It was International Women’s Day yesterday so I decided to take the day off, or at least the afternoon ( the morning was taken up by a Maternity Services Liaison Committee) and head for the Wellcome Institute on Euston Road where I’d heard there was to be a lecture about midwives and doctors through history and some old books and other documents on display. Anna Ostrowska, the lecturer, and her librarian colleague were clearly not expecting a big turn out and were rather startled to see around 50-60 people packing the room.
Anna began by asking how many of us had had a home birth or knew someone who had. Five or six hands shot up. She was evidently surprised but should not have been – the subject was bound to attract people with a real interest in birthing and such people often choose home birth because they have troubled to find out their options. She rightly described the Peel Report of 1970 as “infamous” and showed how midwives and male doctors have been fighting over the territory since the sixteenth century.
The sixteenth century – at the time of the Reformation, in other words – was when things started to go wrong for midwives and women.
There was not an awful lot which I didn’t know already but the documents and ancient books were wonderful to see (not to touch, of course!). One or two things I hadn’t known before:
- The popular belief that the Catholic Church persecuted midwives on the grounds that they performed abortions and infanticide is not born out by evidence.
- The “obstetrical chair” i.e. birthing stool was the most popular birth position – upright, more or less forward, and open – until the 16th century.
- Midwives were licenced, from Henry VIII’s time onwards, by the Church and their licence issued by a bishop. One such licence, from 1695, was on display – signed by six women, presumably her former patients, who were attesting to the midwife’s worthiness. The criteria were that she be a married woman, church-going and of good character and in agreement with the articles of the Church. “A woman of a good life and conversation”.
- Husbands were not entirely excluded from the birthing room, especially in poorer homes.
- Trotula of Salerno was a woman who wrote the first ever gynaecological manual. There is an English translation of it in the Wellcome Library.
- Hippocrates set the scene for the medical attitude to birth when he focussed on pregnancy as akin to a disease. Doctors in the 17th and 18th century used reprints of texts dating back to the 16th century.
- Many “man midwives” whose arrival in the 17th century heralded the decline of the English midwive were in truth failed surgeons and significantly less knowledgeable than their female counterparts. Yet because they charged more they, and male doctors, were hired by more affluent families.
- Forceps were not entirely a bad thing – they did in fact save lives which, where a birth was complicated because of the baby’s presentation, were otherwise lost. But midwives had to fight to be trained to use them.
- A great (if depressing) quote from Jacques Guillemeau of 1609, quoted by Brudenell Exton in 1751 – summing up the doctor attitude: “The greatest disease that woman can have is that of the nine months, the crisis and cure whereof consists in their safe delivery”.
- Sterne’s caricature of Dr Slop with his badly wielded forceps indicates that there was widespread criticism of male birthing attendants. By contrast, Dr William Hunter prided himself on having forceps “rusty from disuse” (hope they weren’t really)
- The accoucheurs were suspected of lewdness and often had to work under sheets or hide under the bed. So why not just hire a midwife?
- Jane Sharp’s 1671 Midwife’s Book – a copy on display. I promptly put this on my wishlist at Amazon!
- Robert Storr – apothecary in Doncaster who guessed the reasons for childbed fever.
- All Grantly Dick-Read’s papers are at the Wellcome Library and available for inspection. We were shown a lovely picture of one of his antenatal classes. The ladies are in their underwear (wearing harlequin eyemasks for privacy reasons, which gives them the air of a pregnancy masked ball!) and kneeling with their knees apart – a perfect position for optimal foetal positioning.