User:Perrone.h/new sandbox

History
The process of childbirth in Western society has evolved significantly over the years.

ROLE OF MEN
Historically, women have been attended and supported by other women during labour and birth. Midwife training in European cities began in the 1400s, but rural women were usually assisted by female family or friends. However, it was not simply a ladies' social bonding event as some historians have portrayed - fear and pain often filled the atmosphere, as death during childbirth was a common occurrence. In the United States, before the 1950s the husband would not be in the birthing room. It did not matter if it was a home birth; the husband was waiting downstairs or in another room in the home. If it was in a hospital then the husband was in the waiting room. '''Fathers were only permitted in the room if the life of the mother or baby was severely at-risk. In 1522, a German physician was sentenced to death for sneaking into a delivery room dressed as a woman.'''

'''Ironically, the majority of guidebooks related to pregnancy and childbirth were written by men who had never been involved in the birthing process. A Greek physician, Soranus of Ephesus, wrote a book about obstetrics and gynecology in the second century, which was referenced for the next thousand years. The book contained endless home remedies for pregnancy and childbirth, many of which would be considered heinous by modern women and medical professionals. '''

FROM HOME TO HOSPITAL
Historically, most women gave birth at home without emergency medical care available. '''In the early days of hospitalization of childbirth, a seventeenth century maternity ward in Paris was incredibly congested, with up to five pregnant women sharing one bed. At this hospital, one in five women died during the birthing process.''' At the onset of the Industrial Revolution, giving birth at home became more difficult due to congested living spaces and dirty living conditions. This drove urban and lower class women to newly available hospitals, while wealthy and middle-class women continued to labor at home. Consequently, wealthier women experienced poorer maternal mortality rates than those of a lower social class. Throughout the 1900s there was an increasing availability of hospitals, and more women began going into the hospital for labor and delivery. '''In the United States, 5% of women gave birth in hospitals in 1900. By 1930, 50% of all women and 75% of urban-dwelling women delivered in hospitals . By 1960, this number increased to 96%.  By the 1970s, home birth rates fell to approximately 1%'''. In the United States, the middle classes were especially receptive to the medicalization of childbirth, which promised a safer and less painful labor.

'''Accompanied by the shift from home to hospital was the shift from midwife to physician. Male physicians began to replace female midwives in Europe and the United States in the 1700s. The rise in status and popularity of this new position was accompanied by a drop in status for midwives. By the 1800s, affluent families were primarily male doctors to assist with their deliveries, and female midwives were seen as a resource for women who couldn't afford better care. This completely removed women from assisting in labor, as only men were eligible to become doctors at the time. Additionally, it privatized the birthing process as family members and friends were often banned from the delivery room. There was opposition to this change from both progressive feminists and religious conservatives. The feminists were concerned about job security for a role that had traditionally been held by women. The conservatives argued that it was immoral for a women to be exposed in such a way in front of a man. For this reason, many male obstetricians performed deliveries in dark rooms or with their patient fully covered with a drape. As one author puts it, "since the 1920's, physicians have been the unchallenged birth attendants."'''

USE OF MEDICATION
The use of pain medication in labor has been a controversial issue for hundreds of years. '''A Scottish woman was burned at the stake in 1591 for requesting pain relief in the delivery of twins. Medication did become more acceptable in 1852, when Queen Victoria used chloroform as pain relief during labor. The use of morphine and scopolamine, also known as "twilight sleep," was first used in Germany and popularized by German physicians Bernard Kronig and Karl Gauss. This concoction offered minor pain relief but mostly allowed women to completely forget the entire delivery process. Under twilight sleep, mothers were often blindfolded and restrained as they experienced the immense pain of childbirth. The cocktail came with severe side effects, such as decreased uterine contractions and altered mental state. Additionally, babies delivered with the use of childbirth drugs often experienced temporarily-ceased breathing. The feminist movement in the United States openly and actively supported the use of twilight sleep, which was introduced to the country in 1914. Some physicians, many of whom had been using painkillers for the past fifty years, including opium, cocaine, and quinine, embraced the new drug. Others were rightfully hesitant.'''

FORCEPS
In the late sixteenth century, the Chamberlen family developed obstetric forceps for safely delivering fetuses in compromised positions. '''They kept this design a family secret for two hundred years. Before forceps, babies stuck in the birth canal almost always faced imminent death - the mother's life was typically spared at the expense of the unborn child. After many generations, a Chamberlen offspring decided to go public with the design. By the 1800's, midwives and doctors began using forceps, although with strong hesitation at first. In 1908, a Harvard-graduated OB/GYN, Franklin S. Newell, publicly recommended that forceps be used for upper class women, who he considered too physically and emotionally weak to naturally deliver a baby. The use of tools and medication was highly encouraged for use in all deliveries by American physician Joseph Bolivar DeLee in the 1920s. This received major backlash from the medical community, with some claiming that Dr. DeLee's advice to use forceps when not medically necessary resulted in "many unnecessary deaths." '''

C-SECTIONS
'''While forceps have gone through periods of high popularity, today they are only used in approximately 10% of deliveries. The caesarian section (or C-section) has become the more popular solution for difficult deliveries. In 2005, one third of babies were born via C-section. Historically, surgical delivery was a last-resort method of extracting a baby from its deceased or dying mother. There are many conflicting stories of the first successful C-section in which both mom and baby survived. It is, however, known that the procedure had been attempted for hundreds of years before it became accepted in the beginning of the twentieth century.'''

NATURAL CHILDBIRTH
'''The re-emergence of "natural childbirth" began in Europe and was adopted by some in the U.S. as early as the late 1940s. Early supporters believed that the drugs used during deliveries interfered with "happy childbirth" and could negatively impact the newborn's "emotional wellbeing." By the 1970s, the call for natural childbirth was spread nationwide, in conjunction with the second-wave of the feminist movement. While it is still most common for American women to deliver in the hospital, supporters of natural birth still widely exist, especially in the UK where midwife-assisted home births have gained popularity in recent years.'''

MATERNAL MORTALITY
'''Childbirth statistics in US before 1915 were not recorded but moving forward the US has had historically poor maternal mortality rates in comparison to other developed countries. There is more reliable data on maternal mortality from Britain from 1880 onward. Outcomes for mothers in childbirth were especially poor before 1930 due to high rates of puerperal fever.  Until germ theory was accepted in the mid-1800s, it was assumed that puerperal fever was either caused by a variety of sources, including the leakage of breast milk into the body and anxiety, rather than by a pathogen that was transmitted by the dirty hands and tools of doctors. This misconception was likely responsible for the high prevalence of puerperal fever.  The home-births facilitated by trained midwives produced the best outcomes from 1880 to 1930 in the U.S. and Europe, whereas physician-facilitated hospital births produced the worst. The change in trend of maternal mortality can be attributed with the widespread use of sulfonamides, along with the progression of medical technology, more extensive physician training, and less medical interference with normal deliveries.'''