In 2004, Shu-Shya Heh, Lindsey Coombes, and Helen Bartlett studied the association between Chinese postpartum (post-childbirth) practices and postpartum depression in Taiwanese women. The researchers surveyed Taiwanese women about the social support they received after giving birth and then evaluated the depression rates in the same women. Heh and her colleagues focused on the month following childbirth, which according to traditional Chinese medicine, is an important period that warrants a set of specialized practices to aid the woman's recovery. Collectively called zuoyuezi (doing the month), the postpartum practices require the help of someone else, typically the woman's mother or mother-in-law, to complete. Heh and her colleagues found that generally, Taiwanese women with more social support displayed fewer postpartum depressive symptoms, and concluded that the practice of doing the month helped prevent postpartum depression in Taiwanese women.

A Treatise on the Theory and Practice of Midwifery is a three volume collection of patient accounts that William Smellie published from 1752 to 1764. Smellie, a physician and instructor in obstetrics in Great Britain, published these compilations to share his expertise in reproductive medicine, while also providing his students and colleagues with a source of reference in their own medical practices. Smellie wrote these books to shift obstetrics from a discipline practiced by midwives with limited medical training to one practiced in a medical context by physicians. Throughout his books, Smellie describes effective and ineffective treatments, tools, and interventions for complications during pregnancy. Due to the popularity of Smellie's writings, access to Smellie's work expanded beyond his students, allowing obstetricians, man-midwives, and physicians to refer to scientific literature and apply Smellie's teachings to their own practice.

Starting in 1929, the Royal College of Obstetricians and Gynaecologists was a professional association of physicians in the UK that aimed to improve the care of women in childbirth through training and education and to establish obstetrics and gynecology as a medical specialty. The Royal College of Obstetricians and Gynaecologists has contributed to women’s reproductive health by fostering research, establishing standards for physicians specializing in obstetrics and gynecology, and influencing legislation.

Leonard Colebrook was a physician who researched bacteria and infections in England during the twentieth century. In 1936, Colebrook deployed the antibiotic Prontosil to treat puerperal fever, a disorder that results from bacterial infections in the uterine tracts of women after childbirth or abortions. Colebrook also advanced care for burn patients by advocating for the creation of burn units in hospitals and by using antisepsis medication for burn wound infections. Colebrook’s work on treatments for puerperal fever reduced cases of puerperal fever throughout the world.

An intrauterine pressure catheter (IUPC) is a device placed inside a pregnant woman’s uterus to monitor uterine contractions during labor. During labor, a woman’s uterus contracts to dilate, or open, the cervix and push the fetus into the birth canal. The catheter measures the pressure within the amniotic space during contractions and allows physicians to evaluate the strength, frequency, and duration of contractions. Those measurements enable physicians to evaluate the progression of labor and intervene when contractions are too weak to properly dilate a laboring woman’s cervix to successfully deliver a fetus. Though IUPCs are not used routinely, they are important in cases where external fetal monitoring is not sufficient to monitor a difficult labor. Intrauterine pressure catheters give physicians an extremely accurate measurement of intrauterine pressure, making it possible to determine whether intervention is needed to progress the labor.

In 1992, five maternal-infant health researchers founded Doulas of North America, later renamed DONA International to train certified birth attendants called doulas to provide care to pregnant women both before and after the birthing process. Annie Kennedy, John Kennell, Marshall Klaus, Phyllis Klaus, and Penny Simkin used the term doula, derived from the Greek word for woman servant, to describe a female birthing aide who provides non-medical emotional and physical support to laboring pregnant women. Eventually renamed DONA International, the organization has certified over 12,000 doulas as of 2017. Though the organization aims to provide a doula to everyone who wants one, there have been controversies surrounding the accessibility, affordability, and necessity of pregnant women using a doula before and after birth. DONA International is the largest doula-certifying program in the world and has created global awareness of the risks and benefits associated with using a doula during the birthing process.

Twilight Sleep (Dammerschlaf) was a form of childbirth first used in the early twentieth century in Germany in which drugs caused women in labor to enter a state of sleep prior to giving birth and awake from childbirth with no recollection of the procedure. Prior to the early twentieth century, childbirth was performed at home and women did not have anesthetics to alleviate the pain of childbirth. In 1906, obstetricians Bernhardt Kronig and Karl Gauss developed the twilight sleep method in 1906 to relieve the pain of childbirth using a combination of the drugs scopolamine and morphine. Twilight sleep contributed to changing childbirth from an at home process to a hospital procedure and increased the use of anesthetics in obstetrics.

Ina May Gaskin is a certified professional midwife, or CPM, in the US during the late twentieth and early twenty-first centuries. She worked at the Farm Midwifery Center in Summertown, Tennessee, a center well known for its low rates of intervention, which contributed to low rates of maternal and fetal mortality. One technique Gaskin used when assisting women with delivery helped resolve a complication called shoulder dystocia, which is when a part of the infant’s body is delivered, but the rest of the body is stuck in the birth canal. Her work served as an example for midwives and obstetricians, physicians who specialize in a woman’s reproductive system, childbirth, and pregnancy, to use a low-intervention approach without medication or a cesarean section. Through her work in developing different birthing techniques, Gaskin provided women with alternative ways to deliver infants without the need for hospitals, medication, or surgical intervention, even in the case of complicated births.

During the mid-twentieth century, Virginia Apgar worked as an obstetrical anesthesiologist and gave drugs to women that reduced their pain during childbirth in the US. In 1953, Apgar created a scoring system, called the Apgar score, that uses five measurements, including heart rate and breathing rate. The Apgar score evaluates newborn infants and determines who needs immediate medical attention. Apgar's work helped decrease infant mortality rates. As of 2020, hospitals around the world use the Apgar score.

Subscribe to Childbirth