Midwifery has existed for around 4,000 years, starting out as a community based, female‑led role and evolving over the centuries into the highly trained, regulated profession it has become today.
Research shows there are approximately 27 million midwives globally, each playing a crucial role in improving maternal and newborn wellbeing, offering sensitive care and ensuring healthcare access for all.
History of Midwifery
In ancient Egypt, in around 1900 BC, midwives were highly respected figures in society, as documented in historic texts such as the Ebers Papyrus and illustrated in temple paintings that depicted their central role during birth.
Similarly, in ancient Greece and Rome, midwives combined practical care with emerging medical knowledge. Some were skilled enough to be considered physicians in their own right, earning both respect and a good living. One notable example from the 4th century BC, a renowned Greek midwife and physician named Phanostratê was honoured with a statue in Athens, which is now housed in the National Archaeological Museum of Athens.
Considered spiritual guides across many cultures, two Hebrew midwives, Shiphrah and Puah, are noted in the Biblical book of Exodus as defying Pharaoh's orders to kill baby boys during birth, fighting oppression as they safely delivered newborns.
Medieval and Renaissance Periods
Midwifery continued to be a home centred, community profession during the Middle Ages, carried out by women who also cared for the sick. However, growing suspicion of female healers led to accusations of witchcraft in the 14th century. This dark period in history continued both across Europe and in the US until the 17th century, resulting in persecution and the execution of many female healers.
However, during the 17th century, attitudes across Europe began to change. Many midwives in England, Germany, Holland and France completed a training period of two to four years as apprentice to a medical practitioner. They learned how to read and write and improved their knowledge by studying the small amount of scientific literature available at the time.
The Renaissance period heralded new scientific interest after Greek and Roman midwifery documents were unearthed. Scientific works such as Soranus of Ephesus’s On Midwifery and the Diseases of Women became medical references, with early books formalising midwives’ knowledge, paving the way for greater professionalism. Soranus’ groundbreaking book recognised the podalic version of childbirth, describing safe delivery of the baby feet first, and detailed using an obstetric chair (also known as a birthing chair), which was of a specialised design aimed at supporting a woman during childbirth.
Formal Training and Regulation
The 18th and 19th centuries marked a significant turning point, especially in Western Europe, when formal midwifery schools and state licensing systems first emerged, led by Dutch initiatives in Amsterdam. In many European nations, the legal requirement to be licensed came into effect during this period.
Advancements in medical science and a growing understanding of infection control drastically transformed midwifery practices. The introduction of antiseptic methods, sterilised instruments and hospital births reduced maternal and infant mortality rates significantly. During the 17th century, the rate of babies that died at childbirth was high. Around 25% of all infants didn’t survive to see their first birthday, and one in 80 pregnant women (1.25%) died from complications related to the birth.
In the past, although midwives had achieved better outcomes than unregulated care, a lack of knowledge about hygiene had often led to tragedies. As the medical profession’s understanding of asepsis improved, midwives gradually shifted from traditional home birth settings to sterile environments.
Modern Training and Professionalism
Today, midwifery often requires a university degree, clinical placements and adherence to stringent regulatory standards. Midwives comply with national and international regulatory frameworks, such as the International Confederation of Midwives, which is an organisation that ensures they meet competency standards in pre-natal, intrapartum, postpartum and newborn care. This evolution represents a full-circle, from knowledge handed down orally and through apprenticeships to highly standardised professional training. Modern midwives combine wisdom and experience with a foundation in evidence based medical science.
The use of personal protective equipment has become essential in contemporary midwifery, helping to protect mothers, babies and caregivers from infections. PPE such as disposable gloves is essential to ensure the safety of both care provider and patient. Generally speaking, vinyl gloves are a cost-effective option for low-risk healthcare settings, providing a smooth, comfortable feel.
With superior puncture resistance and barrier protection against contaminants, nitrile gloves are preferred when durability and chemical resistance are required. They don’t contain any latex, which makes them ideal for individuals who have allergies or sensitive skin. Like nitrile, latex gloves offer superior barrier protection, although their use may be limited by allergy concerns. Employing proper PPE and hygienic protocols reduces the risk of transmitting infections during examinations and delivery, reinforcing both maternal and neonatal wellbeing.
Continuity of Care Midwifery
An increasingly promoted standard; continuity of care midwifery involves the same midwife, or small team, supporting a woman throughout her prenatal visits, labour, birth and postpartum period. This fosters trust, improves satisfaction and is instrumental in achieving better maternal and neonatal outcomes. Today’s midwives follow this philosophy while incorporating more sophisticated clinical skills and safety practices throughout their patient’s journey.
The 21st century has witnessed a resurgence in midwifery, driven by a growing preference for personalised birth experiences and a dislike of unnecessary medical interventions. Looking to the future, it remains firmly rooted in its core mission: empowering women throughout pregnancy, childbirth and beyond. The ancient profession will continue to serve as a cornerstone of maternal and newborn health worldwide.
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