The process of giving birth becomes increasingly medicalized and pathologized, while traditional birthing practices decrease under pressure from doctors and the medical establishment. "Two reports on medical education, published in 1910 and 1912, concluded that America’s obstetricians were poorly trained. To improve obstetrics training, one report recommended hospitalization for all deliveries and the gradual abolition of midwifery. Rather than consult with midwives, the report argued, poor women should attend charity hospitals, which would serve as sites for training doctors" (Rooks, 2012).

In 1900, 50% of all births were attended by midwives. By 1915, that number will decrease to 40%, and by 1935, to only 10.7%.