As Loretta Lynn sang it, we've come a long way, baby. And when we're talking about the delivery room, this statement is especially true. Giving birth has come changed A LOT over the years (and it hasn't always been pretty), but there are a few areas we can't wait to see improved. According to the World Health Organization, while maternal mortality rates dropped 50 percent between 1990 and 2014, 800 women still die every day from preventable causes related to pregnancy and childbirth. Let's hope this look through history will remind us how far we've come, but also how far we still have to go.
Birth in the Middle Ages
Births in the middle ages were assisted exclusively by midwives, since men generally considered it uncouth to set foot in the delivery room. Of course this included the doctors, since they were men. Needless to say, male doctors also wrote all the guidelines of the time on labor and delivery—despite not performing live births themselves. Talk about taking mansplaining to a whole new level!
Birth in the 16th Century
The best-selling midwifery handbook of the time, Rose Garden for Pregnant Women and Midwives, comes out in 1513 and is republished in multiple languages, offering advice on such things as removing a stillborn ("shove a dough made of dung, cow bile, and 25 herbs into the vagina"). Sitting on a birthing stool—basically a horseshoe-shaped wood chair without a seat—is advised for delivery. And pain killers? Forget it. According to the book Get Me Out, by Randi Hutter Epstein, Scottish woman Eufame Maclayne was burned at the stake in 1597 when she asked for pain relief from delivering twins. Yikes.
Birth in the 17th Century
Three to five women shared a bed at the famous Paris hospital Hotel Dieu. This means that "if a woman died in childbirth, the other ones waited hours or even overnight for the orderly to cart the corpse away," Epstein writes in Get Me Out.
Birth in the 18th Century
Doctors become involved in deliveries in the 18th century, and, according to a study published in the American Society for Clinical Nutrition, puerperal (also called childbed) fever was to blame for more than 40 percent of deaths during childbirth, making it the most frequent maternal mortality cause.
Forceps were also introduced in the mid-1700s. Before forceps, according to Get Me Out, when a baby was stuck in the birth canal, doctors would sometimes break the mother's pubic bone, resulting in her death, but not the baby's, or midwives might break the baby's skull, killing the child and sparing the mother. Awful.
Birth in the 19th Century
The "twilight sleep" method, where women were given the sometimes-fatal combo of morphine and scopolamine, is introduced in Europe in the late 1800s (making its way to America about 20 years later). According to the University of Minnesota, the drugs made it difficult to push (hello, forceps!) and babies often required resuscitation. Vacuum extraction is first used late in the century.
Birth in the 20th Century
Most American births are performed at home in the early 1900s. Commonplace practices at this time include shaving pubic hair (the predecessor to the pre-birth Brazilian?), enemas and bichloride of mercury douches. New moms are also separated from their babies to prevent infection. Forceps are touted by Joseph Bolivar DeLee, a top American obstetrician, in the '20s, who wrote that all patients should be anesthetized, babies should be delivered with forceps and the placenta should be removed using a "shoehorn maneuver," according to a study in the American Journal of Clinical Nutrition. Many deaths followed.
By the 1930s, half of births take place in hospitals, according to Childbirth in America and mortality rates start to see a steep decline. In the '50s, serious drugs are used during childbirth, including Thorazine, nitrous oxide, Demerol and Benzedrine. The "saddle block", a spinal anesthesia that made it difficult to push, is introduced. Ninety-five percent of births are now performed in hospitals and episiotomies are the norm. By the '60s, Lamaze and natural childbirth begin to become a movement, and, in the '70s, with 99 percent of births taking place in a hospital (where epidurals become prevalent), dads are more common in the delivery room.
Roughly one-third of births are performed via C-section, with the rate of delivery growing by 60 percent between 1996 and 2009, The New York Times reports, reaching a high of 32.9 percent of all births in 2009. (It was 20.7 percent in 1996, according to the Centers for Disease Control and Prevention (CDC), and, in 2011, the rate dropped back down to 31 percent.) "The climb that began in the mid-1990s was driven in part by an increase in the number of pregnant women who were scheduling the procedures before 39 weeks of gestation, even when they were not medically necessary," The Times wrote.
Another popular trend today is the home birth. Although home births only account for about 1 percent of births in the U.S., the number is growing. According to the CDC, planned home births were up 7 percent between 2011 and 2012 alone. Looks like the old way is becoming the new way.
Birth in the Future
According to the World Health Organization, most maternal deaths can be prevented. What will help drop death rates even more? "All women need access to antenatal care in pregnancy, skilled care during childbirth, and care and support in the weeks after childbirth," the group reports. "It is particularly important that all births are attended by skilled health professionals, as timely management and treatment can make the difference between life and death. The WHO also points to the prevention of unwanted and too-early pregnancies, the availability of health care in remote or poor areas and quality care for all income levels.