The "oldest and the newest of nurses": Nursing and the Professionalization of Obstetrics and Gynecology.

When in the late nineteenth century American physicians increasingly replaced midwives in the care of obstetrical and gynecological patients, they could do so only because they were aided by another emerging group of healthcare professionals: nurses. Nurses were instrumental in assisting physicians in the care of patients in labor and during recovery. They were also necessary for male physicians because the vast majority of nurses were women and their presence during gynecological and obstetrical treatments made it more socially acceptable for men to examine female patients. In hospital schools in the northeast and through long-distance nursing programs, physicians taught students about obstetrical nursing and instructed them to protect the modesty of female patients. They also tried to instill strict professional hierarchies between nurses and physicians, emphasizing that nurses should never attempt to deliver a patient without a physician. But as nursing emerged into a unique professional practice separate from that of physicians, nurses were able to negotiate better education in the care of laboring patients. In order to take over women's sexual and reproductive health care from traditional providers, physicians conceded to nurses' demands for more authority in patient care.