Thursday, August 29, 2019

Childbirth in Colonial America

by Elaine Marie Cooper

In a recent conversation with my very pregnant daughter-in-law, we discussed childbirth practices, from the time I gave birth to my son—her husband—to the current trends. Back when I had my babies, hospital births were the norm and mostly male physicians delivered babies. 
Today, my daughter-in-law sees a doctor regularly but will have a midwife assisted birth in the hospital. If any complications occur, a doctor is just a step away.

While most childbirths throughout history have involved midwife assistance, the last centuries of doctor-assised birthings may leave many with misunderstandings about the history of giving birth. In summation, midwives have delivered most of earth’s inhabitants throughout the millenia. 
In fact, the introduction of male-assisted birth practitioners in the late 18thcentury was quite shocking to many.
         In 1998, I was thrilled to visit the Smithsonian Institution in Washington, D.C. While I have forgotten many of the historical displays, one definitely stands out in my memory. It was a poster depicting a “Man Midwife.” 
The title alone was enough to intrigue me, especially since I was a registered nurse, then working in a mother/baby unit at a local hospital. The display at the Smithsonian highlighted the debate going on in the late 1700s concerning male physicians undertaking the business of delivering babies. I believe I remember the phrase “Half Man, Half Midwife: Man Midwife.” 

This picture shows a person of two parts— half physician with his tools of the trade, including forceps and medications; the other half, a female midwife with her arms outstretched in motherly care. The symbolism of interfering medical practitioner vs. comforting, female arms was loud and clear. But the image was also prompted by the disapproval of many who were offended by males becoming involved in such intimate medical care of women.
  A letter addressed to “All men in general and to all married men in particular,” was written in 1764 by Philip Thicknesse. His words expressed his outrage at the growing practice:

“Let it be remembered that my motive is thereby to put a stop to impure acts, immodest actions, and the indelicate, unchaste, and unnecessary transactions of Men Midwives, such as they avowedly and publicly profess and such that every man of sense, decency, sentiment, and spirit must and will disapprove, or be totally indifferent as to his wife’s conduct or his own honor.”

             Considering the history of childbirth, it is not surprising that only female midwives were considered the acceptable assistants in the birthing process. 
Since earliest recorded childbirths in the Bible, midwives were called upon to assist in a birth. And ever since Bridget Lee Fuller delivered the first Colonial babies on board the Mayflower in 1620, midwives had established themselves as the ones to call upon when labor began in the New World. For the next 200 years, midwifery reigned.
 Midwives did not go to school to learn the craft—the skill was taught by other women. There was no formal training in the early colonies until 1765 when an institute for training was offered in Philadelphia. But many could not afford such schooling and most still apprenticed under more experienced trainers. Many midwives were widows who delivered babies as a way to make a living.

  When a pregnant woman knew that birth was imminent, she “called her women together” for the event. Friends, relatives, the midwife—whoever a woman wanted to attend her and speak words of comfort to her—became a part of the birthing scene. It was definitely a female affair, although occasionally, husbands were needed to assist.
  Childbirth in Early America was especially difficult. One in eight births resulted in the death of the mother, usually as a result of exhaustion, dehydration, infection, or excessive bleeding. Women often looked toward impending childbirth with dread, one referring to it as “the greatest of earthly miseries.” 

  A midwife with great skills was highly valued. A diary kept by a late 18thcentury midwife from Maine named Martha Ballard describes the difficult life that she faced—fording rivers in winter, spending hours and days tending to laboring patients, and occasionally, preparing a deceased patient for burial. But Martha’s record was a successful one for the times: Out of 996 deliveries, there were only four fatalities.
  Highly devoted to her profession, Martha continued delivering infants in her community until just before her death in 1812 at the age of 77.
  But long before Martha Ballard passed away, the tide was beginning to turn.
  By the late 1700s, doctors in England had begun to play a greater role in childbirths. They, in turn, influenced American doctors who trained across the ocean and then brought these ideas home. The practice of physician-assisted childbirth became popular in the urban areas of Philadelphia, Boston, and New York. These man-midwives brought with them medications and forceps. While the forceps could be helpful during difficult deliveries—perhaps saving many infants and mothers who would otherwise have died—the physicians tended to interfere more in a delivery rather than allowing the child to be born at a natural pace like the midwives.
  By 1790, midwifery was losing ground to the doctor-assisted delivery. But midwives continued to reign in many areas as the main caregivers of laboring women.            
Today the art of midwife-assisted deliveries is on the rise. Approximately 9% of American babies slip into the world with the help of a midwife. There are currently over 12,000 Certified Nurse Midwives in the United States.
 The shift towards the middle ground, with many certified midwives assisting births and physicians available in case of emergency, makes it seem like the perfect time for my daughter-in-law to give birth.   
(Update on my daughter-in-law: She gave birth on August 17 to Endeavor James Cooper, 8 lbs. 13 oz. Endeavor "Indy" was born on my son's birthday—his daddy! Brianna had a midwife assisted delivery.) 

Elaine Marie Cooper is the author of several historical novels including War’s Respite(Prequel novella) and Love’s KindlingLove’s Kindling is available in both e-book and paperback. They are the first two books in the Dawn of America Series set in Revolutionary War Connecticut. Cooper is the award-winning author of Fields of the Fatherless and Bethany’s Calendar. Her 2016 release (Saratoga Letters) was finalist in Historical Romance in both the Selah Awards and Next Generation Indie Book Awards. She penned the three-book Deer Run Saga and has been published in numerous magazines and anthologies. You can visit her website/ blog at



  1. Congratulations, Elaine on your grandson, Endeavor!
    I enjoyed your post on midwives. As a retired RN, I am always interested in the nursing and medical practices of the early 1700-1800's.
    Blessings, Tina

    1. Hi Tina! Thank you so much! Endeavor is a delight and growing fast. I share your enthusiasm for the old medical practices. Some were quite clever and some, downright frightening! Thanks so much for stopping by!

  2. Congratulations on the birth of your grandson Endeavor James Cooper, Elaine. I like the name. I know he's loved by all of you and his adorable sister Jubilee.
    This was a very interesting post about midwives and childbirth in Colonial America. Blessings to you and yours.

    1. Hi Marilyn, thank you so much! We are so blessed by both Jubilee and Endeavor! What a joy they are. :) So happy you enjoyed the post. It is amazing to me to see all the transitions in childbirth practices through the years. Some things change and some do not. Blessings back to you as well!

  3. How interesting that male doctors were considered interlopers! In the 50's through the 70's I bet it was a different story. I had a male doctor for both of my hospital deliveries. I wasn't opposed to women, I just didn't come from a family where you did anything but go to the local obstetrician. Thanks for the post, and congrats on that new grandbaby!

    1. Thank you, Connie! I was astonished at the scandal created by male physicians delivering babies when I studied about this! Like you, I assumed male doctors were the automatic choice because, at the time, that was the situation. I'm glad there are choices for moms now. At such a time as delivering a baby, comfort is very important! Thanks so much for leaving a comment!!

  4. I know you are excited about this new grandchild--congratulations. thanks for the interesting post.

    1. Hi Kay! Yes, I am quite excited about our new grandson! He is a joy and surrounded by love in both families. Praise God for the blessing of little ones! Thanks for commenting. :)