Midwives and Midwifery

Last up-dated 24.02.06

Midwifery was traditionally a female occupation.  The conventional history of midwifery presents a story of women midwives, skilled, well respected, economically successful and employed by all classes in the population whose monopoly of the occupation was shaken when male physicians and surgeons became interested in the work.

'Men midwives' gained increasing influence from the seventeenth century.  The nineteenth century is usually considered to have seen the virtual take over of birth by 'men midwives' or obstetricians in Britain.

The Midwives Acts of 1902 which laid down the requirements for Midwife education and registration is sometimes seen as demonstrating the achievement of professional status for midwives.  Others have suggested that it finally marks the loss of autonomy and the regulation of midwifery by others. This bland account conceals many interesting variations and complications.

A number of general texts give insight:

  • Donnison, J., Midwives and Medical Men: a history of inter-professional  rivalries and Women's Rights London: Heinemann Educational 1977.
  • Roberts,  H., ed. Women, Health and reproduction. London: Routledge & Kegan Paul, 1981.
  • Wilson, A., The Making of Man-Midwifery, Childbirth in England 1660-1770. London: UCL Press, 1995.

There is a standard history of the Royal College of Midwives.  Like all commissioned histories, one of the objectives of this is to justify and explain the actions of the College.

    Cowell,  B., and D. Wainwright, Behind the Blue Door: History of the Royal College of Midwives1881-1981. London: Bailliere Tindall, 1981.

In an account of the nurses registration act Rosemary White discussed some of the issues of the Midwives Act:

    White,  R. Some political influences surrounding the Nurse's Registration Act 1919. Journal of Advanced Nursing 1 (1976): 209-217.

In the face of much change traditional practices persisted.  Some Scottish customs have been documented:

  • Bennett, M., 'Part One : Childbirth and Infancy.' In, Scottish Customs from the cradle to the grave. Edinburgh: Polygon,  1992.
  • Buchan, D., ed. Folk tradition and folk medicine in Scotland: the writings of David Rorie.  Edinburgh: Canongate Academic, 1994.

The quality of the work of midwives is difficult to determine.  Medical journals published horrific accounts of the work of incompetent midwives, but they had a vested interest in enhancing the reputation of doctors and diminishing that of midwives.  The voice of the midwives themselves is difficult to find.  Some historians have attempted to defend them.

The good qualities of eighteen & nineteenth century midwives working in London have been demonstrated by an analysis of the returns from the Royal Maternity Charity:

    Seligman, S. A.  'The Royal Maternity Charity: the first hundred years.'  Medical History 24 (1980): 403-418.

In Scotland 'schools' for training midwives existed in centres such as Edinburgh, Glasgow and Aberdeen from at least the mid eighteenth century.  It seems to have been accepted, in some parishes in Scotland that midwives should be educated or trained and that they were expected to go away to do this.  A short story by John Galt tells of the actions in one parish :

    Galt, J. 'The Howdie.' In John Galt Selected Short Stories. ed. I. A. Gordon, 73-95. Edinburgh: Scottish Academic Press, 1978. [First published 1833.]

The complications of childbirth could be tragic.  In particular the ravages of puerperal fever have attracted attention.  An excellent account of these issues is to be found in the work of Irvine Loudon:

  • Loudon, I., Death in childbirth: An international study of maternity care and maternal  mortality 1800-1950. London: Clarendon Press, 1993.
  • Loudon, I., 'On Maternal and Infant mortality 1900-1960.'  Social History of Medicine 4 (1991): 29-73.

The experience of women in childbirth and their attitudes to their midwife are presented in a number of texts.  A good example of oral history looking at the early twentieth century is:

    Leap, N. and B. Hunter, The Midwife's Tale: An oral history from handywoman to professional midwife. London: Scarlet Press, 1993.

The experience of eighteenth century aristocratic mothers is explored in:

    Lewis, J. S., In the Family Way: Childbearing in the British Aristocracy 1760-1860. New Jersey: Rutger's University Press, 1986.

The co-operative movement gave some women a voice.  Accounts of the experience of childbirth can be found in:

    Llewelyn Davies, M., ed. Maternity: Letters from working women. London: Virago 1978.

The 'advances' in the science of childbirth led to the founding of maternity hospitals.  Here skills of midwifery were passed on by using the labours of poor women to teach medical students and midwives.  The effect of this change on women has been discussed in:

    Versluysen,  M., 'Midwives, medical men and poor women labouring of child: lying in hospitals.' In Women, Health and reproduction. ed. H. Roberts, London: Routledge and Kegan Paul, 1981.

A rare account of the experience of an untrained midwife at the time of the Midwives Act in 1902 is to be found in the first personal account in:

    Llewelyn Davies, M., ed. Life as we have known it  by  Co-operative Working Women. London: Virago, 1977. [First published 1931.]

The work of community midwives is considered in:

    Fox, E., 'Midwifery in England and Wales before 1936: handywomen and doctors.' International History of Nursing Journal 1 (1995): 17-28.

Infant feeding could be a problem if the natural mother was unable to feed her infant.  Satisfactory artificial feeding was not introduced until the second half of the nineteenth century.  Wet nurses were used extensively.  The British tradition differed somewhat from the systems used in continental Europe:

  • Fildes, V., Wet Nursing a History from antiquity to the present. Oxford: Basil Blackwell, 1988.
  • Fildes, V., Breasts bottles and babies. Edinburgh: Edinburgh University Press, 1986.

Two important collections of essays in the history of British and European midwifery have been published by Hilary Marland. These essays set a high standard of scholarship.

  • Marland, H., The Art of Midwifery, Early Modern Midwives in Europe. London: Routledge, 1993.
  • Marland, H. and A. M. Rafferty, eds. Midwives, Society and Childbirth. Debates and controversies in the modern period. London: Routledge, 1997.

You might like to look at the website which examines the life of Martha Ballard, a midwife in eighteenth century Massachusetts USA:
Martha Ballard's story, the Midwife's Book.