‘Like sausages in a sausage machine’: medical resistance to the dehumanisation of obstetrics in postwar Britain (Morris 1960, 913)

In post-Second World War Britain the locus of childbirth shifted from women's homes to the hospital. Alongside the hospitalisation of childbirth, obstetric technologies and practices on maternity wards transformed experiences of birth, leading many women to describe their loss of agency and poor quality care, likening their deliveries to being on a factory production line. While historical and sociological scholarship has demonstrated the agency of feminist health campaigners and childbirth organisations in resisting these changes in maternity provision, this article explores a further, underexamined line of resistance. During the 1950s and 1960s, a vocal group of obstetricians and psychiatrists criticised what they described as inhumane conditions on maternity wards, which resulted in loneliness, disempowerment and trauma among many new mothers, and in some cases bonding failure and postnatal mental illness. Adopting a rich descriptive language, they depicted birth in hospital as a 'sausage machine' process. This article suggests that, while doctors emphasised their positions of authority in the birth process, they drew extensively on women's experiences and descriptions of childbirth and aimed to enhance women's agency in their deliveries. They stressed the need to pay more attention to women's emotions and psychological well-being during pregnancy and childbirth, while psychiatrists lobbied for a larger role in maternity care. Though seeing the hospital as the appropriate place to give birth, some obstetricians advocated and employed natural childbirth techniques and instigated improvements in the training of medical staff, particularly midwives, and in the organisation and atmosphere of maternity wards. The article demonstrates how the aims of doctors advocating reforms dovetailed with those of childbirth organisations. Finally, the article briefly highlights continuities in the provision of maternity services in the UK with regard to their enduring association with emotional neglect and trauma.