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.
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