Birth is a deeply personal, powerful experience, but it hasn’t always been treated that way. Over the years, obstetric practices have evolved significantly thanks to better research, a deeper understanding of physiology, and a growing respect for informed choice.
Some common routines of the past are now considered outdated, or even harmful.
I like to have these in mind because it helps me to question EVERYTHING. What practices do we do now that will later be considered outdated? 🤔
If you’re pregnant or planning a birth, here’s a look at some past birth practices that have (thankfully) been left behind:
1. Routine Episiotomies for Everyone
Once considered necessary to prevent tearing and speed delivery, episiotomies (a surgical cut to the perineum) were once routinely performed. Today, we know that many natural tears heal better than surgical incisions and that routine episiotomies can cause more pain, infection, and complications. Now, they’re used only when medically necessary.
2. Twilight Sleep (Scopolamine and Morphine)
This 20th-century practice sedated women into a dreamlike or amnesic state during labour, with little memory of the birth. It often left women disoriented, restrained, and unable to push effectively, leading to more forceps deliveries. We now recognize the importance of maternal autonomy, clear thinking, and informed consent in childbirth.
3. Shaving the Pubic Area
It used to be standard to shave a labouring woman’s pubic hair, with the idea it reduced infection during delivery. Research has since shown no real benefit, and shaving can actually lead to skin irritation or small cuts that increase infection risk.
4. Giving Enemas Before Labour
Hospitals once administered enemas routinely to “clean out” the bowels before birth. Aside from being uncomfortable, this practice has no proven benefit for labour or birth outcomes and is now largely abandoned. Interesting fact. Your body often “clears out” your bowels right before labour!
5. Lying Flat on the Back for Pushing
The classic “hospital bed” position is more about provider convenience than optimal birth. Lying flat can actually make pushing harder and restrict blood flow as well as close your pelvis 🤯 . Today, many people are encouraged to push in upright, squatting, or side-lying positions, which can help gravity do its job.
6. Withholding Food and Drink During Labour
The old rule: “nothing by mouth” during labour. The fear was that you’d aspirate the food contents into your lungs if you needed to be put to sleep during an emergency surgery. But for most low-risk labours, small snacks or sips of water can help maintain energy levels and comfort. Many care providers now individualize these decisions based on a person’s risk and preferences.
7. Forceps Used Frequently
Forceps deliveries were once widespread, but they can come with risks like nerve damage or bruising to the baby, and tearing or trauma for the birthing person. These days, forceps are used only in specific situations, and often, vacuum assistance or cesarean delivery is considered instead. Also, not every doctor is trained to use forceps so they might try other options instead.
8. Immediate Cord Clamping
Cutting the umbilical cord immediately after birth was once routine. But now we know that delayed cord clamping (waiting 30–60 seconds or longer) allows the baby to receive more blood from the placenta, boosting iron stores and oxygen levels.
9. Separating the Baby Right After Birth
Babies used to be whisked away for weighing, exams, or a bath. Now we recognize that skin-to-skin contact immediately after birth regulates the baby’s temperature, promotes bonding, and supports early breastfeeding. Routine care can usually wait a few minutes.
10. No Support People Allowed
There was a time when birth was considered a “medical event” that didn’t allow for the presence of a partner, family member, or doula. Today, we know that continuous support during labour improves outcomes and increases satisfaction with the birth experience.
11. Scheduled Cesareans for Convenience
In the past, some cesarean births were scheduled without a strong medical reason. We now know that cesareans are major abdominal surgery and carry risks. Current guidelines emphasize that non-medically necessary cesareans should be avoided when possible.
12. No Informed Consent or Birth Planning
Not long ago, patients were rarely consulted about their options. Birth plans? Hardly. Informed consent and shared decision-making are now considered essential parts of respectful maternity care. Your birth, your body, your voice.
The Good News?
Birth is safer, more respectful, and more evidence-based than ever before. We still have work to do, but understanding the history of birth helps us advocate for better experiences today.
If you’re pregnant, planning a birth, or supporting someone who is, don’t be afraid to ask questions, discuss your options, and build a care team that supports your preferences.
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