A Short History of Clinical Midwifery: The Development of Ideas in the Professional Management of Childbirth (review)

British emeritus professor and consultant Philip Rhodes wrote this book, in his retirement, for “midwives” and “ordinary men and women” (p. vii). The work comes from the perspective and bias of a clinician, not a professional historian. Though the bibliography consists mainly of secondary sources, this is an “insider’s” history, written by a master physician with intimate knowledge of twentieth-century scientific obstetrical literature.

The central theme is progress in the management of difficult labor and the obstetrical complications that for centuries claimed the lives of pregnant women and their babies. There appears to be very little about the actual practice of midwifery, despite the title and the innumerable mentions of midwifery throughout the text. This reviewer automatically substituted obstetrics for the word midwifery during the reading. Perhaps this is the bias of an American clinician, but a more appropriate title might be “A Short History of Clinical Obstetrics.”

Starting in ancient Mesopotamia, the story skims to the seventeenth century in twenty-two pages. The chapters on the seventeenth, eighteenth, and nineteenth centuries read like miniature biographies and annotated bibliographies interspersed with very interesting commentary. Chapters 10, 11, and 12, the second half of the book, deal with the twentieth century. Here the story gains from the personal experience of a master clinician conversant with the clinical problems and with some of the major obstetricians from that era.

The strength of the book for graduate students in history would seem to be the authoritative interpretation of practical clinical obstetrics by a knowledgeable British consultant who trained and practiced during the transitional eras: from heroic obstetrics, characterized by spontaneous deliveries, destructive operations on the fetus, and internal podalic version and extraction; to the specialty of obstetrics and gynecology, characterized by low forceps and episiotomy, and the conservative use of cesarean section; to the postmodern era of spontaneous delivery, liberal use of cesarean section, and the subspecialty of fetal and maternal medicine. The work is generally applicable to American obstetrics.

Obstetrical residents and nurse midwives trained in the philosophy of normal vaginal delivery and cesarean section, as well as young mothers and fathers with the expectation of normal outcome—healthy mothers and babies—will appreciate reading of the long struggle to achieve the present state of the art.