From Twilight Sleep to Push Presents: How Birth Has Changed Through the Decades

by ParentCo. November 29, 2023

mother and baby looking at each other

Staring at my pregnant belly in the mirror, I desperately tried to ease the anxious thoughts swirling in my head. I embodied the typical mom-to-be, trying every old wives’ tale to get my baby boy to make his overdue debut. But of course, I knew there was only one way to meet him. And like many first-time mothers, I was terrified. I wanted birth to come, and yet, if he stayed in there forever, that was fine by me. The one thought, however, that did actually calm my mind was that I was not the first woman to push out a watermelon. That one little thought connected me to countless women before me. It also emboldened and encouraged me to take my place in line and witness one of the greatest gifts of life. Still, I wondered about all those women before me. I was headed to a hospital with a doctor and would experience my fair share of interventions (which saved us both, by the way). What was labor and delivery like for women before me? If only I had a time machine…

Debut of maternity clothes Deciding where to actually give birth was of little concern during this decade. Nearly all (more than 95 percent) of births took place at home with a midwife in attendance. Only the super rich gave birth in a hospital with a doctor present. Nearly all births were unmedicated. A bit of trivia: Maternity clothes debuted in 1904 by dressmaker Miss Lena Bryant. In an era of corsets, the Lane Bryant clothing company paved the way for women feeling comfortable as their bellies expanded to hold that watermelon. These aren’t the stretch leggings and tunic tops we’re used to though. Dresses simply had an adjustable waist. But still…so much better.


Pain management emerges…sort of I feel confident speaking on behalf of women of the 1910s when I say this was a terrifying decade to have a baby. Not only were 90 percent of doctors practicing medicine without formal education (!!!), but they implemented Twilight Sleep – a method of pain management that has a pleasant sounding name but in reality was anything but pleasant (risky combo of morphine and a “scope” that frequently left newborns with breathing problems and new mothers with temporary amnesia).  

Parent Co. partnered with Americord because we believe in preserving the power of baby’s first connections.



The intervention-happy decade Lurk in any pregnancy and birth forum and you’re likely to stumble upon a debate about the necessity (or overuse) of birth interventions. But none of these debates on the interwebs compares to the intervention-happy doctors of the 20s. Why the obsession with interventions, like sedatives, episiotomies, and forceps? Well, one name rises to the surface: Dr. Joseph DeLee. The head of OB at Northwestern University and a highly influential voice of his time, Dr. DeLee used the first issue of the American Journal of Obstetrics and Gynecology as a platform to encourage doctors to use all the interventions available to suppress the “evils natural to labor.” I know that contractions feel like evil, but I’m not so keen on a routine Twilight Sleep-episiotomy-forceps combo. Yikes!
  Joseph DeLee
" often wondered whether nature did not intend women be used up in the process of reproduction, in a manner analogous to that of the salmon, which dies after spawning. Perhaps laceration, prolapse and all the evils are, in fact, natural to labor and in fact normal... If you adopt this view, I have no ground to stand on, but, if you believe that a woman after delivery should be as healthy, as well as anatomically perfect as she was before, and that the child should be undamaged, then you will have to agree with me that labor is pathogenic, because experience has proved such ideal results exceedingly rare." - Dr. Joseph DeLee


Rising rate of hospital births A huge departure from the stats of 1900, in the ’30s nearly all (75 percent) of births occurred in a hospital. Thanks to all those interventions and the continued use of Twilight Sleep (seriously, people?), birth injuries were on the rise. Moms had no awareness, let alone opinion, of her labor and delivery. Even though most women gave birth at home, the American Hospital Association created insurance so that hospital births were made accessible to more women. This was the birth of the Blue Cross Association. The monthly premium? Fifty cents.


Making childbirth easier – for the doctors More and more women delivered in hospitals, but interventions were still a bit on the scary side. Sure, women had pain-free births thanks to chloroform and opium, but they were also subject to procedures that made birth easier for the doctors. Think: shackles, pubic shaving, and routine enemas. Mamas-to-be still had to endure birth without any support from her partner.
  Maternity dummy "Miss Chase" designed and made by midwife instructor Jule Graves (1949)
State Archives of Florida


Back to birth as a natural phenomenon Learning about birth prior to the 50s made me thank my lucky stars I wasn’t a laboring mom in the first half of the 20th century. But the 50s planted the seed of what we see in labor and delivery rooms today. Dr. Ferdinand Lamaze and Dr. Robert Bradley made their mark by re-introducing the naturalness of birth. A bit of trivia: If you’ve ever laid in a doctor’s office staring at the ceiling and praying to hear that “thump thump thump” on the Doppler, you can thank Dr. Edward H. Hon, who invited the machine in 1958.


Burn the bra and whatnot The feminist movement of the 60s also spread to the delivery room, where women reclaimed control of their bodies and their births. Birth classes empowered women to partake in decisions and pain management options. Fathers were allowed into the delivery rooms for the first time.
  Men jump for joy at being allowed in the delivery room


Dawn of the epidural The decade of the epidural. Finally, a pain management option that didn’t involve morphine or opium! During this time, many mothers started looking back in time for birth advice, creating a “new” movement for home births once again. Sometimes it’s best to get back to basics.


1980s Birthing centers: midway between home and hospitals A woman had choices (finally). She could plan her pregnancy and childbirth as she saw fit. As birthing centers rose in popularity, hospitals and home births remained viable options. A bit of trivia: Medicaid was altered to give more women coverage for prenatal care.


Boom in OB technology While mothers still continued to have a voice in the delivery room, advances in technology to monitor the health of the baby continued to explode into OB offices. Amniocentesis became a viable option to check for genetic abnormalities, and fetal ultrasounds became part of standard care.


Boutique pregnancies C-section births continue to rise – particularly elective C-sections scheduled at the convenience of both doctors and patients alike. Nearly one in three births are a C-section during the first decade of the 21st century. Boutique ultrasound studios offered parents the opportunity to “peek” at their baby before birth, thus creating an entire party genre: the Gender Reveal.


Present Women aren’t merely voicing their opinions; we tote fully dictate birth plans to the hospital or birthing center. Ruth Castillo, a doula and Lamaze Certified Childbirth Educator from Salty Mama recognizes the incredible movement towards birth as a family event: “It’s amazing that the medical side of birth is starting to soften to include the entire family in the event. Partners can be present to support birthing moms through vaginal and cesarean births in so many cool ways.” This is the decade in which women research birth and medical practices and are incredibly informed on every step of the way. Birth is seen as a natural process that women celebrate. Hello, push presents! Postpartum care has also revolutionized with incredible attention to healing moms both physically and emotionally after birth. This decade also marks one of the greatest scientific advances in labor and delivery. We are not only saving lives during L&D today, but we are also saving lives tomorrow thanks to the hematopoietic stem cells (HSCs) stored during the cord blood banking process. Even moms can get a taste of the lifesaving power of the placenta with the option to bank placenta tissue. The HSCs extracted during both of these processes can morph into the blood cells and cellular blood components in our bodies (white blood cells, red blood cells, platelets, etc.). Cord blood and placenta tissue cells can be used to treat 80 diseases in you, your child, or your blood relatives. One thing is for sure: the old tools of the trade are getting a makeover, and the sky is the limit. Our time machine brings us back to the current decade, and we are left with a map of what birth looked like over the past 117 years. It seems only natural to question what comes next? The first half of the 20th century focused on intervention and (scary) pain management tactics with male doctors calling all the shots, while the latter half gave women their voice back and dads a front row seat. The future: a perfect fusion of helpful and lifesaving technology blended with the voice of motherhood.


Parent Co. partnered with Americord because we believe in preserving the power of baby’s first connections.


Additional sources:

The History of Midwifery and Childbirth in America: A Time Line via Midwifery Today

Medical Education in the United States and Canada via Carnegie Foundation



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