The History of Birth in the U.S.: How We Moved from Home to Hospital

Why I’m Writing This

My grandmother in Brazil gave birth to seven children at home, attended by a midwife who wasn’t just a birth professional—she was family. My grandfather’s sister, a skilled midwife, supported my grandmother through each of her births, bringing with her the wisdom passed down through generations. Birth was an intimate, community-centered event, guided by trust, tradition, and deep knowledge of the body’s natural rhythms.

Yet, just one generation later, my mother had three C-sections in a hospital. The shift from home birth to highly medicalized birth happened so quickly that it makes me wonder—why?

How did we go from birth being a physiological, family-supported experience to one that is managed almost entirely by the medical system? What changed in such a short span of time that women like my mother no longer saw home birth as an option, while my grandmother knew no other way?

Today, I find myself in a unique position. I’m living in a generation of choice—one where I can navigate the balance between ancestral wisdom and the advancements of the modern world. While medical progress has undoubtedly saved lives, we must also question whether the hospitalization of birth was always necessary for every woman.

I’m writing this blog post to share the history of birth in the U.S. and how it became what it is today. My hope is that by understanding this shift, you’ll feel more empowered to make informed decisions about your own birth journey—whether that’s in a hospital, birth center, or at home.

So, let’s dive in.

Birth Before Hospitals: A Tradition of Midwifery and Home Birth

For thousands of years, birth was a natural event attended by midwives, family members, and traditional healers. Women labored and birthed in familiar surroundings, using movement, breath work, and instinctive positions to support the process. Birth was seen as a rite of passage, not a medical emergency.

The Role of Midwives in Early Birth Practices

Midwives were the primary caregivers for childbirth, passing down knowledge through apprenticeships.
Birth took place at home, with women choosing where and how they labored.
The experience was deeply personal, focused on supporting the mother and baby with minimal intervention.
Midwives provided holistic postpartum care, ensuring the mother was nourished and rested.

This was the norm for all of human history—until the late 19th and early 20th centuries, when the medical system intervened.

The Rise of Medicalized Birth: How Hospitals Took Over

Starting in the late 1800s, birth in the U.S. began shifting from home to hospitals due to several key factors:

1. The Rise of Obstetrics & Male Physicians

In the late 19th century, doctors began replacing midwives, arguing that childbirth should be managed by trained medical professionals.
Obstetrics became a male-dominated field, and midwifery was slowly discredited.
Midwives, many of whom were women of color, were pushed out of the profession due to systemic medical policies.

2. The Germ Theory & Sanitation Movement

With the rise of germ theory, hospitals promoted themselves as cleaner and safer than home births.
Women were told their homes were unhygienic, even though early hospital births had higher rates of infection due to poor sanitation.

3. The Introduction of Anesthesia & “Twilight Sleep”

In the early 1900s, chloroform and ether were introduced as pain relief options.
By the 1920s, many women were given “Twilight Sleep”, a drug that made them forget the experience of giving birth—but also left them unconscious, restrained, and without control over their bodies.
This separated women from their birth experiences and increased their reliance on hospital care.

4. Government & Institutional Influence

1921: The Sheppard-Towner Maternity and Infancy Protection Act encouraged states to promote medicalized birth over midwifery care.
By 1940, over 50% of births took place in hospitals—a dramatic shift from just decades earlier.

5. The Shift Toward C-Sections & Intervention-Based Birth

By the 1960s and 1970s, hospital birth was nearly universal, with C-section rates increasing significantly.
Routine interventions like episiotomies, forceps deliveries, inductions, and continuous monitoring became standard.
Women were placed on their backs, strapped to beds, and heavily medicated, removing their autonomy over the birth process.

Where Are We Now? The Return of Choice

Today, over 98% of births in the U.S. take place in hospitals, but many women are once again seeking alternatives. The midwifery model of care is making a comeback, with more families recognizing that:

Birth is a natural, physiological process that doesn’t always require medical intervention.
Midwives are highly trained in supporting low-risk births safely.
The hospital system, while necessary for emergencies, is not always the best environment for undisturbed, natural birth.

Next Up: Choosing Your Birth Location

Now that we’ve explored the history of birth, let’s talk about how to choose the right birth setting for you. In the next post, we’ll break down the differences between home birth, birth centers, and hospital births—so you can decide what feels best for your body, baby, and birth experience.Stay tuned!

Final Thoughts:

I hope you found this information interesting and insightful. My goal is not to advocate for one specific birth method, but rather to provide knowledge that allows you to make an informed choice. Birth is deeply personal, and you deserve to feel confident and supported in whatever path you choose.

If this topic resonates with you, or if you have questions and want to dive deeper, I’d love to hear from you! Feel free to reach out, share your thoughts, or connect with me to discuss more. Birth is a journey, and we are all here to learn and support one another.

Stay empowered, stay informed, and trust in your body’s wisdom. 💛

With Love & Gratitude -

Thays