William Smellie's Use of Obstetrical Machines and the Poor

William Smellie's Use of Obstetrical Machines and the Poor PAM LIESKE In 1722 the British obstetrician William Smellie began taking notes on his most notable midwifery cases, a practice he continued throughout his professional life. These case notes eventually made their way into his A Treatise on the Theory and Practice of Midwifery (1752).' One case from 1724 involved a midwife who had no education "and who had formerly vaunted that she always did her own work," as he writes, "and would never call in a man to her assistance."2 When the child presented wrong and the midwife had difficulty delivering it, the woman's husband insisted on sending for Dr. Smellie. On hearing the news, the midwife "fell to work immediately , and pulled at the child with [such]... force and violence ... [that] the body was pulled from the neck, and she fell down on the floor... [after which she] was immediately seized with faintings and convulsions, and ... put to bed in another room" (7). Arriving to find the house in an uproar, Smellie claims he quickly determined that the mother's vaginal bleeding was not from the uterus, but from the child's head, "which to my great joy, I found lying in the vagina and pelvis" (7). In meticulous detail, he describes his successful delivery of the head through careful use of his fingers , a crochet, and the exact positioning of the mother's body. This amazing story concludes with Smellie reflecting that, "this accident was lucky for me, and rendered the midwife more tractable for the future" (8). 65 66 / LIESKE While Smellie's story is noteworthy for a number of reasons, what is of primary interest to me is not the opposition between male and female midwives . In the early eighteenth century, it was common for midwives to call in a surgeon or man-midwife when a laboring woman's health was in danger and the unborn child was either soon to be or already dead; it was also routine for many, if not most, female midwives to distrust male midwives. They were seen, with good reason, as a potential threat to a female midwife's reputation and livelihood. Thus the mutual dislike between Smellie and his female counterpart is not surprising.3 What interests me, rather, is the way Smellie constructs his narrative. There is an immediacy and urgency to his story, as if he wanted his readers to peer over his shoulder and see firsthand exactly what he experienced moment by moment. The effect is more reminiscent of an epistolary novel than of a medical case history. With the focus clearly on Smellie's task, the mother who experiences this grisly birth recedes from view and virtually disappears from the narrative. We are not told her reaction to the decapitation of her baby or to Smellie's attempts to remove its head from her vagina—nor, tellingly, is the baby's sex ever identified. She is merely the body that he works on; he locates the baby's head within her and positions her for delivery. In such an obstetrical emergency, one could argue that Smellie has no time for patient empathy or social niceties. He has to think and act quickly or the mother may die of hemorrhage. While any absolute judgment about Smellie's treatment of women based on this one case would be suspect, his detached way of reporting events and of ignoring maternal subjectivity is suggestive. The purpose of this paper is to examine William Smellie's career in more detail, so we can come to a firmer sense of how he, and other male midwives, perceived women and used them in their clinical practice. Since ideas about gender and sexual difference accompany all relationships between and among the sexes, it stands to reason that analyzing the doctor-patient relationship where the doctor is male and the patient is female will yield new insights into eighteenth-century assumptions and beliefs about women. We will find that for Smellie, as for many male midwives of the eighteenth-century, the mother is important, but only as a vehicle for the scientific study of childbirth. In addition to treating their female...