You were probably born in a hospital. Exceptional around 1900, when the vast majority of women gave birth at home, within three generations institutional deliveries were the norm in most industrialized countries. The sharpest growth in hospital births occurred after World War II, as pronatalist western governments expanded health-care spending during reconstruction, but in some places the shift was already well under way. The United States, where the proportion of women delivering their babies in hospital leapt from 37 per cent in 1935 to almost 79 per cent in 1945, is only the best-known case. Although resource-rich nations led the way, the trend was not confined to the west. The Soviet Union claimed, like the United States, that by the late 1960s practically all births were in hospitals.
Visible by the last third of the twentieth century even in low-income countries, the ‘relocation of birth to the hospital’ was first defined as a historical phenomenon in the western world, especially in the United States and Britain. New technologies for monitoring the fetus and intervening in labour, together with the mid-century decline in maternal mortality, sustained obstetric specialists’ claims that hospitals were the only appropriate place to give birth. But by around 1970, among wider critiques of medical authority, women and their partners in both countries were systematically questioning hospital-based, high-technology obstetrics. Emboldened by the second-wave feminist call for women to control their own bodies, activists campaigned against professional paternalism and for greater choice in maternity care. During the so-called birth wars of the mid-1970s and early 1980s, some rejected hospital obstetrics altogether.
History and the Birth Wars
The same movement that pushed women's health, including maternity care, to the centre of the political stage in the United States and Britain also transformed understandings of the history of childbirth. In the 1960s, obstetricians’ accounts of hospitalized birth as the triumphant end-point of a story of medical and technological progress that began with the forceps went largely unchallenged. Then second-wave histories reinterpreted the postwar trend towards near-universal hospital birth as the takeover by male medicine of a traditionally women's affair. In this view, the first lying-in institutions founded in the eighteenth century were instruments for diminishing female autonomy, of a piece with the maternity hospitals that many of these authors and their readers encountered first-hand.