Undoubtedly, we have seen huge medical advances, with the use of antibiotics and particularly in the care of premature babies, and the prevention of premature birth. Globally the number of neonatal deaths has more than halved in the last 30 years, between 1990-2019, which is incredible-but there is still much work to be done.
Over the last 100 years, not only have we seen great change in our legislation and regulation as a Midwifery profession, but there have also been significant changes in the pattern of the care that we provide.
The advent of the NHS switched the norm for birth. Where home birth was considered the norm, nowadays over 95% of births take place in the hospital. Increased hospital rates have been supported by various Government backed reports as far back as the 1950’s, where the Cranbrook Report (1956) recommended 70% hospital birth, and the Peel Report (1970) recommended 100% hospital birth!
The 1960’s and 70’s saw a huge rise in medical intervention such as the introduction of induction of labour, Syntocinon use for labour augmentation, electronic fetal monitoring as well as the use of routine episiotomies for all. The 1980’s saw the regular and routine use of ultrasound technology, not just for high-risk pregnancies, but for the majority. The number of Obstetricians that were employed within maternity services increased also, further impacting the role of the Midwife within the service, and the model of care that was being provided.
The medical model of care and the increased reliance on technology use within the maternity system, largely followed the pattern of change from the U.S, where intervention was the norm. The medical model of care treats the birthing person as something that is ‘broken’ and in need of ‘fixing’, instead of viewing birth as a normal physiological process, which is the philosophy Midwives are trained in.