Baby, How Times Have Changed: A Look at Childbirth Through the Ages

Dr. Randi Hutter Epstein, Photo by Nina Berman

Humans have been mystified by pregnancy and the birth process since Cain first peeped his head out of Eve’s womb. In our desire to perfect the way in which the next generation is brought into the world, we’ve scrutinized both childbirth and the women going through it.

In her new book, “Get Me Out: A History of Childbirth From the Garden of Eden to the Sperm Bank,” Dr. Randi Hutter Epstein, a medical journalist, explores the myths, medical advancements and intrusions of everyone from family members to male midwives in the birthing process. Delving deep into the annals of history, she writes about the practical and not-so-practical ways that women have attempted to have healthy babies — everything from eating rabbit’s testicles (the secret to having a boy in the Middle Ages) to the insistence of feminists that women be placed under twilight sedation during labor at the turn of the last century.

Epstein offers a practical history of birth and the ways in which societal norms have shaped the process over the years.

Jewish Journal: What gave you the idea for the book?

Randi Hutter Epstein: As a doctor, journalist and mother of four, I’ve always had this interest in childbirth. When I started to investigate, I saw that the history was just fascinating. I’ve also always had this interest in what I call the great dawn of medicine. What doctors tell you to do is often based on hunches and common sense, but what’s common sense today wasn’t common sense years ago. I focused on childbirth for another reason — the patients are healthy and it sets up more tension between doctors and patients. Lastly, I’m just fascinated by the science of sperm and egg.

JJ:There’s still so much that we don’t understand. Did you learn anything new about what causes pregnancy to actually happen in the first place?

RHE: We figure that the sperm that is the fastest and swims the straightest has to be the one that gets to the egg first. I spoke to a scientist who does sperm research, and he said that some of these loser-looking sperm that are swimming around crooked or slower or going around in circles might be the winners, because they might be the ones sniffing out where the egg is.

JJ: What was the most interesting thing you learned about childbirth or the history of childbirth?

RHE: When I started doing the book, I thought things are so different today. Those of us who [have gone] through pregnancy in the last 10 to 20 years [were] just bombarded with advice, and a lot of times [it was] conflicting advice. But I was surprised at all the pregnancy advice books that were written way back when. Women have always been bombarded with advice, and we’ve always tried to figure out which advice we should listen to, which we shouldn’t — whether it was: Do we have a midwife or a man? Do we use forceps or not? And of course today, all these questions about which tests we need.

JJ: In the book, you discuss the way that the man-midwife became popular several hundred years ago. Yet men considered it akin to adultery, and it sounds like it was no picnic for women [the vagina was required to be covered by a sheet for decorum, so the physician could not see what he was doing]. How and why did the man-midwife take off?

RHE: From my research, when forceps came about, that was considered high-tech. Men were doctors and male midwives had the forceps, and there was a feeling that, gosh, maybe we should go that high-tech route. That, combined with the fact that in the late 1800s, obstetrics as a specialty in medicine started to professionalize and [they] wanted to increase their status.
I think that also male midwives felt smarter than [female] midwives. Even though they might never have seen a baby born, the feeling was: Why would you want to be delivered by this grandmother in your village, even if the grandmother had tons of experience?

JJ: In discussing feminism’s influence on childbirth over the years, one of the things you said was that a push for twilight sleep [at the turn of the 20th century] was ironic coming from feminists. Do you think that there is a feminist way to give birth in the modern day?

RHE: I think that the feminist way to give birth today is to be very informed, which of course is more difficult now because there are so many tests and so much to know. I would say that the feminist way to give birth is to inform yourself and be able to have an educated conversation with your doctor.
We are also so judgmental about the way other women give birth that there are women who feel badly if they choose to go for the epidural. Know what’s going on, and then once you’re informed, if you feel that you want the epidural, fine. And if you feel you want to go natural childbirth, that’s fine.

JJ: With documentaries like ‘The Business of Being Born,’ do you think that the arguments about C-sections are just another way of rebelling against the authority of doctors?

RHE: I think that these are repeats of what we’ve done in the ’70s. ‘The Business of Being Born’ was very pro-natural childbirth, and I think it’s so easy in anything where there is a gray area — whether it’s medicine or politics or whatever — to take one side of view. Natural childbirth is not for everyone. And not everyone needs a C-section.

JJ: What is the future of childbirth?

RHE: It’s so hard to predict. I think that [with] everything that comes along, we’re all shocked. IVF was shocking. Doctors come up with these ideas and we think they’re obscene, and then everyone does them. But I think people are going to laugh at what we’re doing now. People will say: That’s the way you chose embryos, that’s the way you choose sperm? Women were smoking in the ’50s, until that was considered unhealthy. Who knows what we’re doing now?