- The Court Midwife
The Court Midwife, by Justine Siegemund (1690), edited and translated by Lynne Tatlock, is a welcome addition to the University of Chicago Press's series The Other Voice. That a work on childbirth authored by a woman about her own craft appears in the series epitomizes how profoundly women authors, and especially female medical authors, violated gender and professional boundaries. Indeed, Siegemund's handbook was only the third midwifery text to be published by a woman since the advent of print, and the first in the German territories.
Although in 1690 Siegemund was official court midwife at Brandenberg and had had a long and respected career as a midwife, she felt compelled to include official political and religious approval from the appropriate authorities. She also included sworn testimony of eleven patients attesting to her good character and skill. Since Siegemund had never given birth herself — the one most usual and expected prerequisite for birthing others — she also felt it necessary to claim that she had been "miraculously called" to her profession by God after almost dying in the hands of ignorant midwives who thought she was pregnant when, in fact, she suffered from a prolapsed uterus. She vowed to learn the craft herself to better aid other women.
As Tatlock tells us, Siegemund became "the next best thing to an expert in obstructed labor and had perfected the techniques of cephalic and podalic version" (3). Her protocols obviated the need for male interventions with dangerous instruments in almost all situations. That all of these skills and the spunk they demonstrated might cause enmity among male rivals is obvious.
Siegemund not only transgressed gender boundaries in authoring a book and including innovative procedures, but also by showing intellectual sophistication. According to Tatlock, Siegemund "allies herself with reason and in this sense participates in public male-dominated discourses of her era" (20). Thus, Tatlock sees Siegmund as a pre-Enlightenment figure who based her practice on experience and reflection, and "not specific information" (5). Ultimately, she became a rebel who thumbed her nose at convention and traditional authorities
This particular aspect of Siegemund's text differentiates her from her two predecessors, Louise Bourgeois (Observations diverses, 1609) and Jane Sharp (The Midwives Book, 1671), who demonstrated their knowledge of Hippocrates and other ancient authorities in their respective midwifery manuals. In contrast, Siegemund never discussed ancient knowledge. Her intention was to present the appropriate protocols for "difficult" and "unnatural births" (63).
Siegemund presented most of her instruction in the form of a dialogue between an experienced midwife (herself) and an inexperienced one. The dialogue, a common device among humanist authors such as Erasmus, but unusual for medicine, allowed her to approach her subject from various angles. By means of a set of methodical, well-thought-out questions, Siegemund conveys a wealth of [End Page 933] information about the successful delivery of a baby in almost any birth position. She devised her questions, answers, and illustrations to explain in detail how to reposition the infant manually inside the womb, or in extremis by means of instruments. In addition, Siegemund emphasized the importance of "touching" (an internal examination of the cervix and the womb) to determine the infant's position, thus avoiding premature breaking of the amniotic sac to release the "waters," which could be fatal to mother and child.
Tatlock has made a valuable contribution to the history of medicine, midwifery, and the body by smoothly translating and editing this important work. Her introduction, notes, and glossary help greatly to put the text into its historical context. I don't agree with Tatlock's claim that the mortality rates were high for both parturient mothers and infants. While infant mortality in the early modern period was high by modern standards — about 20–25% in the first year — maternal mortality rates were no higher than they were in the 1930s. Also, Tatlock might have spent more time discussing the significance of the images...