Modern German Midwifery, 1885–1960 by Lynne Fallwell (review)

When Lynne Fallwell mentioned her research about the professionalization of modern German midwifery since the late nineteenth century to colleagues, she was greeted with surprise. North American colleagues questioned her time frame: wasn’t midwife-assisted home delivery a recent phenomenon and linked to second-wave feminism in the 1960s? German colleagues could not understand why the modernization of midwifery should be considered a “novel topic” (p. xi); the professionalization of midwives had a long history in Germany. Fallwell’s German colleagues might also have wondered whether a new monograph was necessary, in light of the extensive existing German scholarship on the subject.

Fallwell’s book does indeed rely heavily on this literature, especially in the earlier chapters, although later chapters are also informed by her own research. In an overview of midwifery from the early modern period to the mid-nineteenth century (chap. 1) the author argues that a proliferation of medical regulation raised the public profile of midwives who were, however, increasingly expected to act in the service of municipal officials and clergy, particularly by upholding sexual mores. While new schools promoted the gradual process of midwifery professionalization, it was jeopardized, according to Fallwell, by the mounting rivalry between midwives and scientifically educated physicians and, more importantly, by the introduction in 1872 of a liberal trade law in the newly unified German Reich (not in 1869 as claimed). This permitted everyone to heal with or without formal qualifications. As a result midwives faced the competition of a large number of lay women who brought the profession into disrepute.

In chapters 2 and 3, respectively, the author concentrates on two well-known women activists to recount successful campaigns for midwife reform in the modern period: Olga Gebauer (1858–1922) and Nanna Conti (1881–1951). Thanks to Gebauer and her associates midwifery developed from a vocation in crisis to an organized profession complete with associations, journals, and an updated program of practical and scientific training that shored up the profession’s autonomy. After 1933 the national midwives association was aligned with the Nazi health organizations. As an anti-Liberal, anti-Semite, early party member, and convinced eugenicist, Conti was well qualified to be appointed Reich midwifery president, a post she held until the end of the Second World War. But Conti was also a devoted midwife and managed, supported by her son, the Reich health leader, to consolidate the status of midwifery. While hospital deliveries had increased markedly in Weimar Germany, Nazis preferred home births. This enabled Conti in 1938 to enshrine the right to delivery at home in the first national midwifery code, which remained unchanged until 1985. Furthermore, the code prescribed for the first time that midwives had to attend all deliveries with or without a doctor present. If it had not been motivated by eugenics and pronatalism it would indeed appear ironic that a regime known for its extreme misogyny also guaranteed the autonomy of this women-specific vocation and helped its survival as an essential part of German birthing culture until today.

Chapter 3 also gives a brief outline of events after the Second World War, when midwives continued to receive legal recognition of their professional rights. Even today midwifery organizations remain strong, and the traditional fighting spirit is kept alive in multiple campaigns for a secure professional future.

The second half of this book adopts a topical approach, and the use of more primary research, mostly from Bavaria, makes this the more original part. Chapters 4 and 5 concentrate on midwife education, discussing studiously, if rather tediously, the changing criteria for selecting, retaining, and training students. A case study from 1942 to 1943 in the Bavarian town of Bamberg usefully delineates the progress of one young hopeful from application to graduation. Chapter 5 compares course curricula in the Nazi era with the two postwar states and reveals, again hardly news, strong ideological contents in midwife training under...