The Midwives of Seventeenth-Century London (review)

The history of midwifery is a narrative that has been polarized by gender and professional rivalries since man-midwives and physicians first began to encroach on the traditionally female domain of childbirth in the seventeenth century. Male medical accounts had a vested interest in portraying midwives as ignorant, illiterate, and superstitious, and female midwives responded in kind by accusing physicians of economic greed and a disastrous lack of practical knowledge. Twentieth-century histories have tended to reproduce these stereotypes, but in the past two decades, more nuanced treatments have begun to appear; Doreen Evenden is one of the strongest of these revisionary historians. Like Laurel Thatcher Ulrich, who won a Pulitzer Prize for her 1991 reconstruction of an eighteenth-century New England midwife's diary, Evenden is a meticulous archival scholar. Evenden's area is seventeenth-century London midwifery, and her careful combing of ecclesiastical records, diaries, account books, tithe rolls, tax records, oaths, wills, and testimonial certificates has yielded both a richly detailed portrait of an elided history and some surprising insights into early modern midwifery.

The challenge of understanding the culturally central place that midwifery had before it was co-opted by medicine is complicated by two impediments: the practice and theory of midwifery in seventeenth-century England relied primarily on the oral - and hence irrecoverable - transmission of knowledge, and childbirth as an event was secret, largely hidden from public scrutiny. Recovering this occluded history is thus an arduous task; by sifting and analysing often mundane bits of evidence, Evenden has pieced together the forgotten names of London midwives (almost twelve hundred), their economic circumstances, their training, their clients, and the licensing practices that regulated their work. The book's most original and important chapters ('Ecclesiatical Licensing of Midwives, 'Pre-Licensed Experience,' parts of 'Mothers and Midwives') treat the process of licensing and the training necessary to achieve that accreditation. Evenden summarizes but avoids entering into the controversial aspects of this topic (the disputed origins of licensing, midwifery and witchcraft, the social and theological role of baptism), choosing instead to focus on how the licensing system worked and how it affected London midwives. Much of her evidence comes from oaths and testimonials (useful samples of these are included in the appendices), which are key sources for understanding this complex network of relations.

The result is a quite stunningly detailed portrait of how integral a part of the social fabric midwifery was. Rather than being regulated solely by Church authorities, it had, as Evenden describes it, an internal regulatory mechanism that obliged midwives to report fellow midwives who did not adhere to the standards of the profession. Unlike physicians and surgeons, whose expertise was judged by other physicians and surgeons, being licensed as a midwife required sworn testimonials of six women, most of whom would have been clients. These testimonials give new insight into the client-midwife relationship, revealing, among other things, the high rate of 'repeat business,' midwives who attended multiple births for the same client. Evenden's analysis of midwifery training also forcefully argues - contra Percival Willughby and others - how rigorous a preparation a licensed midwife had, typically serving as a deputy or attendant midwife for a number of years before she was licensed. Evenden's analysis of wills and tax records gives a fascinating glimpse into the economic dimension of midwifery, and it is apparent from the monetary and material legacies they left that some midwives were handsomely remunerated.

Revisionary though the book is, the wealth of archival material that Evenden presents sometimes overburdens the analysis. One chapter, 'Midwives of Twelve London Parishes,' is essentially a list of the information she has compiled for each parish. Valuable though this raw material will be for other scholars, some interpretive framework would give it greater impact. Evenden spends little time on midwifery's engagement with anatomy and medicine, either with respect to training or in relation to medical questions and procedures (although she does treat podalic version and forceps briefly). Given her highly suggestive epilogue, which...