The vast majority of births occur in hospitals attended by physicians. However, this has not always been the case. Prior to the turn of the twentieth century, home births held the majority and were primarily attended by midwives, the majority of whom were women of color and immigrant women. The move toward hospital birth is rarely discussed today and midwifery and home birth, though now both experiencing a small comeback, are often viewed with skepticism and fear. This Note discusses the raced and gendered history of this change in American birth norms and argues that the racist and sexist motivations and phenomena that prompted the move into hospitals and away from midwives is relevant to understanding current birth trends and statistics. The Note begins with an overview and discussion of the raced and gendered history of American midwifery. Next, the Note explains the history of the Medicalization of pregnancy and birth–here, exerting excessive medical rhetoric into and oversight over reproduction, and especially women of color’s reproduction, in order to control it. Finally the Note considers current home birth and midwifery trends and statistics and their connection to the race and gender discrimination of twentieth century birth and midwifery. The Note concludes that the racist and sexist underpinnings of the change from home to hospital birth still operate in our current birthing systems to keep women of color in hospitals and out of the midwifery profession.