Midwifery and the Diseases of Women

LETTER I.. History of Midwifery.

HISTORY OF MIDWIFERY.

The Art of Midwifery in Ancient and Modern Times—To what extent may the Perils of Childbirth be Lessened?

Midwifery is the art of aiding women in childbirth. In some mode—rude, simple, or complex—it has been practiced in all ages of the world. According to the records of medicine, however, the great mass of the human family has been born and brought up without the aid of the so-called obstetrical science of modern times. The ruder nations anciently, as well as the savage nations in later times, appear to have exhibited, practically at least, a much greater confidence in the prophylactic and healing powers of nature than we see among the more civilized and enlightened portions of our race.

But let us, for a little, glance at midwifery as it has existed at different periods of the world.

We read in the Book of Genesis, chapter thirty-fifth, that as Jacob and Rachel were journeying from Bethel, Rachel travailed, and had a hard labor.

“And it came to pass, when she was in hard labor, that the midwife said to her, Fear not, thou shalt bear this son also.

“And it came to pass, as her soul was departing (for she died), that she called his name Ben-oni: but his father called him Benjamin.

“And Rachel died, and was buried in the way to Ephrath, which is Bethlehem.”

In the twenty-fifth chapter of Genesis, Moses informs us that Rebekah, who had been barren, conceived, being the wife of Isaac.

“And when her days to be delivered were fulfilled, behold, there were twins in her womb.

“And the first was born red, all over like a hairy garment: and they called his name Esau.

“And after that his brother was born, and his hand took hold on Esau’s heel: and his name was called Jacob.”

The birth in this case appears to have been a natural one, in which the children followed each other in quick succession.

We read also in the thirty-eighth chapter of Genesis, the case of Tamar, who bore twins, being attended by a midwife.

“And it came to pass, in the time of her travail, that, behold, twins were in her womb.

“And it came to pass, when she travailed, that the one put out his hand; and the midwife took and bound upon his hand a scarlet thread, saying, This came out first.

“And it came to pass, as he drew back his hand, that, behold, his brother came out; and she said, How hast thou broken forth? this breach be upon thee: therefore his name was called Pharez.

“And afterward came out his brother that had the scarlet thread upon his hand; and his name was called Zarah.”

Some have supposed that this was a case of spontaneous evolution of the fetus, a thing which has been known to occur in modern practice, proving that nature sometimes works in a very wonderful manner in these circumstances. It is certainly a very singular fact for the hand of one child to recede after coming into the world, and the other child to be born first.

The Hebrew women, when in captivity, had, as we read, two midwifes, Shiphrah and Puah. These were commanded by Pharaoh, that when they did the office of a midwife to the Hebrew women, if a son should be born, they should kill him. But the midwives feared God, and did not as the king of Egypt had commanded them, but saved the male children alive.

The period of suckling appears to have been prolonged, in Bible times, to a much greater length than it is in modern times. In the Apocrypha, the woman says to the son, “I, who gave thee suck three years.”

Profane writers, prior to the time of Hippocrates, give little account of the art of midwifery; and from the time in which the Father of Medicine lived, down to a comparatively recent date, little was said or known concerning it as an art.

Dr. Francis informs us, that toward the latter part of the sixteenth century, a Dr. Raynald published in England a work, the first of the kind that had appeared in that country, which he called the “Garden of Lying-in Women and Midwives.” It was afterward translated into the Latin, and most of the modern languages, and became the manual of instruction for females. “The popular prejudice was so great at that time in favor of female practitioners,” observes Dr. Francis, “that an unfortunate physician of Hamburgh was publicly branded, whom curiosity had induced to be present at a delivery, in female attire.”

Still quoting from Dr. Francis, we learn, concerning this old work, the following particulars: “In his prologue to women readers, he states that the byrth of mankynd doth mostly concern and touch only women, and that he hath declined nothing at all from the steps of his Latin author, but that many things are newly added to this boke. In his first part of the work he gives the anatomy of the inward parts of women; in the second, he declares the divers sorts and manners of the deliverance or birth of mankind. In the third, he treats of the election and choice, by signs and tokens, of a good nurse, which may foster and bring up the child, being born. In the fourth and last, he communes of conception, with the causes hindering or furthering the same, showing the councils and remedies whereby the unfruitful may be made fruitful, and the impediments of conception, by virtue of medicines, removed. He solicits the favor of the reader to good acceptance of his labor and pains spent in compiling these aforesaid matters. He invocates all the nine muses of Helicon, with their poetical spirit, to breathe over this his boke, against the strange, perverse, and wayward wits who would desire this performance to be suppressed and kept in darkness, rather than that it be sent forth into the light. There is nothing, he says, that may not be abused and turned to evil, even meat and drink; but that to the good every thing turneth to good. He is fearful that the medicines he recommends may be abused; that light persons ought not to read his boke, and some would that neither honest nor dishonest should have it. He adds, every one may read it; because no one shall become by it either lewd, unhappy, or knavish. The consideration which prompted the publication he declares to be on account of the manifold, daily, and imminent dangers, which all manner of women, of what estate or degree soever they be, in their labors, do sustain and abide, even with peril of their lives. He considers it to be a charitable and laudable deed, and thankfully to be accepted of all honorable and other honest matrons, if this little treatise were made to speak English, as it hath been long taught to speak Dutch, French, Spanish, and divers other languages.

“He enjoins that ladies and gentlemen have this boke in their hands, and cause such parts of it to be read before the midwife and the rest of the women present in labor, whereby the laboring woman may be greatly comforted and alleviated in her travail. And though some midwives would have this boke forbidden, yet, he adds, the good need not be offended, though the evil-hearted endeavored to make it that it was nothing worth, and that he hath exposed the secrets and privities of women, so as that even boys read his boke openly, as the tales of Robin Hood. Notwithstanding all these accusations, he trusts that all good midwives would be glad of his work, because of their familiar knowledge, and that others of them such as could read, would read it themselves, and laud it as its merits deserve.”

In regard to the employment of men as midwives in France, it appears that in 1663, the Duchess de Villiers was delivered by the assistance of Julien Clement, a professor of surgery in Paris. He was soon after appointed to the office of midwife to the Princess of France.

The princess, it is said, had some scruples in regard to employing Clement. As she desired it might be kept a profound secret, she sent for him, he being a surgeon of great reputation; and he was conducted with the greatest secrecy into a house where the lady was, with her head covered with a hood. The same surgeon was employed in subsequent labors of the same lady, and the princesses made use of surgeons on similar occasions; and as soon as it became fashionable, the name of accoucheur was invented to signify that class of surgeons. Foreign countries soon adopted the custom, and likewise the name of accoucheurs, for they had no such term in their own language; but in Great Britain they have more generally been termed midwives.

Dr. William Shippen, of Philadelphia, a very worthy citizen and exemplary man, had the honor of being the first teacher of midwifery in the United States. In London he enjoyed the advantages of the instructions of the celebrated Dr. William Hunter, and on his return to his native country he was chosen professor of anatomy in the earliest of its medical schools, the University of Pennsylvania. His lectures on obstetrics, like those upon anatomy and surgery, are said to have evinced great ability and command over his auditory. His first course on midwifery was delivered in 1762, and was attended by only ten pupils. He, however, lived to give instructions to a class of two hundred and fifty. This leads me to the reflection, will those who now advocate the employment of females principally in midwifery, even when the country has grown many times larger in numbers than it then was, meet with one half the success that Dr. Shippen did? If so, may it be, and Heaven speed the right.

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