Midwifery has been around for hundreds of years, as women would assist other women in childbirth. According to Midwifery Today, New York City first required the licensing of midwives in 1716. Doctors were not usually formally educated, so midwives were utilized for childbirth due to a greater knowledge base.

Formal training first began in 1765; however, many midwives felt that childbirth was the domain of women and they were reluctant to receive training from male instructors. Also, many women were not literate which made formal education near impossible.

Beginning in the early 1800s, middle-class families started using doctors for childbirth. As anesthesia became more widely used towards the end of the 1800s and early 1900s, delivery began shifting to hospitals. By 1900, physicians were attending about half of the nation's births. Midwives were only used for those who could not afford a doctor. During the economic boom in the early 1920s, upper and middle-class women preferred doctors, instead of the "lower class" midwives.

By the 1950s, eighty-eight percent of births occurred in hospitals, increasing to ninety-seven percent in the 1960s. However, during this time formal education for nurse midwives and the concept of family-centered maternity care was introduced in the field of obstetrics.

A resurgence in midwifery sprung up in the 1970s along with the women's movement. Feminists maintained that childbirth is natural, and hospitalization and supervision by a physician are not required.

By the mid-1980s, regulations were introduced by the American Medical Association to prohibit midwives from practicing without physician supervision and were finalized by the mid-1990s.

Today, nurse midwives are highly educated, specialized professionals who work alongside obstetricians to provide holistic women's health and maternity care.

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Amanda Bucceri Androus, RN, BSN

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