Wealhtheow's Reviews > Midwives and Medical Men: A History of the Struggle for the Control of Childbirth

Midwives and Medical Men by Jean Donnison
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Jul 08, 2011

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bookshelves: british-history, historical, health, sociology, non-fiction

The fascinating history of midwifery in Europe, with particular attention paid to England. It becomes particularly detailed in the seventeenth century, and after reading this book one will be able to name many boardmembers, politicians, and doctors instrumental in the struggle over gynecological treatment. I noted some of my favorite quotes and historical details in the The appendices are a treasure trove of seventeenth century midwifery license (in which the midwife must promise not to "in anywise use or exercise any Manner of Witchcraft, Charm, Sorcery invocation, or other prayers"), a prospectus of the British Ladies' Lying-in Institution, and broadsheets for and against midwifery and man-midwifery.

After allopathic doctors managed to claw their ways up the social ranks, they began to see midwives, dentists, herbal healers, etc as rivals for patients. The rest of society accepted these attacks on midwives because of their cultural associations with witchcraft, late-night drinking, abortions, and helping non-married pregnant women give birth and hide the babies. Because midwives were women and predominantly illiterate and without leverage or connections, doctors managed to push midwifery from a respected profession into one so stigmatized it could not even be spoken in polite society. Of course, this didn't benefit doctors as much as they'd assumed, because few families could afford doctors' fees and few doctors would commit to the long hours of labor. Instead, the stigmatization and marginalization of midwifery meant that midwives were even less likely to have education and training, and the poor (for whom midwives were the only option) went without help during labor. Maternal and infant mortality rose (it was much lower with midwives, and much higher with just doctors or in hospitals) due to non-hygienic conditions and an increased reliance on technological interventions (like forceps). In continental Europe (and Scotland and Ireland), there was regulated training and licensing, so midwives maintained their knowledge and social status, and poor women had birth attendants. In the US, midwives lacked the few noble patrons they had in the UK, and so were even worse off. After the disgraces of the Boer War, the British government was scared that their population was too small and that their maternal death rate was too high. They began licensing and training midwives. After the world wars, they finally began a system whereby midwives would be paid a decent wage for attending on the poor. Nevertheless, midwives continue to exist in an uneasy space in the medical realm: too independent to be a nurse, but legally required to rely upon doctors if something goes wrong with a birth. This book was published in the 1970s, and doubtless much has changed in regards to midwifery in England since it was written (certainly much has altered in the US since then).

Overall, fascinating subject and replete with details and factoids that catch at the mind. The book is a delightful, comprehensive blend of history and cultural studies; Donnison points out what each legal development, international conflict, or change in government meant to the status of women, the poor, or the medical establishment. I highly recommend it if you want an in-depth look at the history of England's gynecological and reproductive health workers!
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Reading Progress

July 8, 2011 – Started Reading
July 8, 2011 – Shelved
July 8, 2011 – Shelved as: british-history
July 8, 2011 – Shelved as: historical
July 8, 2011 – Shelved as: health
July 24, 2011 –
page 10
3.86% "17th century European public uncomfortable with man-midwives, so man-midwives crawl into the room in secret, or work blind, with their hands under the sheet (which understandably sometimes led to serious errors)."
July 24, 2011 –
page 11
4.25% "1600s British thought: forcibly stretching the labia vulvae to help labor; also believe that "the foetus itself, rather than the spontaneous contractions of the womb, provided the motive power for the birth""
July 24, 2011 –
page 16
6.18% "When the man-midwife Jules Clement attended the Dauphine in 1682, he bled her at regular intervals during the 30 hours of the labor...[after, to promote recovery] the Dauphine was wrapped in a newly-flayed sheep-skin which had just been taken off the live animal in the lying-in chamber. Then, since to allow the mother to sleep immediately after a difficult birth was considered dangerous, she was forcibly kept awake"
July 24, 2011 –
page 22
8.49% "In Britain, episcopal licensing of midwives starts dying out in 1700s, dead by end of 1800s. Scotland and Ireland pass laws on the regulation, examining&licensing of midwives, also start training them by 1726. No such measures in England mean midwives are of variable quality, have low status."
July 24, 2011 –
page 25
9.65% "Vast majority of lying-in hospitals in England only serve married women, although 2 serve single women pregnant with their 1st child. All women must be of "good character", "cleanly clad and free of vermin and contagious disease." Given the high mortality rate (not least from septic infections) in lying-in hospitals, this is ironic to me."
July 24, 2011 –
page 55
21.24% "While France, Prussia, etc provide state schools for midwives, in 19th century England "midwife" has become unspeakable in polite society, indecent for husbands to be in lying-in room, women don't have the moral courage or skill with mechanical operations ("which midwifery is") to be midwifes. Genteel women, no matter how poor&in need of employment, would therefore not become or be employed as a midwife."
July 24, 2011 –
page 61
23.55% "By 1850s, last midwifery work published by a midwife was Martha Mears's Pupil of Nature in 1797. Midwives rarely educated or respectable, women shouldn't seek self-advancement, the subject of midwifery could not be mentioned in polite female society."
July 24, 2011 –
page 62
23.94% "1850s England:"40 years before, in 1817, the family of an old Norwich midwife, Mrs. Phoebe Crewe, had proudly recorded on her gravestone her 40 years' work in this calling. Now the word 'midwife' itself was hardly respectable, and [Dickens's character] Sairey [Gamp]'s continued celebrity was to eclipse all."
July 24, 2011 –
page 63
24.32% "Increasing industrialization and growing wealth of society worsens women's economic and social position relative to men. 'Industrialization had brought new independence to the women who worked in the factories, but had made it harder for mothers of young children to earn money. For middle-class women who had to support themselves the loss of opportunities for work was equally, if not more, serious."
July 24, 2011 –
page 89
34.36% "Contagious Diseases Acts of 1864, 1866, 1869: require prostitutes in garrison towns and seaports to undergo medical examinations (and if infected, detention in hospital) and had established a special corps of non-uniformed police to administer them."
July 24, 2011 –
page 151
58.3% "The Obstetrical Society's view had always been that the registered midwife should only attend the poor...[because poor women], being stronger, had less need of skilled assistance. Moreover, registration would have the merit of putting midwives in their proper place--doing the hard, tedious, ill-paid work appropriate for women....'women will have their fair and natural share of...midwifery work, whilst medical men"
July 24, 2011 –
page 174
67.18% "The Midwives Act of 1902 was considered a victory by most midwives and a loss by most physicians, but 'it put midwives in a uniquely disadvantaged position among the professions.' The Act subjected midwives to the same local supervision otherwise associated with tradesmen, not medicine. Midwives could be erased from the register for any misconduct (no other registration act dealt with private lives of practictioners)"
July 29, 2011 – Finished Reading
July 30, 2011 –
page 197
76.06% "dehumanizing, assembly line procedures of delivering a hospital, where, instead of being the central figure in a family drama, supported by husband and friends who can share in her great achievement, the woman is stripped of personal possessions and placed in stark, unfamiliar surroundings, to undergo among strangers what is usually a painful experience of at least several hours' duration...the rack-like delivery bed"
July 30, 2011 – Shelved as: sociology
December 31, 2011 – Shelved as: non-fiction

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