The statistical case for elimination of the midwife: fact versus prejudice, 1890-1935 (Part I).

The medical literature from 1890 to 1935 that examines the "midwife problem" in the United States is reviewed to evaluate the arguments of that period urging elimination of midwifery in the United States. Although many midwives at first delivered poor care, this was the result of efforts to deny them education and supervision. Due to physicians' poor training and philosophy of interference in birth, lay midwives delivered care as safe or safer than the average physician. Trained midwives delivered superb medical care and gave birthing women personal attention that physicians were too rushed to provide. It is suggested that the elimination of midwifery in the United States slowed the decline in infant and maternal mortality.