At the beginning of the twentieth century most babies were born at home. My grandmother gave birth to seven children safely at home. By the time I entered nursing school most births in the United States took place in the hospital. The use of twilight sleep to deliver babies with forceps was just beginning to fade.
In the thirty-seven years since becoming a nurse I have seen incredible change take place in childbirth care. The rate of medically induced labor has increased exponentially. The rate of cesarean section has risen dramatically. The use of technology has expanded, and the cost of giving birth has increased. And yet the United States is ranked 29th among nations for infant mortality. The maternal mortality rate is the highest it has been in decades.
How do we explain the status of maternity care in the United States? I have been wrestling with this question while writing my story about a nurse. My novel, Aliisa’s Letter, will be released in 2010.
