WILTIMS #359: Modern midwifery

Today was another didactic day, so we had a session on knot tying and suturing (action shot to the right!), then we had a lecture on ovarian cancer and another on midwifery, before finally having a patient panel on being diagnosed with pelvic cancers.

Midwifery has always confused me as a modern profession. I think, like most people in the US, I first heard of midwives in history class. When I began hearing of them in the present tense it confused me must as it would if someone said they were waiting for the milkman or ordering an ice block from the iceman. To my naive mind, all of these professions had become obsolete either due to safer practices or the decline of the extremely rural environment.

But midwifery has had a resurgence. After being pervasive from ancient times up to the 1800s, the practice of the midwife was ridiculed by modern medicine as being a lay-practice and not based on science, often very true claims. But in the second half of the 20th century, midwifery made a comeback. Now with proper training, midwives make a really nice addition to the obstetrics team. Contrary to popular stereotypes, 94% of midwife-supervised births take place in hospitals, not at home. Generally midwives take low risk births where the close supervision of a full obstetrician simply isn't needed. If anything goes wrong, the patient is already in a hospital and the midwife just calls one of the on-call doctors for backup.

TIL: Ephraim McDowell, a physician in Danville, KY, performed the first successful elective laparotomy (opening the abdomen to peek around and cut out any bad stuff) in 1809. That's just insane. 1809! That's before antibiotics, before anesthesia, even before aseptic surgical technique. Our lecturer today pointed out that we've done laparotomies since ancient times. If someone was dying of a giant tumor in the abdomen, it was really easy to see where the problem is. But until this random Kentucky surgeon, every patient every operated on in this way died.

"Midwife" is not actually a gendered word. It comes from the old English word for being "with the wife." Around 5% of midwives are actually men.