The Midwives of Seventeenth-Century London (review)

Doreen Evenden. The Midwives of Seventeenth-Century London. Cambridge Studies in the History of Medicine. Cambridge: Cambridge University Press, 2000. xvii + 260 pp. Ill. $64.95.

This study of midwives in early modern London adds admirably to what we know about who midwives were. Organizing chapters around her answers, Doreen Evenden raises several key questions: What kinds of women were midwives? What was the relationship between mothers and midwives--in both a regional and a qualitative sense? What was the relationship between the ecclesiastical licensing of midwives and the rise of male midwifery? An emphasis on local history (in this case, urban) helps to deepen the historiography of midwifery studies.

One strength of this book is Evenden's use of the urban geography of seventeenth-century London. Establishing a group of twelve core parishes, selected by size and wealth, she mines records from ecclesiastical licensing in church visitations and associated testimonials regarding the competence and practices of midwives applying for license. She also uses Nicholas Culpeper's A Directory for Midwives to investigate both midwifery's social geography and the changes in the practice of female midwifery throughout the century. Tables and maps combine with tangible details of wills and inventories to give a sampling of seventeenth-century midwifery. Evenden creates a sense of who the women were, where they practiced, and how their practice changed over time.

From evidence originating in the ecclesiastical licensing process, Evenden details the midwives and the ritual of childbirth, paying exceptional attention to the mothers involved. She determines patterns of repeated birth attendance by a midwife for the same mother; having discovered a high percentage of "repeaters," she narrates the respect and loyalty given midwives by London mothers. Further evidence comes from testimonials of mothers, who often recorded praise for their midwives. Evenden also explores the economic and social status of the mothers, finding a broad spectrum from the gentry to the less well off. The testimonials tend to come from the upper end of the continuum, perhaps a reflection of the licensing process itself.

Despite the requirement that midwives call a surgeon in case of an obstetrical "disaster," Evenden found no sign of declension in the practice of midwives among women of high status, including the wives of surgeons. These women continued to prefer female midwives even as predominantly male physicians began to preside at births.

Not only were midwives competent, Evenden argues, but they were often financially secure, and were sometimes highly visible and celebrated Londoners. Moving to evidence supplied by the midwives themselves, she evaluates wills and inventories to establish midwives' historical identity. Impressive is the extent of economic security uncovered in these records. Singular details of estates and funerals present an image of women held in high regard, and also help to counterbalance places in the book where the enumeration of research results becomes somewhat flat and dry.

Midwives of Seventeenth-Century London demonstrates the strength of the midwifery practice, adding further evidence for the high rate of positive outcomes in birth governed by midwives. Evenden argues that the loss of prominence for the female practice accompanied social changes involving the subordination of women. Her work establishes that the diminution of the authority of the church was a loss for midwives, giving power to male physicians motivated by the desire to control midwifery. Not forceps, but the growing prominence of medicine and empiricism eventually eroded the well-established and high-quality female practice of midwifery. Evenden's thoroughgoing reconstruction of midwifery and revision of ingrained stereotypes of midwives as illiterate, incompetent, and impoverished challenges much historical literature.

Deborah Kuhn McGregor
University of Illinois at Springfield

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