Jean Donnison

The fascinating history of midwifery in Europe, with particular attention paid to England. It becomes particularly detailed in the seventeenth century, and after reading this book one will be able to name many boardmembers, politicians, and doctors instrumental in the struggle over gynecological treatment. I noted some of my favorite quotes and historical details in the The appendices are a treasure trove of seventeenth century midwifery license (in which the midwife must promise not to "in anywise use or exercise any Manner of Witchcraft, Charm, Sorcery invocation, or other prayers"), a prospectus of the British Ladies' Lying-in Institution, and broadsheets for and against midwifery and man-midwifery.

After allopathic doctors managed to claw their ways up the social ranks, they began to see midwives, dentists, herbal healers, etc as rivals for patients. The rest of society accepted these attacks on midwives because of their cultural associations with witchcraft, late-night drinking, abortions, and helping non-married pregnant women give birth and hide the babies. Because midwives were women and predominantly illiterate and without leverage or connections, doctors managed to push midwifery from a respected profession into one so stigmatized it could not even be spoken in polite society. Of course, this didn't benefit doctors as much as they'd assumed, because few families could afford doctors' fees and few doctors would commit to the long hours of labor. Instead, the stigmatization and marginalization of midwifery meant that midwives were even less likely to have education and training, and the poor (for whom midwives were the only option) went without help during labor. Maternal and infant mortality rose (it was much lower with midwives, and much higher with just doctors or in hospitals) due to non-hygienic conditions and an increased reliance on technological interventions (like forceps). In continental Europe (and Scotland and Ireland), there was regulated training and licensing, so midwives maintained their knowledge and social status, and poor women had birth attendants. In the US, midwives lacked the few noble patrons they had in the UK, and so were even worse off. After the disgraces of the Boer War, the British government was scared that their population was too small and that their maternal death rate was too high. They began licensing and training midwives. After the world wars, they finally began a system whereby midwives would be paid a decent wage for attending on the poor. Nevertheless, midwives continue to exist in an uneasy space in the medical realm: too independent to be a nurse, but legally required to rely upon doctors if something goes wrong with a birth. This book was published in the 1970s, and doubtless much has changed in regards to midwifery in England since it was written (certainly much has altered in the US since then).

Overall, fascinating subject and replete with details and factoids that catch at the mind. The book is a delightful, comprehensive blend of history and cultural studies; Donnison points out what each legal development, international conflict, or change in government meant to the status of women, the poor, or the medical establishment. I highly recommend it if you want an in-depth look at the history of England's gynecological and reproductive health workers!… (més)