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Is Childbirth Any Place for a Woman? The Decline of Midwifery in Eighteenth-Century England BARBARA BRANDON SCHNORRENBERG For many centuries, the normal assistant for all women in child­ birth was a midwife. In the eighteenth century, however, the profes­ sion of midwifery began to decline markedly in England. By the nine­ teenth century midwives were mostly women of little education and generally no social status; their patients were the same. For the middle and upper classes, the stereotype of the midwife was the fat, dirty, drunken old woman whose image culminated with Dickens's Sairey Gamp in Martin Chuzzlewit. She is an old literary type, found in stories at least since the late Middle Ages, who still appears in popular novels about old and ignorant times. This view of the mid­ wife has also passed from fiction into fact to encompass all midwives in all periods in many serious works. The latest evidence of this can be found in Lawrence Stone's The Family, Sex, and MarriageP How the profession of midwifery sank to this state is the subject of this paper. There were three major factors that depressed the role and reputation of the midwife in England during the eighteenth century. The least important of these was the increase in scientific knowledge and med­ ical skill. Far more important were the professionalization of medical practitioners and the emergence of what we usually call "Victorian" ideas of the role, abilities, and status of women. 393 394 / SCHNORRENBERG At the beginning of the eighteenth century, the position of the mid­ wife in Britain seemed fairly secure.2 Any woman could set herself up in practice as a midwife. She was supposed to have a license, issued by a bishop; its qualifications were concerned with good moral character rather than knowledge or experience in the job. Since the enforcement of licensing was the responsibility of the church courts, little was done to pursue it, especially after the Restoration.3 The mid­ wife's training was primarily through experience. The best served an apprenticeship with an established midwife, and some even received instruction from physicians. Various handbooks and treatises on mid­ wifery and related subjects were also available, although the value of these was sometimes questionable. Certainly one of the most valid criticisms of English midwifery was its lack of any kind of required training and regulation.4 In the seventeenth century there had been attempts to remedy this situation. Under the Commonwealth the licensing of midwives had been placed in the hands of the physicians, but this change, which might have meant more training, lapsed in 1660. In the first half of the seventeenth century, members of the prominent family of manmidwives , Peter Chamberlen I and Peter II, attempted to establish a corporation for midwives which would have regulated itself and en­ forced requirements for training. But these proposals were opposed by both midwives and physicians and so came to nothing.5 Whether licensed or not, however, the midwife who read the available litera­ ture and who received training under a reputable midwife or physi­ cian had practical education as good as most males. The midwife was seldom involved in any kind of prenatal care. She was called in when labor began, having perhaps been consulted shortly before about supplies or equipment she might need for the delivery. At the beginning of the eighteenth century there were es­ sentially no provisions for delivery in hospitals; only in the second quarter of the century did lying-in hospitals and wards begin to be established in London, primarily for poor but respectable (married) women.6 If the delivery was a normal one, all went well; the labor after all in such cases is that of the mother. If, however, things began to go wrong, the midwife was limited in what she could do. The better trained could use manual manipulation, but the midwife had no instruments. If things got really bad, the only recourse was to call in the physician or man-midwife. This provided another ground for criticism of the midwife; it was often said that she waited so late that even the skill of the physician was inadequate to save the...


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