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By the mid-twentieth century, two things appeared destined for extinction in the United States: the practice of home birth and the profession of midwifery. In 1940, close to half of all U.S. births took place in the hospital, and the trend was increasing. By 1970, the percentage of hospital births reached an all-time high of 99.4%, and the obstetrician, rather than the midwife, assumed nearly complete control over what had become an entirely medicalized
procedure. Then, seemingly out of nowhere, an explosion of new alternative organizations, publications, and conferences cropped up, documenting a very different demographic trend; by 1977, the percentage of
out-of-hospital births had more than doubled. Home birth was making a comeback, but why? The executive director of the American College of Obstetricians and Gynecologists publicly noted in 1977 the "rising tide of demand for home delivery," describing it as an "anti-intellectual-anti-science revolt." A quiet revolution spread across cities and suburbs, towns and farms, as individuals challenged legal, institutional and medical protocols by choosing unlicensed midwives to catch their babies
at home. Coming Home analyzes the ideas, values, and experiences that led to this quiet revolution and its long-term consequences for our understanding of birth, medicine, and culture.
Who were these self-proclaimed midwives and how did they learn their trade? Because the United States had virtually eliminated midwifery in most areas by the mid-twentieth century, most of them had little knowledge of or exposure to the historic practice, drawing primarily on obstetrical texts, trial and error, and sometimes instruction from aging home birth physicians to learn their craft. While their constituents were primarily drawn from the educated white middle class,
their model of care (which ultimately drew on the wisdom and practice of a more diverse, global pool of midwives) had the potential to transform birth practices for all women, both in and out of the
hospital.
By the mid-twentieth century, two things appeared destined for extinction in the United States: the practice of home birth and the profession of midwifery. In 1940, close to half of all U.S. births took place in the hospital, and the trend was increasing. By 1970, the percentage of hospital births reached an all-time high of 99.4%, and the obstetrician, rather than the midwife, assumed nearly complete control over what had become an entirely medicalized
procedure. Then, seemingly out of nowhere, an explosion of new alternative organizations, publications, and conferences cropped up, documenting a very different demographic trend; by 1977, the percentage of
out-of-hospital births had more than doubled. Home birth was making a comeback, but why? The executive director of the American College of Obstetricians and Gynecologists publicly noted in 1977 the "rising tide of demand for home delivery," describing it as an "anti-intellectual-anti-science revolt." A quiet revolution spread across cities and suburbs, towns and farms, as individuals challenged legal, institutional and medical protocols by choosing unlicensed midwives to catch their babies
at home. Coming Home analyzes the ideas, values, and experiences that led to this quiet revolution and its long-term consequences for our understanding of birth, medicine, and culture.
Who were these self-proclaimed midwives and how did they learn their trade? Because the United States had virtually eliminated midwifery in most areas by the mid-twentieth century, most of them had little knowledge of or exposure to the historic practice, drawing primarily on obstetrical texts, trial and error, and sometimes instruction from aging home birth physicians to learn their craft. While their constituents were primarily drawn from the educated white middle class,
their model of care (which ultimately drew on the wisdom and practice of a more diverse, global pool of midwives) had the potential to transform birth practices for all women, both in and out of the
hospital.
Acknowledgments
Introduction: From Hospital to Home
Ch 1. Back to Bed: From Hospital to Home Obstetrics in the City of
Chicago
Ch 2. Middle-Class Midwifery: Transforming Birth Practices in
Suburban Washington, DC
Ch 3. Psychedelic Birth: The Emergence of the Hippie Midwife
Ch 4. The Bowland Bust: Medicine and the Law in Santa Cruz,
California
Ch 5. From El Paso to Lexington: The Formation of the Midwives
Alliance of North America
Ch 6. From Professionalization to Education: The Creation of the
Seattle Midwifery School
Conclusion: There's No Place Like Home
Notes
Bibliography
Index
Wendy Kline is professor and Dema G. Seelye Chair in the History of Medicine in the Department of History at Purdue University. She is the author of Building a Better Race: Gender, Sexuality, and Eugenics from the Turn of the Century to the Baby Boom and Bodies of Knowledge: Sexuality, Reproduction, and Women's Health in the Second Wave.
"In Coming Home: How Midwives Changed Birth, Wendy Kline offers an
engaging read about an important chapter in the feminist health
movement and the history of childbirth...Coming Home is a good read
and a welcome addition to the growing literature on the American
feminist health movement and the history of childbirth." -- Paula
A. Michaels, Monash University, Bulletin of the History of
Medicine
"Kline has written an engaging history of how midwives accomplished
this feat in light of the reach and power of institutionalized
medicine. Anyone interested in learning where and how babies were
born will want to read this book...Kline's book will undoubtedly
convince readers that midwives should be at the center of
delivering these better outcomes." -- Elizabeth Reis, Journal of
the History of Medicine and Allied Sciences
"this book could (and probably should) lead to a reconsideration of
a medical practice that has altered the beginning of life in this
world ... a book that is worth the effort. It should be on
permanent display in multiple places" -- Alain Touwaide, Doody's
Reviews
"The publication of Wendy Kline's book is welcome, as it makes a
significant contribution to our understanding of how midwifery has
developed. Its major strength to me as a midwife is that it takes
me back to my roots, reminding me of the fundamentals of the
meaning of midwifery" -- Rosemary Mander, Emeritus Professor of
Midwifery, Formerly University of Edinburgh
"In her engaging and well-researched book ... Kline presents a new
and necessary chapter in the story of the medicalization of
childbirth in the United States: the history of the home birth
movement. Kline has a keen eye for entertaining anecdotes and knows
exactly when to sprinkle in intriguing biographical details ... We
get a real sense of who these midwives were, how they fit within a
broader home birth movement, and how, between the 1970s and the
present,
their practices and Americans' reception of them evolved. More than
a history of the home birth movement, Coming Home updates the
history of American childbirth and complicates a number of big
ideas in
the history of modern medicine, making it a terrific addition to
the field of women's health ... A new starting point for the
history of childbirth." -- Kelly O'Donnell, Nursing Clio
"The real critical strength of Coming Home is the author's ability
to read beyond midwives' professional gains, examining their
influence on traditional medicine, spiritual movements, psychiatry,
civil rights, and the public imagination." -- Audrey Farley,
Marginalia
"This is a magnificent and nuanced history of home birth and
midwifery over the past half century. Kline not only depicts with
great care and precision just how resistance to unnecessarily
medicalized birth developed in communities across the United
States, she traces the development of a complex social movement
that continues to have an impact on public policies that affect
birthing experiences in all settings. The personal narratives of so
many extraordinary
midwives will certainly inspire generations of younger people who
will be following in their footsteps."--Judy Norsigian and Jane
Pincus, co-authors and co-founders of Our Bodies Ourselves
"Wendy Kline provides a valuable and much-needed contribution to
the social and medical history of childbirth in America. The vivid
and moving stories of midwives and home births leap off the pages
as Kline takes us from Chicago to California to Washington, DC,
Tennessee, Texas, and Seattle. She compellingly analyzes and
explains why some women came to prefer midwife-attended home births
over physician-attended hospital deliveries. This well-written book
about
twentieth century women's home-delivery experiences is
exceptionally readable and historically meaningful and
important."--Judith Walzer Leavitt, author of Brought to Bed:
Childbearing in America,
1750-1950
"In Coming Home, Wendy Kline weaves a series of individual stories
into a compelling narrative of the home birth movement in the
United States in the past century and places into context a long
neglected chapter of American medical history."--Eugene Declercq,
Founder, Birth by the Numbers website
"The profession of midwifery was deliberately and systematically
obliterated by jealous physicians at the turn of the twentieth
century. Kline's dogged research chronicles the rebirth of our
hallowed profession in the 1970-80s."--Carol Leonard, co-founder of
the Midwives Alliance of North America
"Kline offers a rich and complicated history of direct entry
midwifery and the twentieth-century American homebirth movement ...
At the core of Kline's thesis is that in each locale where women
were called into midwifery, they collaborated with physicians.
These women saw childbirth as requiring much more than medical
technology, yet they recognized it had its place, and thus sought
out or welcomed unsolicited supportive medical advisers and
teachers." --
Jennifer Block, Midwifery Today
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