.

Birthing on the Down Low

Supply and demand is greater than any law. Women in Virginia wanted to give birth outside of hospitals and sought out midwives. While CNMs were still available they could only legally operate in a hospital under the supervision of a doctor. Enforcing the law was difficult unless the child died because the parents were usually in full support of the midwife (Craven 2005). This did not stop the state from charging midwives with defying the law and practicing without a license.

Several bills passed through the state only to be struck down. In 2003, after 26 years, HB 1961 struck down the 1977 law (Craven 2005). While DEMs are still considered to be practicing without a license. This law led the way to recognizing Certified Professional Midwives (CPM) (Craven 2005). The bill provides that the CPM can act independent from physicians (Craven 2005).

Within one century it we have completely turned around. Midwives were marginalized and so were women's rights. The two connected so easily that restricting and eliminating midwives smothered the authority women have in regards to birth and maternal care. In addition to stigmatizing a profession so old as midwifery by offering something labeled as better. Using the authority of science to promote an increase in specialization in the medical industry. Continuing today with pregnancy as a medical problem and not as a conditional which is natural for women. Women need to be able to regulate their own bodies personally and inside the industry of childbirth or there will be no objectivity to judge physicians by.

References

Craven, Christa. 2005. "EDUCATED, ELIMINATED, CRIMINALIZED & REDISCOVERED: A HISTORY OF MIDWIVES IN VIRGINIA." Retrieved May 1, 2005.

( http://www.midwivespac.org/historyofmidwifery.pdf)

Craven, Christa. 2005b. "Is Reproductive Rights Healthcare Access a "Consumer Rights" Issue?" Anthropology News, January 2005. Retrieved May 1, 2005.

(http://www.aaanet.org/press/an/0501craven.htm)

Davis, Angela Y. 1981. Women, Race and Class. New York, NY: Random House.

Dye, Nancy Schrom. "History of Childbirth in America." Journal of Women in Culture and Society, 6:1. Retrieved May 1, 2005 Available: JSTOR The Scholarly Journal Archive.

Reagan, Leslie J. When Abortion Was a Crime: Women, Medicine, and law in the United States, 1867-1973. Berkley, CA: University of California Press.