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  • Catching Babies: The Professionalization of Childbirth, 1870–1920
  • Janet Golden
Charlotte G. Borst. Catching Babies: The Professionalization of Childbirth, 1870–1920. Cambridge: Harvard University Press, 1995. xi + 254 pp. Ill. $39.95.

Charlotte Borst’s Catching Babies is a beautifully written account of the transition from midwife- to physician-attended births during the years 1870 to 1920. While she focuses on four counties in Wisconsin, her findings clearly suggest how gender, culture, ethnicity, and medical professionalization shaped birthing practices in much of the United States. The book’s blend of quantitative analysis, case studies, and a thoughtfully nuanced interpretation of the meaning of professionalism and specialization is a model for medical historians who seek to combine qualitative and quantitative methods.

In the opening chapters Borst presents the midwife and the conditions shaping her practice. Most were married mothers seeking not a professional career, but a means of supplementing the family income. Most confined their practices to their neighborhoods; in rural areas with low population densities, this meant that they delivered, on average, six or fewer babies a year. Urban midwives attended an average of twenty-four or more births annually, but, like their rural counterparts, they confined their work to a narrow geographic area. Borst argues that despite a high level of formal preparation—most midwives had received specialized training in European or American midwifery schools—they did not (and because of structural and cultural limitations could not) become professionals. Instead, she argues, they are best compared to entrepreneurs who opened shops and started services within immigrant enclaves, rather than to trained nurses or physicians.

In the second part of the book Borst details the rise of physician-attended births. First, general practitioners made their way to the bedsides of patients with whom they shared ethnic and geographic ties. Thus, the Norwegian-born Dr. Olson of Trempealeau County supervised maternity cases among Norwegian immigrants, while Dr. Wasielewski, the son of Polish immigrants, had an active maternity practice in the Polish community in Milwaukee. In addition to cultural [End Page 174] bonds with their patients, physicians drew on their growing status as community leaders and as scientifically trained experts to find a place in the birthing room. By the 1920s, however, general practitioners such as Olson and Wasielewski were ceding ground to obstetrical specialists, who delivered American-born patients in hospitals, rather than in their homes.

Blending medical history, women’s history, immigration history, and demography, Catching Babies illuminates how and why childbirth attendants changed from midwives to physicians in the late nineteenth and early twentieth centuries. Borst establishes that the demise of midwives and the rise of physician-assisted births did not depend just on the professionalization of medicine and the growth of medical science, but was shaped by the characteristics of midwives, patients, and communities. The book deepens our understanding of these communities and the practitioners serving them, offering a glimpse into the worlds of both rural and urban medicine during a crucial period in their transformation. It belongs on the bookshelf of all historians of medicine.

Janet Golden
Rutgers University, Camden
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