Part 24

There is a better thing than making women into medical men, and that is making them into medical women.

Surely it is the first object to enable women, by the most thorough training, practical and scientific, to practise that branch of the art of medicine which all are agreed should be theirs, not ‘like men’—for nearly all the best men are agreed how deficient are the practical training and opportunities of medical students, especially in midwifery, which deficiency yet does not prevent them from obtaining diploma, license, all they want, in order to practise—not ‘like men’ then, but like women, like women who wish to be real physician accoucheuses; that is, to attend and to be consulted in all deliveries, abnormal as well as normal, in diseases of women and children, as the best accoucheurs attend and are consulted.

Sensible women say, ‘But the only means to obtain a scientific education is to enter men’s classes.’

Is that the case?

Is the student’s scientific and practical education all that could be wished?

Could there not be given (and is there not given, in some Continental schools?) a far more thorough and complete scientific education, as well as practical, where there are none but women, in a midwifery school, without all this struggle and contest, which raises questions so disagreeable and ridiculous that a woman of delicate feeling shuns the indelicacy of the contest—not the indelicacy of the occupation?

The parody, the qui pro quo, is a curious one.

The indelicacy of a man attending a woman in her lying-in is by necessity overlooked.

The indelicacy of a woman attending with men in medical classes is made much of.

Would it not be far better to get rid of both at once? to have women—trained with women, by women—to attend women—trained in all branches of a scientific and practical midwifery education?

But let no one think that real midwifery education can be less complete and thorough for a woman than it ought to be for a man, if women are really to be physician accoucheuses.

And let no one think that two or three courses of lectures—a month, three months, six months at a lying-in institution, conducting twenty, thirty, or one hundred labours—will make a woman into a (real) midwife.

One hundred labours may be normal, requiring no interference but that which a good midwifery nurse can give. The one hundred and first may be abnormal and may cost the patient her life or health, the attendant her reputation and peace, if her education has been nothing but the few lectures, the few weeks, the few labours.

Let us suppose for a moment that, leaving aside the ordinary talk of giving a woman a ‘man’s medical education,’ good or bad, we imagine what a college might be to give the whole necessary training—medical, scientific and practical—to make real midwives, real physician accoucheuses.

There must be first, of course, the lying-in institution, the deliveries conducted by fully qualified head midwives, of whom enough perhaps exist already for this purpose, who will give practical instruction to the pupil midwives at the bedside.

There must be a staff of professors, to give scientific instruction in midwifery, but also in anatomy, physiology, and the like; in pathology and pathological branches; above all, in sanitary science and practice.

Dissections and post-mortem examinations will have to be practised. It need not be said that these must be at a quite different time and place in the ‘course of education’ from the training about the lying-in patients.

Probably all these professors, or nearly all, must at first be men.

Probably in time all these professors, or nearly all, will come to be women.

The course of education, before the end of which no pupil can receive the certificate of a fully qualified midwife, must certainly not be less than two years.

Is this merely an ideal? Is it an Utopia? Have we never seen it in practice? Could it not be put in practice in practical England?

Seen it in practice we have—save and except the sanitary practice, which is wofully deficient—on the continent of Europe.

And lady professors there have been in midwifery on the Continent quite equal to the most distinguished physician accoucheurs in this or in any other country; who took their place among these, among the Sir James Simpsons and the Sir Charles Lococks, as of them, and not outside of them, in all midwifery matters, scientific as well as practical.

The names of Madame Boivin and Madame Lachapelle, of Paris, are known to all Europe. And there are many other names of lady professors in midwifery and of midwives, not known in England at all, who take their uncontested places on the continent in practice, in consultation, in teaching, as a Sir James Simpson here. They teach in midwives’ colleges, and imperial and royal ladies are sometimes, and often wish to be always, attended by them.

Note.—A society has already existed for several years, the object of which, according to its programme, is ‘to provide educated women with proper facilities for learning the theory and practice of midwifery, and the accessory branches of medical science.’

The programme states most justly that, for want of these, for want of ‘proper means of study,’ of ‘any public examination,’ ‘any person may undertake the duties of a midwife.’

Let us look what the ‘proper means of study’ are which it provides.

They are—1. Attendance upon lectures during two winter sessions. 2. Attendance ‘during the intervening summer’ upon clinical practice at ‘a’ lying-in hospital or maternity charity, with personal attendance upon at least twenty-five deliveries!