Professionalizing Midwifery in Iran, 1919–1941: The Transition from Traditional Birth Assistance to Institutional Maternal Healthcare

Abstract

The professionalization of midwifery in Iran between 1919 and 1941 represents a significant yet insufficiently examined transformation in the history of maternal healthcare. During this period, childbirth assistance gradually moved from predominantly apprenticeship-based and community-oriented practices toward a more structured system shaped by formal education, clinical training, institutional regulation, and emerging medical authority. This study examines the historical transformation of midwifery as a professional occupation and analyzes how the expansion of formal education contributed to the institutionalization of maternal healthcare in Iran during the transition from the late Qajar period to the first Pahlavi era. A historical-analytical research design was employed using published scholarly studies that document the development of midwifery education, professional regulation, clinical training, and healthcare institutions in Iran. The analysis focused on changes in educational organization, professional competencies, clinical preparation, regulatory structures, and the institutional position of midwives within the developing healthcare system. The findings indicate that the transformation of Iranian midwifery was not simply an educational reform but a multidimensional process of professional restructuring. Formal educational institutions progressively introduced standardized curricula, systematic clinical instruction, defined competency requirements, and new forms of professional recognition. These changes altered the relationship between midwives, physicians, hospitals, and pregnant women and gradually relocated childbirth assistance from predominantly community-based settings toward institutional healthcare environments. The professionalization process also created new boundaries around midwives’ responsibilities and contributed to the increasing influence of biomedical authority over reproductive healthcare. At the same time, the emergence of formal education did not immediately eliminate traditional practices; rather, traditional and institutional forms of childbirth assistance coexisted during the transitional period. The study argues that the professionalization of midwifery should therefore be understood as a gradual institutional transformation in which education, regulation, clinical practice, and medical authority interacted to reshape maternal healthcare. Examining this transition provides a historical basis for understanding the subsequent development of midwifery education and the organization of maternal health services in contemporary Iran.