Jacob Rueff’s textbook The Expert Midwife printed in an English translation in 1637, first appeared in Latin under the title De Conceptu et Generatione Hominis in 1554. Rueff, himself an expert surgeon, paid tribute in his introduction to the ancient origins of the midwives’ profession: ‘It is observable that in all the ages of the world and throughout all countries in the world …’ such women had ever been useful ‘for release and succour of all the daughters of Evah, whom God hath appointed to bear children into this world.’ At the same time he pointed to the undeniable weakness of women as active obstetricians: the two methods of learning being the use of books or ‘conference with the skilful’, women were unhappily liable to fall behind in the former, since they were traditionally unable to understand anything except their native tongue.
Rueff’s book, in its English translation, was intended to remedy this state of affairs. Nor did it approve in principle of the rise of the ‘Man-Midwife’. On the contrary, it stated that some men had already gone far too far – ‘perhaps for private profit’ – in encroaching ‘upon women’s weaknesses and want of knowledge in these their peculiar businesses’.11
Rueff’s argument that midwifery was the peculiar business of women (only sacrificed to men by default of learning) was certainly one with which the midwives themselves agreed. ‘We knowing the cases of women better than any other’, wrote a famous London midwife, Mrs Hester Shaw. Jane Sharp was another experienced midwife; in 1680 she either died or retired after forty years of active work. The Midwives Book of 1671, based on her experiences, was the first book of its sort written by an Englishwoman in English and as such is an interesting guide to women’s own preoccupations on the subject. Like Rueff’s book, that of Jane Sharp went through many editions, the last appearing in 1725 under the title of The Compleat Midwife’s Companion, by popular demand, according to the printer. Jane Sharp was at pains to point out the range of her own studies: that she had had French, Dutch and Italian books on the subject translated in order to consult them. Like many others in her period, Jane Sharp took her stand on the Bible, and the fact that midwifery as a craft had been designed by God exclusively for the practice of women: ‘Men-Midwives are forced to borrow the very name they practise by … The holy Scriptures hath recorded Midwives to the perpetual honour of the female Sex, there being not so much one word concerning Men-midwives mentioned there.’12
Jane Sharp then quoted the story of Shiphrah and Puah, the heroic midwives of the Israelites, in the first chapter of Exodus, who were instructed by the Egyptian King to get ready to kill any boy babies when they saw a Hebrew woman ‘upon the [ birthing] stools’. (It was this order which led to the concealment of the baby Moses in the bulrushes by his sister Miriam.) Shiphrah and Puah however ‘feared God, and did not as the king of Egypt commanded them, but saved the men children alive’. They pretended to the Egyptian King that Hebrew women, unlike the women of the Egyptians, had a habit of giving birth before they could be reached by a midwife. The story ended: ‘Therefore God dealt well with the midwives … he made them houses.’13 (This text in the hands of women, was to the concept of exclusive female midwifery what the famous text of St Paul in the hands of men was to the concept of exclusive male preaching.)
According to Jane Sharp, the very fact that men enjoyed a superior education and could unlike women gain a knowledge of anatomy at university, demonstrated God’s support for women as midwives. Without divine approval in the role, how should women have managed to preserve their reputation down the ages? ‘It is not hard words that perform the work,’ wrote Jane Sharp, ‘as if none understood the Art of midwifery that cannot understand Greek.’14 Like the heroism of Shiphrah and Puah, the innate and essentially natural skills of the midwives, handed down from generation to generation of women, were another cardinal point in the fierce discussions which broke out as to whether ‘Men-Midwives’ had any right to function at all.
This belief in the natural, inherited skill of a woman (as opposed to a man) to deliver a baby safely and healthily was implicitly supported by society; just as nursing in general was regarded as the prerogative of the weaker but tenderer vessel – ‘woman’s work’ wrote Sir Ralph Verney (see p.244). At the beginning of the seventeenth century, the mistress of the household would count among her accomplishments not only cooking and the use of medicinal herbs, but also the ability to attend to her servants and neighbours in childbirth (Elizabeth Walker, for example, counted this among her good works). Lady Margaret Hoby was the pattern of the great lady ordering her servants and her estates, although unusual in that she kept a diary, half personal half spiritual, between 1599 and 1605 (the first known British woman’s diary).15 Of one particular Wednesday she wrote: ‘In the morning at six o’clock I prayed privately: that done, I went to a wife in travail of child, about whom I was busy till one o’clock, about which time, she being delivered and I having praised God, returned home and betook myself to private prayer.’ There are numerous other references to her attendances at the labours of local women; delivery being a basic female skill it was not considered relevant that Lady Margaret Hoby was herself childless. Mrs Pepys for example, who also had no children, was summoned to the bedside of Betty Mitchell in July 1668 ‘when she began to cry out’; she helped to deliver the child, and when it proved to be a girl, acted as her godmother.16
None of this emphasis on the archetypal role of women in the great drama of childbirth could however obliterate the unpleasant fact that all too many professional midwives were but ill-equipped to play it; since ‘the business whereunto God hath ordained them [was] of so great and dangerous consequence as concerns the very lives of all such as come into the world’, Reuff wrote, and numbers of mothers and infants died unnecessarily or were mutilated or otherwise injured as a result.17 Jane Sharp was after all herself writing to remedy ignorance, while stoutly defending the exclusive right of her own sex to the work. As we shall see, a noted and independent-minded midwife of the time, Mrs Elizabeth Cellier, writing in the 1680s, ascribed an extraordinarily high figure of infant mortality to the mishandling of the midwives.
Horror stories of women and their babies being literally pulled apart, with fearful damage to both parties, abounded. Dr Percival Willughby, the son of Sir Percival Willughby of Wollaton in Cheshire, was a celebrated and skilful obstetrician He published an account of his cases, the Country Midwife’s Opusculum:18 in which he cited one incident which took place in Threadneedle Street, in the City of London, where the midwife tugged the mother one way and the other woman present tugged the emergent child the other. There were plenty of other tales of the protruding limbs of infants being cut off because they were holding up the process of birth.
Such stories fell into two main groups. In one the midwife accelerated the course of the labour unduly, instead of letting what Dr Willughby called ‘Dame Nature, Eve’s Friend’ do her own work, with far more satisfactory results: for example Dr Willughby related how ‘poor silly Mary Baker’ produced a perfectly good child on the bare freezing ground, having avoided being ‘miserably tortured’ by the midwives. In the other group, the midwife or midwives proved incapable of helping forward a highly difficult birth. Alice Thornton described in her autobiography how her son died in 1657 because the midwife lacked the skill to ‘turn’ him. Mrs Elizabeth Freke was another diarist, who wrote from 1671 to 1714, her literacy being due to the solicitude of her father, a Fellow of All Souls, who educated all his four daughters.19 She gave a chilling description of the birth of her son Ralph Freke in Wiltshire in June 1675: the labour lasted an agonizing five days, with four midwives in perpetual attendance, including a ‘Man-Midwife’ who half-way through the proceedings pronounced the baby dead. Mrs Freke’s benevolent neighbour Lady Thynne was also in attendance as a charitable duty, and it was Lady Thynne who eventually secured the services of yet another midwife, Mrs Mills; she it was who successfully delivered a living child. (Little Ralph Freke even survived another seventeenth-century peril a few months later when
a careless nurse broke his leg, and hid him in bed to conceal the fact, pretending he was teething.)
Expert practitioners were highly prized: Dr Willughby educated his two daughters so well – once again in the great seventeenth-century tradition of benevolent educative fathers – that they both enjoyed thriving careers as expert midwives. One ‘Mrs’ Willughby began by accompanying her father on his rounds, with the advantage of being able to call in her father in a particularly difficult case. One such dilemma occurred with the confinement of the ‘wife of one of Oliver’s creatures’, under Cromwell’s Protectorate; Mrs Willughby hastened to call in the senior doctor for fear of the political implications. By 1658 she was practising in London with great success. Her sister specialized in the delivery of twins, never forcing the pace of the second birth. (Both Willughbys, incidentally, married, like most midwives of the time. The antiquary George Ballard and his clever sister were the children of a midwife.)20
The fame of a Quaker midwife in Reading, Frances Kent, was sufficient for the Verney family after the Restoration to consider employing her despite her awkward beliefs (they were assured that Mrs Kent never discussed religious matters with her patients) and her price: she could command as much as £25. In 1684, however, when Sarah Fell was about to be delivered of her first child at the age of forty-two, Frances Kent’s Quakerism was of course an added bonus. ‘She is a fine woman’, wrote Sarah, following her successful accouchement. ‘It was the Lord sent her to me. It was the Lord’s mercy that I had her, who is a very skilful and tender woman for that employment.’21
The overseeing of Quaker midwives was one of the responsibilities of the Women’s Meetings: in February 1675 at Swarthmoor, a Meeting was informed that Mabel Brittaine had been so lacking in skill that the child was born dead. On examination, Mabel Brittaine was found sufficiently deficient in medical knowledge to be told to hire an assistant (if she did not, people who employed her did so at their own risk).22
The care of the Quakers was not matched in other sections of society. The midwife was by the nature of her profession a powerful social figure, but she was not necessarily a particularly edifying one. A traditional connection with drink – ‘red-nosed midwives’ – existed in the popular imagination, which was not unfounded. Dr Sermon in The Ladies Companion, or The English Midwife of 1671 suggested that midwives should be sober and discreet, ‘not quarrelsome nor choleric’, above all not ‘rash and drunken women’. His picture of the ideal midwife – ‘very cheerful, pleasant, and of good discourse, strong, not idle, but accustomed to exercise, that they may be the more able (if need requires) to watch’ – makes it clear that the contrary was all too often to be found: that ‘pitiful, old, ugly, ill-bred woman in a hat’ for example, who married Pepys’s Uncle Fenner in 1662 and was a midwife.23
A midwife’s business, of its very nature, offered her the opportunity for certain murky sidelines, of which abortions were the most obvious; it was for fear of this that the authorities were zealous in their requirements that midwives were to report stillborn births. A practical woman who was not too particular might also most conveniently pursue the combined careers of midwife and procuress: several of the ‘Crafty Bawds’ mentioned in numbers of The Wandering Whore, such as Mrs Davies and Mrs Barber of Holborn, were also listed as midwives.24
Under the circumstances, the most important gynaecological advance of the seventeenth century was the invention of the forceps, by the beneficial use of which in a difficult and prolonged labour the infant could be skilfully delivered without damage to either mother or child. In the absence of the forceps, types of instruments available were as crude as the techniques by which they were employed. Richard Gough, in The History of Myddle, described how the village blacksmith made some ‘iron hooks’ at the direction of the local midwife; she was then able to draw forth a dead child from its mother successfully. The sensible Dr Willughby condemned the use of ‘pothooks, pack-needles, silver spoons, thatcher’s hooks and knives’ to speed on ‘Dame Nature’ unnecessarily.25 But of course where a birth was not straightforward, some form of instrument might have to be employed if mother and child were not to perish, immutably joined together (as so many did).
The man responsible for the invention of the forceps was a member of the Chamberlen family, probably Peter the Elder (so called to distinguish him from his brother and nephew, both also called Peter).26 Unfortunately the character of Peter Chamberlen the Elder was that particular mixture of enlightenment and professional jealousy which has marked many inventors. On the one hand he called on King James I in 1616 to found a Society of Midwives: ‘That some order may be settled by the State for [their] instruction and civil government.’ On the other hand he deliberately and successfully guarded the secret of the forceps within the Chamberlen family: his motives being clearly financial, as were those of the Chamberlens who followed him and jealously kept up the tradition of secrecy. (Another member of the Chamberlen family, author of Dr Chamberlen’s Midwives practice of 1665, which attacked other ‘quacking’ obstetrical textbooks, defended his refusal to give details of the forceps on the disingenuous grounds that they were by now ‘a family secret’ and not his to reveal.) As a result the forceps had to be reinvented quite separately in the eighteenth century.1 In the seventeenth century much ammunition was given by this professional selfishness to those indignant midwives who protested that doctors and others tried to control and license them purely in order to restrict their activities and preserve their personal monopoly.
Many doctors were considered greedy and selfish, but many midwives were held to be ignorant, and there was something to be said for both points of view. Hitherto the licensing of the midwives had been performed by the bishops – Bishop Bonner is said to have been the first to do so28 – a practice which had arisen in the previous century more for religious than for medical reasons. In an age of high infant mortality, it was very often left to the midwife, with mother and child in extremis, to perform the rite of baptism; it was her responsibility that the correct (Protestant) form should be used. At the same time, the ecclesiastical authorities were anxious that midwives should not invoke the darker powers of witchcraft to their aid; although the poor state of medical knowledge at the time, and the desperate sufferings of so many patients, must have made the invocation of supernatural aid where natural aid had failed irresistible to many caring midwives not otherwise connected with evil. (As early as 1486 Malleus Maleficarum had urged an oath upon midwives to eliminate the possibility of witchcraft being used.)29
The oath administered to Eleanor Pead, seeking a licence as a midwife from the Archbishop of Canterbury in 1567, is the earliest which has survived.30 She promised among other things to help the poor as well as the rich, and not to allow a woman to name a man falsely as the father of her child; some significance being attached to these allegations of paternity, extracted as it were by the pangs of labour, which put a responsibility upon the midwife either to remember them or forget them. In addition she had to swear to use no sorcery or incantation, to employ a simple form of baptism if necessary and to register the child’s birth with the curate, and not to use any cutting or dismembering in the course of the delivery.
The trouble with the bishops’ licensing was that their interests were all in the supernatural: in the course of ecclesiastical visitations, it was customary to ask after the use of prohibited sorcery rather than the progress of deliveries. Dr Peter Chamberlen, son of Peter the Younger, cried out vigorously against a system whereby any woman ‘with the testimony of two or three gossips’ could pay a fee for her licence, and then hasten into practice. It was a system, he averred, which produced innumerable and ‘uncontrolled female-arbiters of life and death’. In 1654 he attempted in his turn to form a Corporation of Midwives, with himself as governor; towards this end he seems to have held monthly meetings of midwives for the purpose of instruction at his home.31
This innovation aroused angry protests from the midwives at the interruption of their age-old bu
siness. Dr Chamberlen, it was asserted, had no greater skill than anyone else save for his ‘iron instruments’. Chamberlen was also accused of bargaining with the rich for larger fees, and neglecting the care of the poor altogether. Among those midwives who petitioned was that Mrs Hester Shaw who may have been the violent midwife of Threadneedle Street criticized by Dr Percival Willughby.32
Hester Shaw, towards the end of her career, got into a dispute with Mr Thomas Clendon, the minister of Allhallows, Barking, over some stolen goods: her houses, and the other houses in her row, having been accidentally destroyed by gunpowder, a great deal of Hester Shaw’s property had, according to her version, ended up in the minister’s possession and stayed there.33 The details of the case revealed incidentally how substantial could be the rewards of a lifetime of midwifery: two bags of silver, worth over £100 each, and quilted rolls of gold were mentioned as missing, as well as a quantity of silver plate. Hester Shaw was also described by the minister himself as of ‘a good education, and volubility of tongue, and natural boldness, and confidence’. In herself therefore she also stood for the midwife as an independent female professional, secure (as she had hitherto always believed) in work which a man was quite unable to perform.
The midwives argued in front of Archbishop Laud and the Bishop of London at Lambeth Palace on 22 October 1634. Their case rested in essence on the importance of experience: ‘it must be continual practise in this kind that will bring experience, and those women that desire to learn must be present at the delivery of many women and see the work and behaviour of such as be skilful midwives who will shew and direct them and resolve their doubts’. On the other hand there was a certain lack of logic in the way the midwives added that they also possessed books in English on anatomy, and ‘most of them being able to read’ (or so they claimed), these books would benefit them more than Dr Chamberlen’s lectures on anatomy.34
The Weaker Vessel: Woman's Lot in Seventeenth-Century England (WOMEN IN HISTORY) Page 61
