Most midwives practicing in US cities between 1906 and 1924 were recent immigrants.
education from Europe and some were educated in this country. There was great variation in training and skill of individual .
midwives. Standards of care were varied and many attended births outside of what was considered a midwife's scope.
of practice. Even with concerns with regard to clean technique and training, studies showed that "however bad the midwife, .
on the whole, a patient was better off in her hands than in the care of many of the physicians who compete with her" (Rooks p.27).
Data in 1912, showed that more cases of opthalmia neonatorum and puerperal septicemia could be traced to physicians.
The Children's Bureau studied maternity care in rural areas, including the practices of rural, granny midwives.
A study in rural Mississippi, between 1916-1918, found most midwives were black and 90% could not read .Many were.
found to lack the basic knowledge deemed necessary for competent care. However these studies also showed that most .
of the midwives were eager to learn . Some government supported midwifery training programs were developed.
During the 1920's the federal government enacted the Sheppard-Towner Maternity and Infancy Protection Act. .
This act provided money to help each state development its own maternal and child health services. Some states used.
this money to train and supervise midwives. Eleven thousand midwives were enrolled in federally funded midwifery.
classes in 14 states in 1927. Twenty nine states provided instruction or educational supervision of midwives in 1929.
The AMA opposed the Sheppard -Towner act and congress allowed it to expire in 1929.
More states enacted laws to regulate midwifery, and by 1930 , all but 10 states required midwives to register.
Most state laws included requirements that midwives conform to public health practices and refer complicated cases to .