In the United States, use of hospitals for childbearing started in the early 19th century for women who did not have suitable homes. Since then, the purpose and structure of hospital-based postpartum care changed several times. The trend toward shorter stays began almost 50 years ago. Although the economy was a driving force both now and 50 years ago, the purposes for changes were different. Knowing the history of postpartum care gives insight into the state of care at the turn of the millennium.