During the late 19th century, Americans’ willingness to have doctors attend childbirths gradually increased, as did doctors’ interest in doing so. As described in Chapter 11, 19th-century allopathic doctors faced substantial competition not only from each other but also from many other kinds of practitioners. As a result, doctors attempted to expand into various fields—from pulling teeth to embalm- ing the dead to assisting in childbirth. Doctors considered assisting in childbirth especially crucial because they believed that families who came to a doctor for childbirth would stay with him for other services.

As Americans’ belief in science and medicine grew during the late 19th century, medical assistance in childbirth became more socially acceptable among the upper classes. Many women supported this change because it allowed them to obtain painkillers from doctors without feeling guilty for circum- venting the biblical command to bring forth children in pain. In addition, because midwifery was not a respectable occupation for Victorian women, middle- and upper-class women seeking a childbirth at- tendant had only two options by the late 19th century: lower-class lay midwives or doctors of their own social class. Having a doctor attend one’s childbirth thus could both reflect and increase one’s social standing. Ironically, however, doctors probably threatened women’s health more than did midwives; although inexperienced or impatient midwives certainly could endanger women, doctors more often used surgical and manual interven- tions that could cause permanent injuries or deadly infections.

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