The Politics of Reproduction: From Midwives' Alternative Public Sphere to the Public Spectacle of Man-Midwifery

Why retell, yet again, how the British man-midwife displaced the traditional female practitioner during the eighteenth century? Haven’t medical and feminist historians laid bare all the relevant evidence and problems here? After all, many sources—especially the major obstetric texts, the handful of midwifery texts written by women, and such novels as Tristram Shandy—have been closely examined and have generated scores of scholarly articles and books. Yet for at least thirty years, there seems to be no stopping historians of medicine and gender (myself included) from returning to this well-known tale of male doctors somehow triumphing over midwives.

Why do we tell this story so often? Surely for many feminists, the story serves as a most dramatic example of and also an allegory for the broader, complex shifts in the family, demographics, and professions that occurred in the eighteenth century. For instance, Louis LaPeyre’s 1772 snipe, “a midwife is an animal with nothing of the woman left,” not only reveals how a once important female occupation was dismissed as uncivilized, but also captures the contemporary vitriol used to check female spheres of influence and denigrate powerful women more generally. ¹ Documents such as the learned, lengthy, and frequently sarcastic defense by midwife Elizabeth Nihell reveal how much midwives did know about reproductive anatomy and care at the time; moreover, her observations, such as that “many women have found, by severe experience, their having been enemies to themselves, in abandoning or slighting those of their own sex” also reveal women’s ability to construct an argument based on gender and attempt to create female bonds. ²

Yet, even if we are right to grasp the story as both interesting in itself and standing for much larger shifts in gender relationships, the mechanics of the tale—how men conquered the midwives—seem much more elusive. Two opposing stories explaining obstetricians’ triumphs have dominated historical literature. From the time man-midwives began giving obstetric lectures in the eighteenth century, proponents trumpeted the triumphs of the profession: forceps, fillets, education, masculine ingenuity, and emotional detachment. Naturally, sensible fathers-to-be and their pregnant wives chose obstetricians. ³ From the 1960s onward, many women’s historians echoed Elizabeth Nihell’s 1760 argument: obstetricians denigrated midwives, magnetically described their own charms, unnecessarily wielded instruments, cruelly thrust them into women, and often killed mothers and infants. ⁴ These two versions—medical glory versus gory misogyny—verge on the polemical and often incorporate deeply ahistorical notions.

In the end, neither polemic convincingly explains how the transition from female to male midwives occurred. Even if man-midwives possessed stunning medical expertise, why, in a century of sexual modesty, would a woman permit a man to examine and touch her private parts? And even if man-midwives mesmerized and coerced the naive, why would any mother choose a practitioner who had hacked up other women and babies? Recent historians, most notably Roy Porter and Adrian Wilson, have retold the story in new and nuanced ways, emphasizing previously overlooked features of the doctor-patient relationship. In “A Touch of Danger,” Porter argues that the accoucheur cultivated his clientele not so much by brandishing his medical expertise as by listening to expectant mothers’ concerns, quelling their fears, and serving as friend, even confidante. Wilson argues that mothers were far from coerced, but rather based their decision on what relatives, friends, and neighbors had experienced during their deliveries. Man-midwives, as it turns out, did rather well by word-of-mouth and public recommendations. ⁵ Porter and Wilson offer fresh and plausible insights because they are willing to challenge historical platitudes. Obviously they take on both sides of the obstetricians-versus-midwives polemic, but they implicitly challenge another historical convention: the association of the “private” with women and the “public” with men. Porter places the eighteenth-century man-midwife in the company of expectant mothers, taking tea, chatting, gossiping, engaging in stereotypically feminine, domestic activities; Wilson situates mothers in the public activity of seeking and spreading news.

In this article, I want to push further...