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Medicine, Disease and Society in Britain, 1750 - 1950. ‘ Midwives, men-midwives and childbirth ’. Lecture 5. Lecture themes and outline. The ‘medicalisation’ of childbirth? Traditional childbirth - Fear and ceremony Midwives - Roles, training and characteristics

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lecture themes and outline
Lecture themes and outline

The ‘medicalisation’ of childbirth?

  • Traditional childbirth

- Fear and ceremony

  • Midwives

- Roles, training and characteristics

  • Midwives versus men-midwives

4. The growth of lying-in hospitals

5. Changes in the late C19 and early C20 century

    • General practitioners, registration
diary of isaac archer re his wife anne peachey
Diary of Isaac Archer re his wife Anne Peachey

‘My wife growing nearer her time was troubled with feares she should die; and I feared it too. She was much taken up, I saw, with such thoughts, and I was glad, because it was an occasion of seeking God,…’

His wife delivered a girl: ‘Her pains were sharpe, but short; and she bore them without sickness…and with great courage’.

Thus my heart was full of joy, thinking all over; and praying God for his mercy: but about of 1 of clock my wife began to faint, through an overflow of blood, and was without sensible pulse, or colour; we gave her over, and she took leave of me…’ However, ‘God stayed the flow, and she began to revive’.

Anne bore 9 children over a 13 year period, 8 of whom died in infancy.

(Lane, Making of the English Patient)

diary of isaac archer 1677 and 1682
Diary of Isaac Archer: 1677 and 1682

‘...my wife was delivered 2 months before her reckoning, and of a girle, which came wrong, and stuck so long with the head in the birth, that it was dead when fully borne, although alive at the time of travaile, and so next day ‘twas buried in Freckenham chancell, on the north side of the little boy, under a stone. My wife was in danger of miscarrying often, and was not well...especially a week before her delivery...perhaps I am not worthy of a son...The losse is the lesse because ‘twas a girle, though we could have wished the life of it’ (October 1677)

‘My wife was delivered of a little girle, fatter and larger than any yet, for she had her (health) well and a good stomach. She was in extremity from 1 to 4 in the morning...when, after great danger, God heard us, adn she (was) delivered. I bless God that we have a living child.’(September 1682)

‘We were frighted betimes in the morning with the sad newes of my little girle’s death. She was well the night before, and never sick in in it’s life, only came out with heat, and had a cough, which yet was gone, and thrived to admiration. She had a tender hearted nurse, but we feare ‘twas overliad, as many that saw it did positively say’. (Dec 1682)

(Lane, Making of the English Patient)

adrian wilson the making of man midwifery
Adrian Wilson, The Making of Man-Midwifery
  • Collective female culture
  • Period of lying in for 1 month
  • Organised by women - ‘gossips’
  • Midwife in charge
  • Husband and all men excluded
  • Lying-in chamber was sealed, air and light excluded
  • Feasting and celebration foods
  • Ended with churching ceremony - marking the return of the mother to public life
examples of midwives
Examples of Midwives

In 1767 the obituary of a widow Mrs Mary Hopkins of Salisbury, declared her to be

‘a person well practised in the art of midwifery, and who, during the space of forty-five years last past, delivered upwards of 10,000 women, and with the greatest success, and is therefore greatly lamented by all who knew her’ (Adams’ Weekly Courant, 9 June 1767)

sarah stone
Sarah Stone
  • Practised in Taunton, Somerset
  • Extensive practice with about 300 cases a year.
  • Apprenticed to her mother for 6 years
  • Attended lectures on anatomy and watched dissections
  • Wrote A Compleat Practice of Midwifery (1737)
bishops licences testimonial
Bishops Licences - testimonial

We whose names are under written do hereby Certify that Nancy Littlewood ,wife of Jeremiah Littlewood of the parish of Womborne in the County of Stafford and Diocese of Lichfield and Coventry is a person of sober life and Conversation and well known to us and that she is well skilled in the practice of midwifry and a person fit to be admitted and Licensed to practice that Art Witness our hands this Eighteenth day of June in the year of our Lord 1787.

J. Honeybourne Vicr of Wombourne

Thos Parker, John Rogers (Church Wardens)

Walter Stubbs, Ann Tongue, Mary York, Mary Cartwright, Pru Hill (Lichfield Record Office, B/A/11/5)

slide9
Margaret Stephen, The Domestic Midwife or the best means of preventing danger in childbirth considered (1795)

I teach my own pupils the anatomy of the pelvis &c., and of the foetal skull, on preparations which I keep by me, with everything else relative to practice in nature at labours; also turning, and the use of the forceps and other obstetric instruments, on a machine which I believe few teachers can equal, together with the cases and proper seasons which justify such expedients; and I make them write whatever of my lectures may prove most useful to them in their future practice, for which they are as well qualified as men. I intend to continue my lectures as usual to women entering upon the practice of midwifery, until the men who tech that profession render them unnecessary, by giving their female pupils as extensive instructions as they give the males’.

slide10

William Hunter’s Anatomy of the Gravid Uterus (1774).

This is one of the early accurate illustrations of the lie of the normal full-term baby in the uterus.

slide11

William Hunter (1718-83), was a Scot who settled in London and became the leading anatomy school proprietor and obstetrician of the day.

elizabeth nihell a man midwife or a midwife a treatise on the art of midwifery 1760
Elizabeth Nihell,A Man-Midwife or a Midwife? A Treatise on the Art of Midwifery (1760).

‘That multitude of disciples of Dr Smellie, trained up at the feet of his artificial doll, or in short those self-constituted men-midwives made out of broken barbers, tailors or even pork butchers, for I know myself one of this last trade, who, after passing half his life stuffing sausages, is turned an intrepid physician and man-midwife.’

slide13

Sarah Stone, A Complete Practice of Midwifery (1737), in Irvine Loudon, ‘Childbirth’, in Irvine Loudon (ed.), Western Medicine: An Illustrated History (Oxford: Oxford University Press, 1997, p. 209:

‘every young MAN who hath served his apprenticeship to a Barber-Surgeon, immediately sets up for a man-midwife, although as ignorant, or indeed much ignoranter than the meanest of women of the Profession’.

william ross
William Ross

‘BEGS leave to acquaint the Inhabitants of Ambleside and its Vicinity, that he practices Midwifery.

W.R. Should have thought it unnecessary to have troubled the Public with the present notice, but that he wished to correct a report which has been propagated with great industry, for the purpose of injuring him in the public opinion, that he did not practice Midwifery.-During the four Years he studied at the University of Edinburgh, he attended the Midwifery, in common with the other Medical Professors in that University, and hopes by diligent attention, in this, as in every other part of his Professional Duty, to Merit and Share in the Public Favour’.

J.Soulby,Printer, Ulverstone.

Late C18.

michael ryan a manual of midwifery 1841
Michael Ryan, A Manual of Midwifery (1841)

‘Happily for humanity, the process of labour, in a vast majority of cases, is safe and free from danger, especially when women live according to nature’s laws; but among the higher and middle, indeed all the classes in civilized society in which these laws are frequently violated or forgotten, or when the constitution is impaired by the luxury or dissipation of modern times, the process of child- bearing is attended with more or less danger,... It is, however fortunate for suffering humanity, that the process of parturition may now be greatly accelerated, and the greatest of moral suffering be relieved by the advice and skilful exertions of the obstetrician or medical attendant; ...women are well aware of the superior knowledge whichmedical practitioners possess of their constitutions; and hence, in modern times, we observe a wise and judicious preference given to male obstetricians, and midwives are scarcely if ever employed, unless among the ignorant or lower classes’.

training and registration
Training and Registration
  • 1840s: midwifery added to the medical curriculum
  • 1850s: diplomas awarded by medical schools
  • 1862: King’s College Hospital introduces midwifery training for nurses
  • 1902: Midwife Registration Act
medicalisation of childbirth why did man midwifery appear so suddenly in this period
Medicalisation of Childbirth? Why did man-midwifery appear so suddenly in this period?
  • Birth described as increasingly risky for mothers – the need to intervene, make it a medical matter
  • A new spirit of medical enquiry, especially in the fields of anatomy and physiology
  • New technology (forceps, chloroform)
  • The rise of the surgeon-apothecary as the family doctor
  • Fashion
  • Changing cultures
  • From home to hospital
the medicalisation of childbirth
The medicalisation of childbirth?

YES but........

  • Midwives did not disappear and attended most births
  • Midwives engaged in struggle for training and registration
  • Numerous factors for medicalisation – historians disagree on which was the most important