Hill, Jennifer J. Birthing the West: Mothers and Midwives in the Rockies and Plains. Lincoln, NE: University of Nebraska Press, 2022.
“Birthing the West” is the title of Jennifer J. Hill’s study of reproduction in the American Northwest from the mid-nineteenth century to about 1940. She uses oral histories, diaries, correspondence, and state health department records in the Dakotas, Wyoming, and Montana to observe the practices of childbirth among settler women.
Most useful to contemporary scholars of reproduction is how Hill destabilizes present-day frameworks for understanding birth in order to take the process on its historical terms. What emerges after putting aside the prevailing binary of highly medicalized birth and the so-called natural-birth movement, is a depiction of birth as an ordinary, often constant part of women’s domestic work.
Hill situates birth within the labor landscape of the period. Childbirth was a domestic task, or, rather, series of tasks, that included pregnancy, birth, and keeping the rest of the family (and often livestock) fed and healthy. Birthing women engaged neighbors, friends, and acquaintances in these domestic chores that were essential to the settling of the West. Women with this knowledge and skillset were often not easy to find for isolated settler women who were new to the area; nor were they easily replaceable after death or migration. The title’s inclusion of both “mothers and midwives” points to this crux of Hill’s argument: this was women’s work, which is a major reason it has been under-documented, disparaged, and left out of prevailing histories of the settlement of the American West.
Hill is strongest when demonstrating how medicine and public health demonized women’s birth work and assumed control over birth in the American West. She attributes this to the United States’ desire to transform its settlers into citizens through the introduction of vital statistics and public health, abolishing much of the community work of reproduction that came before. She argues that the Northwest stands out because this transition came later than it happened in the Northeast and other parts of the United States. Her discussion of the early Children’s Bureau and the Sheppard-Tanner Act of 1918 (sponsored by the US’s first woman Congressperson Jeanette Rankin) highlight how the feminized knowledge of the perinatal period was initially valued and implemented into state programs. The act “sponsor[ed] conferences on infant health, provide[d] sterile birthing supplies in advance of home deliveries, pay[ed] for public health nurses, educate[d] mothers about sanitation and hygiene, and disseminate[d] information on maternity care” (151) before the American Medical Association accused it of being socialist and it was replaced.
Hill states that birth and reproduction in the American West must be recognized as “an integral component of the deployment of the racist and simultaneously misogynistic settler colonial enterprise” (12), citing scholars such as Tonia Compton and Neil Campbell. She seeks to enumerate the real qualifications of birth workers who have been left out of the historical record. A slightly more nuanced framing could have led to a more candid discussion of the role of birthing women and birth workers in the dispossession of Native Americans and the development of white supremacy, while still respecting their work and skills and combatting their erasure.
Future work by scholars of reproduction could address the intertwined meanings engendered by Native peoples’ and white settler reproduction. Moreover, Hill highlights how additional work is needed on the complex relationship between professionalized medical knowledge and what it replaced. The perinatal period was and continues to be the highest risk period for morbidity and mortality in female-bodied people: in short, birth can be dangerous. Future work could address the role of medicine in mitigating the risks of pregnancy and birth alongside the loss of feminized knowledge that harmed birthing people.
“Birthing the West” provides an important overview of reproduction work in the West, as well as the history of medicine and intellectual and political history of the region. The book also offers a hermeneutic for understanding how moments of intimacy and the domestic connect to larger systems of power. In this, she continues in the tradition of Laurel Thatcher Ulrich “A Midwife’s Tale,” as well as other social histories. Hill invokes her own births in the introduction, which is a welcome reminder that the most mundane aspects of our lives are part of history.