Thursday, November 8, 2012

Of Midwives and Childbirth

by Sam Thomas


In a post from last month I made the case that – contrary to popular perception and two different groups of historians – midwives were not decrepit crones from the edges of society. But once we’ve established that, we still need to learn more about the work that midwives did in the delivery room. Given the limited medical tools at their disposal, what could they do?

It is first important to note that in the pre-modern world midwifery was midwifery was not a science in the modern sense of the world. Rather, practitioners described their work as an “art” and, significantly, a “mystery.” The 1689 testimonial for the wife of James Phillips noted that she was “a Civill & discreet Matron & one well skilled & knowing in the Art & Mistery of Midwifery.” A few years later, Elizabeth Arrandell was described as “well skild in the Mystery of Midwifery…”

In keeping with its status as an art, there was much room for variation in the delivery room, but a midwife would check the cervix to see how far along the labor was, and prepare the mother for delivery by lubricating the birth canal, usually with oil or animal fat. She might give the mother an enema, rub liniment on her belly, and give the mother ‘caudle,’ a hot drink somewhere between gruel and spiced wine.

In the day of modern anesthetics, such work might seem (to some) to be of questionable value, but in the early modern period a good midwife made labor less painful, moved it along more quickly, and could be the difference between life and death. In the midst of her labor, Susanna Watkin cried out, “Godsake either fetch Ellin Jackson (being a midwife) or else knock me on the head.” Another woman – complaining when her desired midwife was late – claimed that she “might have been delivered two houres sooner if she had had...helpe when they desired it.”

Once the child was born, the midwife had the honor of cutting the umbilical cord, and it was she who washed and swaddled the child before returning it to the mother. She then made the decision whether to deliver the placenta manually or to let nature take its course.

While it would be a mistake not to acknowledge the importance of this work, as one historian noted, “majority of births…were uneventful whether attended by a physician, a midwife or a stork.” So what made one midwife better than another? I would argue that a midwife’s skill lay less on the medical side of the equation, and more on the social side. A good midwife could effectively manage the mother and the delivery room.

Naturally enough, a midwife’s social work focused on the mother. She ruled the delivery room, deciding assigning tasks to the other women present, and managing any conflicts between the mother and her birth attendants, or among the gossips themselves. The midwife also encouraged the mother in the last stages of labor, as in 1739 when a midwife assured her patient that “in less than Two Minutes the Child would be in the World.” 

The midwife also would have reassured anxious fathers during labor and consoled them in the event that the birth ended in the death of mother or child. In performing these tasks, from calming a panicky mother to controlling quarrelling gossips, a midwife would have had to project a great deal of authority – this was not a profession for a shrinking violet!

A good midwife thus had to have the ability to take control of difficult and dangerous situations, and convince her friends and neighbors to do as they were told. She was as authoritative a woman as you’d find. But a midwife’s role in the neighborhood went well beyond labor and delivery, and took her into the world of law enforcement as she investigated and helped to prosecute a variety of crimes.

But more on that next month...


Further reading:

David Cressy, Birth, Marriage, and Death: Ritual, Religion, and the Life-Cycle in Tudor and Stuart England (Oxford, 1997). (An excellent book full of great stories!)

Laura Gowing, Common Bodies: Women, Touch and Power in Seventeenth-Century England (New Haven, 2003).

Mary Lindemann, Medicine and Society in Early Modern Europe (Cambridge, 1999).

----------------------

Sam Thomas is the author of 
The Midwife's Tale: A Mystery from Minotaur/St.Martin's. Want to pre-order a copy? Click here. For more on midwifery and childbirth visit his website. You can also like him on Facebook  and follow him on Twitter.

1 comment:

  1. Nice. It's interesting that a good midwife today does much the same thing. A lot of it is helping the mother feel in control and safe. They have all sorts of tricks for difficult labor, which doctors today don't know anything about (personal experience :). Thanks for the article!

    ReplyDelete