Birth then and now

My grandmothers, each of whom had seven surviving offspring, never discussed labour and never mentioned the pain of birth. This was not a heroic cover-up; their experiences of giving birth, at the beginning of the 20th century, involved chloroform and they had hazy recollections and confused memories of what had happened during their labours and births. The other experience that contributed to women's reticence about their experiences of labour and birth was the high rate of fetal and infant mortality in those times. There were great wells of sadness about the infants who did not survive, even among families who had barely enough to 'keep the wolf from the door'.Halfway through the 20th century, views on pain in labour encompassed almost everything from women's self-blame to blaming nurses, midwives, doctors or partners for 'bad experiences'. Soon after that, giving birth came to be seen – in some settings and by some caregivers – as a 'natural' and thus benign event which women could 'master' or be trained to master. The shift of emphasis at that time included equally strong statements and beliefs about women's 'natural' capacity to give birth, including giving birth without pain. Formal preparation for birth began to be developed as the way of managing or coping with labour and birth in a variety of settings. There was a great diversity of methods and approaches, with some involving an active role for women's partners. Those providing direct care to women in labour, mostly the midwives and nurses, sometimes had a difficult time dealing with the concerns of labouring women, fathers, obstetricians, junior hospital staff, student midwives and student doctors.Preparation and training for childbirth seemed to come into its own close to the time when the expansion of interventions in labour and birth was taking off. This made it increasingly likely that conflict between women themselves and those looking after women before or during labour would be exacerbated. The disa