Lying-In: A History of Childbirth in America / Edition 1

by Richard W. Wertz, Dorothy C. Wertz

Overview

This lively history of childbirth begins with colonial days, when childbirth was a social event, and moves on to the gradual medicalization of childbirth in America as doctors forced midwives out of business and to the home-birth movement of the 1980’s. Widely praised when it was first published in 1977, the book has now been expanded to bring the story up to date. In a new chapter and epilogue, Richard and Dorothy Wertz discuss the recent focus on delivering perfect babies, with its emphasis on technology, prenatal testing, and Caesarean sections. They argue that there are many viable alternatives—including out-of-hospital births—in the search for the best birthing system.
Review of the first edition:
“Highly readable, extensively documented, and well illustrated…A welcome addition to American social history and women’s studies. It can also be read with profit by health planners, hospital administrators, ‘consumers’ of health care, and all those who are concerned with improving the circumstances associated with childbirth.”—Claire Elizabeth Fox, bulletin of the History of Medicine
“A fascinating, brilliantly documented history not merely of childbirth, but of men’s attitudes towards women, the effect of a burgeoning medical profession on our very conception of maternity and motherhood, and the influence of religion on medical technology and science.”—Thomas J. Cottle, Boston Globe
“This superb book…is both an impeccably documented recitation of the chronological history of medical intervention in American childbirth and a sociological analysis of the various meanings given to childbirth by individuals, interested groups, and American society as a whole.”—Barbara Howe, American Journal of Sociology
Richard W. Wertz, a builder in Westport, Massachusetts, is formerly an associate professor of American history at the Massachusetts Institute of Technology.
Dorothy C. Wertz, is a research professor at the School of Public Health, Boston University

Product Details

ISBN-13:	9780300040876
Publisher:	Yale University Press
Publication date:	09/10/1989
Edition description:	Expanded Edition
Pages:	302
Product dimensions:	6.12(w) x 9.25(h) x (d)

Read an Excerpt

Introduction

(to the Expanded Edition)

In 1977, when the first edition of this book appeared, the history of birth as a social event was largely uncharted territory. Medical historians still treated the subject as the story of the development of instruments and techniques or of the lives and achievements of eminent physicians. Social historians had not yet looked at birth. Lying-In broke new ground by attempting to weave the cultural, social, and technological events surrounding birth into a coherent whole. It sought to explain how changes in gender roles and cultural values interacted with the medical profession as it emerged and with its technologies to transform birth from a natural into a technological event.

During the years since 1977, both the history and the sociology of birth have won academic attention and respect. Dissertations and articles continually appear. The social study of contemporary birth has become much more thorough and has even developed subspecialties: prenatal care, postnatal care, nurse-midwifery, lay midwifery, woman physicians, breastfeeding, wet-nursing, obstetrical anesthesia, natural childbirth, neonatal intensive care, and even the economic value of children. The study of the history of birth has found considerable new primary material and has detailed the history of midwives, female physicians, and lying-in hospitals. Two full-fledged social histories of birth, Judith Walzer Leavitt, Brought to Bed: Childbearing in America, 1750-1950, and Ann Oakley, The Captured Womb: A History of the Medical Care of Pregnant Women, about birth in England, havebeen published since Lying-In. We believe that these social and historical studies have substantiated and elaborated on the basic theories of our book and have confirmed the value of the multidisciplinary approach that Lying-In established.

In recent years, "women's agency" has become a key phrase in women's history, and the concept has been applied to birthing women of all social classes, including those in almshouses and charity hospitals. According to this theory, women have always had an active say, frequently the final word, in the conduct of their births and have organized communities around birth. Women's agency is a theoretical framework that corrects the earlier overemphasis on the victimization of women by men and men's institutions, including the male-dominated medicine. Because nineteenth-century medicine frequently had cruel outcomes, early students of women's history tended to see women as the passive victims of male physicians. Later historians of women came to see, however, that the truth was more complex. Lying-In did not regard women merely as passive victims. Without referring to women's agency, it showed how active a part individual women, together with their families and friends, have had in determining their birthing practices and treatments. But we did not and still do not see evidence of active communities of women working to reform birth practices during the nineteenth century.

Some of the more sociological interpretations, notably those of Ann Oakley, have taken our work further by examining the effects of birth events on women's self-esteem and their relationships with their children. Oakley and other authors have placed birth in the context of women's changing roles and have evaluated the long-term importance of birth experiences in women's lives. Most recent writers have agreed that birth must be judged in social as well as medical terms and that women must be the final judges of what constitutes success in birth.

It seemed useful to offer Lying-In once more. Since its publication it has become a classic. More refined works have appeared on particular aspects of birth, but none has looked at the whole panorama from colonial times to the present. There is also a need for general studies that go beyond the confines of academic disciplines to examine critically the larger picture — that is, to make reasoned value judgements that will inform individuals and provide a basis for concerted action and public policy.

Most of the earlier substance stands. More recent works have uncovered new data to support it, but none has challenged the basic theoretical framework of the first edition. We have described the social and technical changes of the past decade in a new chapter, "Crating the Perfect Child," examining how births have become more humane and more technological at the same time. A few of the dramatic developments, such as prenatal diagnosis, threaten to have disquieting social outcomes. In a revised concluding chapter, "Everybody's Search for the Best," we look at the marginal movements for lay midwifery and home birth that seem destined to appeal only to a small minority and yet appear to deserve study and respect. We also consider the great paradox of modern medicine: that it neglects simple preventive care in favor of heroic technical interventions. We have updated the bibliography for readers who wish to explore recent historical and social writing more fully.

Editorial Reviews

"A fascinating, brilliantly documented history not merely of childbirth, but of men's attitudes towards women, the effect of a burgeoning medical profession on our very conception of maternity and motherhood, and the influence of religion on medical technology and science."—Thomas J. Cottle, Boston Globe

"A rich and balanced look at childbirth today and in the past. Its gentle critique, of the childbirth movement is well made and applies also to the trap of planning a perfect child."—Margot Edwards, R.N., M.A., Birth Journal

"The history is written in a very entertaining manner with fascinating illustrations. . . . The book is fun reading and stimulates thought about many of the controversial issues we face with so many choices today. I highly recommend the book to anyone involved with childbirth preparation on a professional or personal basis."—Gail Bursch, Journal of Obstetric and Gynecologic Physical Therapy

"Highly readable, extensively documented, and well illustrated. . . . A welcome addition to American social history and women's studies. It can also be read with profit by health planners, hospital administrators, 'consumers' of health care, and all those who are concerned with improving the circumstances associated with childbirth."—Claire Elizabeth Fox, Bulletin of the History of Medicine

"This superb book . . . is both an impeccably documented recitation of the chronological history of medical intervention in American childbirth and a sociological analysis of the various meanings given to childbirth by individuals, interested groups, and American society as a whole."—Barbara Howe, American Journal of Sociology

"A welcome republication, with appended concluding chapters, of the first effort to explain childbirth practices in the evolving social and economic dynamics of American life since Colonial times. . . . Provocative new essays carry the theme to the present, when technology intrudes before conception. . . . The Wertzes clearly show that high-tech childbirth is in most case[s] unnecessary, and the efforts to reform childbirth have not only yielded ambiguous results for middle-class advocates of change, but also leave intact a two-class health care system that does not provide essential prenatal care. Good reading for everyone."—Choice

"A very readable history of childbirth. . . . Authors Dorothy and Richard Wertz have updated their excellent 1977 book to include the influence of the feminist health movement, overuse of Caesarians, inadequate health care for poor women, and other current topics."—Feminist Bookstore News

From the Publisher