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In the mid-to-late 1800s, the professionalization of medicine became a major trend,
到19世纪中后期，医疗专业化成为主流，
and male doctors began taking control of childbirth away from female midwives.
男医生开始替代女性助产士控制了分娩行业。
It was determined that in order to get women into the hospital,
人们认为，为了把女性弄到医院生产，
you had to get rid of these midwives who were taking care of all of these women in the home.
就必须挤掉那些在家中照顾这些女性的助产士。
All of these women who had been attending births all of these years,
于是，这些一直以来照顾产妇分娩的女性
they were blamed for maternal deaths, infant deaths.
被指责成了造成产妇死亡，婴儿死亡的元凶。
Two days ago a baby, delivered by a midwife, died, when it ought to have lived.
两天前，一名由助产士接生的婴儿死了，它原本可以活下来的。
My examination showed that its cord got infected.
我检查发现它的脐带被感染了。
And you all know what that means.
你们都知道这里面的意思。
Something wasn’t clean.
那就是有些东西不干净。
Joseph DeLee of Chicago, the most influential OB-GYN of his day,
芝加哥的约瑟夫·德利（Joseph DeLee）是当时最有影响力的妇产科医生，
called midwives, relics of barbarismand, "a drag upon the science and the art of obstetrics."
他称助产士为“野蛮时代的遗物”，为“科学和产科艺术的累赘”。
In the South especially, much of the attack on midwifery was rooted in race.
尤其在南方，针对助产士的大部分攻击都跟种族有关。
One Alabama doctor dismissed black midwives as having "fingers full of dirt and brains full of arrogance and superstition."
一位阿拉巴马大夫因为黑人助产士“手上沾满污垢，脑子里都是傲慢和迷信思想。”而拒绝聘用黑人助产士。
Some states outlawed home-birth midwives,
一些州还禁止家庭助产士，
while most others created new regulations that made it harder to enter the profession.
其他大多数州则选择了制定新法规，让助产士更难融入这个行业。
By the 1950s, a vast majority of women gave birth in hospitals, attended by doctors.
到了20世纪50年代，绝大多数妇女都已经在医院分娩，由医生接生。
But something changed in the 70s:
但是，70年代发生了一些变化：
Middle-class white women wanted more of a voice in their maternity care
中产阶级白人女性想在产科护理中听到更多的声音，
and that led to a rise in midwifery, except this time, most midwives were white women.
为此，助产士的数量有所增加，只不过这一次，大多数助产士都变成了白人女性。
The US currently has around 15,000 certified midwives.
目前，美国有约1.5万名认证助产士。
It’s a growing profession, but still overwhelmingly white.
这一职业仍在发展，但绝大部分仍旧都是白人。
Just about 5 percent of the nation’s midwives are women of color.
全国只有大约5％的助产士是有色人种。
In addition to being from the community and understanding not only linguistically and culturally what women need,
除了具有同样的社会背景，能够从语言以及文化了解女性的需求，
midwives of color protect women in a system that is hostile to them.
有色人种助产士能够在这个对妇女存有敌意的社会中保护他们。
With black mothers three to four times more likely to die from causes related to pregnancy or childbirth,
怀孕或分娩导致黑人产妇死亡的概率是白人产妇的三到四倍，
there’s evidence that empowering midwives might change outcomes for moms and babies.
有证据表明，赋予助产士权利或许可以改变母婴的命运。
Researchers found that some states have clearly done more to integrate midwives than others.
研究人员发现，在整合助产士资源方面，一些州做的显然比另一些州更多。
And while there are many factors that can influence maternal and infant health,
尽管影响母婴健康的因素很多，
many states with the least integration also had some of the highest rates on key indicators including premature births, neonatal mortality, and C-sections.
许多整合程度最低的州的早产、新生儿死亡率和剖腹产等关键指标也最高。
In recent years, groups like the American Congress of Obstetricians and Gynecologists have become much more welcoming to licensed midwives.
近年来，像美国妇产科医生大会这样的组织对持照助产士的态度已经变好很多了。
We're all in this together.
我们谁都跑不了。
But that hasn’t resolved the culture war between doctors and midwives just yet.
但医生和助产士之间的文化战争并没有因此得到解决。
There is a role for a midwifery and physician collaborative relationship.
助产士和医生应该是合作关系。
We're not enemies.
我们不是敌人。
We are colleagues who need each other.
我们是彼此需要的同事。
Thanks for watching!
感谢大家收看！
ProPublica has been reporting on the disparities in maternal mortality in the US,
ProPublica一直在报道不同肤色的美国孕产妇死亡率的差异，
and how it’s the most dangerous industrialized country in which to give birth.
以及美国为何是分娩危险性最高的工业化国家。
There’s a lot more to the story of midwives in America that we couldn’t fit in the piece,
因为时间有限，还有很多跟美国助产士有关的故事是我们这期视频没有讲到的，
including the current barriers to entry that a lot of midwives especially midwives of color face in certain states.
包括目前某些州许多助产士，特别是有色人种助产士所面临的各种障碍。
For more on that and ProPublica's latest reporting on maternal health, click on the link below.
欲了解更多信息和ProPublica有关孕产妇健康的最新报道，请点击下面的链接。
