| This is a study of the expansion and professionalization of nurse-midwifery in America during the middle decades of the twentieth century. Initial expansion occurred in response to decreasing numbers of traditional African American and immigrant midwives, increasing availability of health insurance, and the post war baby boom, all of which combined to create an increased demand for obstetric care providers. This expansion prompted nurse midwives to organize nationally, first as a separate section in the National Organization for Public Health Nursing and then, by 1955, in their own organization— the American College of Nurse-Midwifery.; Major social transformation occurred during the two decades beginning in the mid 1950's in response to demands for civil rights, women's liberation, and control over childbirth. Using historical methods, this study examines nurse midwifery's transition toward autonomous practice within the context of power, gender, and class relations in mid twentieth century America. Nurse-midwives responded to provider shortages and demands for women's involvement in birth and for family-centered birth environments by establishing clinical services and educational programs in major medical centers across the country. They also joined physicians in private practices; established their own practices; and set up maternity centers and free standing birth centers specifically for the practice of nurse-midwifery.; Between 1940 and 1980 nurse-midwifery expanded from two small practices, one in New York City and the other in Hyden, Kentucky, to an established clinical profession with nineteen educational programs; practices in cities and towns throughout the United States; nationally recognized accreditation and certification programs; and approval for payment under Medicare, Medicaid, and many private insurance companies. Understanding this expansion, and decisions made during this period, furthers knowledge of the role of nurse-midwifery in today's troubled health care system.; Primary source material for this study came from National Library of Medicine, American College of Nurse-Midwives collections, the Rockefeller Foundation Archives, the Medical Mission Sisters Historical Archives, the stored archival material of Maternity Center Association, the historical archives of the Center for the Study of the History of Nursing, and the personal collections of nurse midwives interviewed during the course of this research. |
