Category Archives: pregnancy

In Vitro Fertilization: From Science Fiction to Reality to History

It was not that long ago that “test tube babies” only existed in science fiction. I remember my shock when, in 2007, one of my students at Wellesley College told me that she was an IVF (in vitro fertilization) baby. “The technology couldn’t be that old, could it?” I thought. In The Pursuit of Parenthood: Reproductive Technology from Test-Tube Babies to Uterus Transplants, historian Margaret Marsh and OBGYN Wanda Ronner demonstrate that IVF — in which an ovum or ova are removed via surgery from a woman’s ovaries, fertilized with sperm in a petri dish, and the resulting embryo or embryos are reimplanted in her uterus — has long since come of age, and deserves historical analysis. The sisterly duo present a lively, panoramic history of IVF and its associated reproductive technologies and social arrangements…

read the rest at Nursing Clio

Journey Into Mothering with Historian Sarah Knott

In Mother Is a Verb, Sarah Knott takes her reader on a historian’s journey into motherhood. It is a sort of train travelogue, riding along parallel rails: personal memoir and wide-ranging social history.

Book jacket cover for Mother is a Verb). (©Amazon)

The path of the narrative is dictated by the chronology of the memoir, starting with choosing to try for a pregnancy, and progressing through her first child’s toddlerhood and the birth of her second child…

Read the rest at Nursing Clio

This is Not a Culture of Life, This is a Culture of Un-Death

Last week at a Vatican conference on abortion, Pope Francis “argued that children who were not expected to live long after birth deserved to be treated in the womb ‘with extraordinary pharmacological, surgical and other interventions.’” He intimated that parents who did not use extraordinary measures were not caring for their children, saying that “Taking care of these children helps parents to grieve and not only think of it as a loss, but as a step on a path taken together.”

In other words, according to the Pope, a mother who chooses to care for her dying child by sheltering him in the safety and comfort of her womb, without medical intervention, is an uncaring, bad mother…

read the rest at Nursing Clio

Coming Home: How Midwives Changed Birth (review)

It’s a rare academic history book that tempts me to binge-read.  Wendy Kline’s Coming Home: How Midwives Changed Birth is one of those special finds.

Cover for 

Coming Home

Admittedly, Kline writes about a topic I find inherently fascinating: the re-emergence of home birth in the United States in the latter decades of the twentieth century and early decades of the twenty-first.  Kline’s approach is typical of nuanced, heavily-researched academic history in many ways, with topical chapters that provide novel analysis and contribute to the larger literature in the history of reproduction, health care, and women’s rights.  Its special appeal comes from its clear and well-organized writing style that allows the narrative to flow and the arguments to seamlessly emerge, combined with Kline’s evident empathy and affection for the midwives, physicians, and birthing women whose history she locates in a fantastic trove of privately-held documents, institutional archives, and oral histories.

Over the course of the late nineteenth and early twentieth centuries, midwifery nearly disappeared from the American scene, and hospitals became the normative place to give birth.  Middle-class women chose physicians to attend their births, and midwives came under regulatory scrutiny.  While many midwives who served urban immigrants at the turn of the century had been formally trained in Europe, in the United States they were regarded dismissively by physicians’ organizations.  “Granny” midwives continued to serve poor rural African-Americans in the south, under heavily-circumscribed licensure, but they were regarded as a backstop for women too poor to hire a doctor.  Midwives and home births looked like they would become relics of the past.

As Kline shows, though, some the seeds of midwifery’s rebirth were already planted, in some unexpected places, in the decades when birth was gradually moving to the hospital.  Home birth survived in Chicago, provided by the Chicago Maternity Center, founded as the Maxwell Street Dispensary by famed obstetrician Joseph DeLee in 1895.  DeLee is known for his outsized role in moving birth from home to hospital, and yet, because he saw home births as an ideal way to train young doctors, he supervised a robust operation that trained physicians in the skills to attend poor women in their homes.  Some of those physicians would become advocates and mentors for home birth midwives in the 1970s. 

Home birth received another boost from La Leche League, a breastfeeding support group founded in a Chicago suburb in the late 1950s.  La Leche League’s founders were Catholic women who valued large families and saw childbearing and rearing as women’s primary purpose.  Just as they wanted to experience immersive motherhood via breastfeeding, many also regarded natural childbirth as central feminine experience.  This often meant delivering at home, and thus, home birth skills were preserved in the middle-class Chicago suburbs in addition to the inner-city neighborhoods served by the Chicago Maternity Center.

In the late 1960s and early 1970s, a swirl of social changes combined with widespread dissatisfaction with the alienating procedures of typical hospital births provided fertile soil for the emergence of home birth practitioners in many locations simultaneously.  Kline specifically examines the Washington, D.C. area, where childbirth educators led a white, middle-class home birth movement that was largely funneled through the Georgetown University nurse-midwifery training program, as well as the wild and wooly California hippie homebirth scene.  By the time Kline addresses the most iconic of homebirth advocates, Ina May Gaskin, and the anti-war school bus Caravan travels during which Gaskin and her fellow travelers taught themselves midwifery from a manual for third-world rural midwives and the hands-on experience of their own births, it is clear that the homebirth movement was much bigger than just its most colorful figures.  Kline includes mystical, psychedelic births in teepees and school buses, but she situates them in the counterculture’s broader critique of mainstream society and medical culture, in a sensitive and nuanced reading of that counterculture and its place in a larger reaction to dehumanizing medical practice.

Later chapters address homebirth midwifery’s struggles with legal recognition and the challenges of developing a structure for a profession full of practitioners wary of routinization.  A chapter on a sting operation carried out on the Santa Cruz Birth Center in 1974, pitting legal and medical authorities against a successful and popular unlicensed midwifery practice, contains one of the biggest archival treats of the book: material from the diary of Kate Bowland, the midwife at the center of the case.  Kline’s reading of the diary is an insightful peek into the thoughts of a central actor at a moment when midwives’ attempts to weave together their best practices, their spiritual insights, and physician backup broke down under legal pressure.   It is also a powerful homage to historian Laurel Thatcher Ulrich’s iconic close reading of early-nineteenth-century midwife Martha Ballard’s diary in A Midwife’s Tale.  Midwives gain insight and authority from tracing and understanding their lineage; so do feminist historians of birth.

In the late 1970s home birth midwives came together to create their own professional organization, the Midwives Association of North America (MANA), while a group of practitioners in Seattle organized one of the first schools for non-nurse midwives in the United States.  As home birth midwifery developed its institutions, at each step, organizers worked to construct a set of shared commitments, knowledge, practices, and institutional arrangements that they believed would best serve their goal of facilitating safe and meaningful births.  Kline gives her reader a sympathetic picture of earnest and idealistic organizers working through inevitable contention to create organizational structures that would recognize and respect the range of legitimate birth practices its practitioners had developed, while reassuring regulators and birthing families that they were offering high-quality services.

We academics sometimes are tempted to talk over our sources, anxious that without explicit interpretation at every moment, our readers won’t take our point.  Kline knows how to get out of her sources’ way and let them tell their own stories, when she brings them into the narrative.  She uses her oral histories judiciously, with the kind of finesse that lets them shine.

Coming Home is an important book for anyone who cares about the history and future of birth in the United States.  Whether or not we would consider a home birth for ourselves, it is inspiring to understand how home birth midwives sought to improve the experience of birth, dedicated themselves to offering care their clients valued, and worked to create organizational structures to be able to offer consistent, safe, legally-sanctioned care to birthing families across the United States.

Washington Post op-ed: What Michelle Obama’s Miscarriage Teaches Us About Modern Pregnancy

“In her new book, “Becoming,” Michelle Obama reveals that she miscarried her first pregnancy, and went on to conceive her two daughters by in vitro fertilization. In an interview with ABC’s Robin Roberts, the former first lady described feeling “lost and alone” and like a failure after she miscarried. She didn’t realize that early miscarriages are very common, ending about 20 percent of confirmed pregnancies.

“Obama’s revelation underscores a striking irony. Although the past two centuries have witnessed dramatic growth in knowledge and control of reproductive processes, that wealth of knowledge has simultaneously obscured what used to be commonly understood: Many pregnancies simply do not work out.”

read the rest at the Washington Post