Outmoded Midwives?

Gender wars of the medical kind for this week’s #SalemSuffrageSaturday post, although I am uncertain of how much of a battle was waged here in Salem. Commencing in the seventeenth century with the efforts of the emigre Chamberlen brothers, armed with their supposed expertise and trade/family secret forceps, male physicians began to move into the lucrative practice of midwifery and consequently push women practitioners out in England. London’s midwives, licensed (first by the Church and later by the Royal College of Physicians), well-established and -esteemed, fought back with petitions, asserting that Neither can Dr Chamberlane teach the art of midwifery in most births because he hath no experience in itt but by reading and it must bee continuall practise in this kind that will bringe experience, and those women that desire to learn must be present at the deliv’y of many women and see the worke and behavious of such as be skilfull midwifes who will shew and direct them and resolve their doubts. These sentiments were expressed more fully in the first book about midwifery written by an English woman, Jane Sharp’s Midwives Book: or The Whole Art of Midwifery Discovered, first published in 1671 and in print until 1725.

Gonville and Caius Library, Cambridge University.

The encroachment of male physicians on an endeavor that had always been confined to women continued and accelerated in England over the eighteenth century, as an “obstetrics revolution” unfolded, but midwives continued to defend their territory with both pen and practice, and satirical artists joined the fray, with images of fumbling and grabbing doctors in wide circulation. The most arresting one by far was Isaac Cruikshank’s Man-Midwife (1793), a strange beast indeed. By the end of the century, midwives had lost about half of their market, as the wealthy and fashionable demanded the services—not quite so suspect as a century before—of educated physicians.

British Museum

The same scenario seems to have played itself out on this side of the Atlantic, although over a more constricted time period and with less organized opposition by American midwives, who did not have the numbers and public presence of their English counterparts. Midwives were very clearly held in high esteem in the new world as well: the adjectives used in their newspaper obituaries (after the hundreds and in some cases thousands of births they facilitated were noted) were: “godly”, “skillful”, “excellent” and “expert”. It is clear that their communities revered them. According to my survey of Boston and Salem newspapers, however, their advertisements get fewer and fewer after the Revolution and then suddenly, around 1795, the man-midwives arrive. That very year, as Mrs. Mary Wardilloe died in the charity hospital, Alexander Hunt, physician, surgeon and man-midwife (always a triple threat) set up shop in Salem.

Wellcome Library +Salem Gazette

After the turn of the nineteenth century, there are few references to professional midwives in the Salem papers, with the exception of death notices. In an effort to revive and professionalize the practice, Dr. Samuel Gregory founded the Boston Female Medical School to train midwives in 1848. Gregory’s motivations seem more moral than feminist, echoing the opinions raised in London a century before in his 1848 tract Man-Midwifery: Exposed and Corrected: “the employment of men in midwifery practice is always grossly indelicate, often immoral, and always constitutes a serious temptation to immorality.” The school was later assimilated into the Boston University School of Medicine, as midwifery was sidelined by the development of obstetrics, the emergence of nursing as a medical career choice for women, and the removal of childbirth from the home to the hospital.

The medical establishment of Boston, represented by The Boston Medical Journal, responded to Dr. Gregory with an opinion that “the transfer of the responsibilities of the lying-in chamber from the midwife to the educated accoucheur, resulted in a diminution of the mortality incident to childbirth, in the course of half a century, to half the former—and that physicians are more moral than clergymen.” Boston Post, April 4, 1856.

Appendix: yes, I have written this post about London and Salem midwives without mentioning witchcraft, because that connection is largely mythical. There’s an excellent discussion of how the connection was created at Dig: A History Podcast: “Doctor, Healer, Midwife, Witch: How the Women’s Health Movement Created the Myth of the Midwife-Witch”.