From home to hospital and back again: How modern childbirth was born

We look at how childbirth has evolved through the years.

When Prince George and Princess Charlotte’s little brother or sister arriving soon, she or he is likely to be born in St Mary’s Hospital, London, with father William looking on, before a bit of ‘skin-to-skin’ bonding with Kate.

[Read more: Call the Midwife: Where are the original cast now?]

No doubt the duchess is dusting off the birthing plan she drew up before having George and Charlotte, in which she’ll have stated her preferences on everything from the use of birthing pools and gas and air to delayed cord clamping and even what kind of music she wanted in her room.

Like everything these days, childbirth in 21st century Britain is about choice. But as we've seen on BBC One's Call The Midwife, the way we give birth now has changed quite a bit through the years.

Full circle

Over the centuries, we’ve come from women giving birth in their private bedchambers to a medicalised approach designed to limit maternal deaths and now, back to a trend for home births with just a midwife present - or in barge-dweller Jo’s case, no one.

Between 2009 and 2012, the maternal death rate in the UK was 10 in 100,000 women. In 1900s America (where this data appears more accessible), the death rate was 850 per 100,000.

In the century in between, medical advances such as monitoring babies’ heart rates and the advent of antibiotics have succeeded in saving more lives. In recent years, the use of medical interventions has increased, with more women having elective caesareans (13.2% between 2013 and 2014) and inductions (25%).

[Read more: Placenta pills - would you swallow them?]

Women only

In 1533, King Henry VIII’s second wife Anne Boleyn disappeared into her private chambers for a month with her closest female attendants, as the Science Museum’s excellent History of Medicine website reveals in its interactive section on childbirth.

No dads were allowed, but alcohol was. Women drank possett, an eggnog-like mixture of cream or milk and alcohol, to nourish and soothe the pain.

Give me drugs

By 1857, when Queen Victoria was giving birth to her ninth and last child, Princess Beatrice, chloroform had become the drug of choice. It could, however, be fatal in strong doses, so her anaesthetist, Dr John Snow kept careful check. Even so, Victoria apparently passed out.

Men were allowed to be in the room, leading the charge for a more clinical version of childbirth - Victoria’s husband Albert was so hands-on, he gave her her first two doses of chloroform.

It was also custom for mothers to share a warm spiced wine drink, caudle, with the women who’d helped them give birth, though that declined when doctors said it made mothers more prone to infection - nowadays women are advised not to drink while pregnant or breastfeeding.

By 1948, when the soon-to-be Queen Elizabeth II was in labour with Prince Charles at Buckingham Palace, laughing gas (nitrous oxide) had become the drug du jour, preceding epidurals. Penicillin meant fewer women died of infection and doctors were more willing to do caesarean-sections, which were considered risky.

[Read more: How will the royal baby's birth compare with the Queen's 89 years later?]

Intervention

Foetal monitoring began in the 1820s, as doctors used a stethoscope to listen to baby’s heart in the womb. By the 1960s, specialised monitors meant a continuous printout of baby’s vital signs was possible, but such monitoring was controversial as some argued it meant the mother was tethered to the device.

Forceps, originally a secret invention by the Chamberlen family of male midwives, had become popular and by the 1850s, with doctors modifying them to make them more comfortable.

Back to basics

In 1933, Suffolk-born obstetrician Grantly Dick-Read advocated a return to more simple methods in his first book Natural Childbirth. His ideas were ridiculed by the establishment, but his second book Childbirth Without Fear (1942) became an international bestseller.

In the US, midwives such as Ina May Gaskin were promoting similar concepts, such as birthing centres, water birth, and homebirth as alternatives to the high-tech hospital model.

Dick-Read became the first president of the charity, the National Childbirth Trust (NCT), which was set up in 1956. Ultimately, whether mothers-to-be choose to give birth in home or at hospital, the goal is still the same: for mother and baby to be safe and well.

More from BT