Early History of English Midwives
In order to arrive at anything like an appreciative understanding of the origin and effects of the Midwives Act of 1902, one must review briefly the vicissitudes of the English…
From: 1554 C.E. To: 1913 C.E.
Location: England, United Kingdom
Note: This article has been excerpted from a larger work in the public domain and shared here due to its historical value. It may contain outdated ideas and language that do not reflect TOTA’s opinions and beliefs.
“Early History of English Midwives” from The Midwife in England, Being a Study in England of the Working of the English Midwives Act of 1902 by Carolyn Conant Van Blarcom, 1913.
In order to arrive at anything like an appreciative understanding of the origin and effects of the Midwives Act of 1902, one must review briefly the vicissitudes of the English midwife herself from at least the beginning of the sixteenth century. Prior to this time the history of this strange person is as elusive as it is interesting, being difficult to extract from the annals of the Church and from medical literature. It is evident, however, that midwives existed in no small numbers and that they attended not only the poor and wretched but also queens and other ladies of high degree.
That the work of these early practitioners was bound up with superstitions is suggested by the injunction of Bishop Bonner (1554) that "The midwyfe shall not use or exercise any witchecrafte, charms, sorcerie, invocations or praiers other than suche as be allowable and may stand with the lawes and ordinances of the Catholike Churche." Bishop Bonner's concern over the methods employed by midwives was apparently due to the fact that these women were licensed by the bishops.
This function of licensing was evidently assumed because of the Church's interest in the christening of infants rather than on account of any concern over their physical welfare. Midwives were authorized, when licensed, to christen infants, and in this connection we find the following question among Canterbury records: "whether parsons, vicars or curates be diligent in teaching midwives how to christen children in time of necessity, according to the cannons of the Church," while the bishop of another diocese asked, "Do any undertake the office of midwife without license?" The midwife's practical qualifications to practice seemed to be entirely overlooked.
It seems that bishops granted licenses until sometime during the 18th century, there being but one interruption to this practice recorded, that being mentioned by Elizabeth Cellier (1687) who says, "Nor did Bishops pretend to license midwives till Bishop Bonner's time, who drew up the form of the first license, which continued in full force till 1642, and then the Physicians and Chirurgeons contending about it, it was adjudged a chirurgical operation, and the midwives were licensed at Chirurgeons Hall, but not till they had passed three examinations before six skilful midwives and as many chirurgeons expert in the art of midwifery. Thus it continued until the Act of Uniformity passed (1662), which sent the midwives back to Doctors' Commons where they pay their money (take an oath which it was impossible to keep) and return home as skilful as they went hither."
In view of the mild conceit prevailing at the present time over twentieth century enlightenment, it is particularly interesting to find that though the public at large is to-day almost unmoved by the ignorance and negligence of midwives, there was much dissatisfaction among the women in England during the 16th century because of the incompetence of this group of practitioners. There was even then frank recognition of the fact that education was seriously needed.
The difficulties attending any effort to promote the education of midwives were almost insurmountable, however, because of the general reluctance to print in the mother tongue any instructions to midwives, and the unwillingness of women midwives to be taught by men. However, in 1540, "a certaine studious and diligent clerke," Richard Jonas by name, "at the request and desire of divers and sad mothers being of his acquaintance did translate out of Latin into English a great part of the booke 'De Partu Hominis,' that is to say, 'The Birth of Mankynde.' " This little volume was later somewhat revised, and published, by Thomas Raynald, under the title of "The Woman's Booke." This was evidently the first work of its kind, and for a long period the only printed material intended solely for midwives. This was a step forward, and evidently helpful, but there continued to be unrest and dissatisfaction, and repeated assertions that not only should midwives be trained but that they should be required to give to the public evidence of their skill—i. e. be licensed by State authority.
The great master, William H. Harvey, and his contemporary and friend, Sir Percival Willoughby (17th century), seemed to be the first serious teachers of midwives in England. These great men, stirred by the distressing accounts which were brought to them describing the horrors endured by mothers and babies attended by untrained midwives, not only undertook; to raise the standard of this despised profession, but they followed it themselves, and have come down in history as noted obstetricians.
We can scarcely improve to-day upon Dr. Willoughby's ideal of a midwife. With infinite sympathy and understanding he says: "I desire that all midwives may gain a good repute, and have a happy success in all their undertakings; and that their knowledge, charity, patience, with tender compassion, may manifest their worths among their women, and give their women just cause to love, honour, and to esteem them. The midwife's duty in a natural birth is no more but to attend and wait on Nautre, and to receive the child, and (if need require) to help to fetch the after-birth, and her best care will bee to see that the woman and child bee fittingly and decently ordered with necessary conveniences. And let midwives know that they bee Nautre's servants. Let them always remember that gentle proceedings (with moderate warm keeping, and having their endeavours dulcified with sweet words) will best ease and relieve and soonest deliver their labouring women." This was more than two hundred years ago and we are still pleading that midwives should be able and conscientious women, attending normal labors only, and giving sympathetic nursing care to their patients.
As the status of the midwife gradually improved, so also did the practice of obstetrics by physicians. So far as this history is concerned the 18th century seemed largely taken up by a stormy controversy between the midwives, headed by Elizabeth Nihell, and the obstetricians, under Dr. Smellie, the latter called in derision "he-practitioners" and "he-midwives," each group fighting for supremacy. The logical result of this conflict was a marked improvement in the work of both groups and the creation of great public interest in the welfare of mothers and babies. Out of this interest grew the establishment of five of the most important lying-in hospitals in London,—the British Lying-in Hospital, 1749, the City of London Lying-in Hospital, 1750, Queen Charlotte's Hospital, 1752, the Royal Maternity, 1757, and the General Lying-in Hospital, 1765.
Another early and successful teacher of midwifery was Dr. Mawbray (18th century), who stated at the height of this bitter dispute that "It is indeed indifferent whether men or women practice this art so that the practitioners be properly educated and duly qualified for so great a work,"
Singularly enough, although for centuries the real problem was recognized and great minds were focussed upon it from time to time with the hope of discovering a solution, and although there seemed to be a general agreement that midwives should first be trained and then licensed, no workable plan was conceived or suggested. The first practical suggestions were outlined by Dr. Mawbray, these relating to the qualifications, theoretical knowledge and practical training of the midwife, who in urging the adoption of his scheme concludes by saying "Can anything better deserve the attention of the Legislature itself?"
Up to this time (18th century), as has been explained, the only licenses issued to midwives were issued by bishops, but the Church also issued licenses to physicians, surgeons and apothecaries. When the Church ceased to discharge this function and medical faculties gave Licenses, the midwife unfortunately was ignored. Although the license issued by the bishops was no guarantee of the midwife's medical skill, it afforded a certain protection to the English mothers against woefully ignorant and dissipated practitioners. When neither Church nor medical faculty licensed this group of women, there was naturally a period of marked retrogression, with the result that the most incapable and unscrupulous women called themselves midwives and practised as such, doing untold damage, and causing great suffering to mothers and their infants, particularly among the poor.
Form of License Issued to Midwives By Bishops During the Eighteenth Century
Joseph, by Divine Permission, Bishop of Rochester, To our wellbeloved in Christ, Elizabeth Chapman, of the parish of Saint Warburg, otherwise Hoo, in the County of Kent, and our Diocese of Rochester, send Greeting in our Lord everlasting: Whereas We understand by good testimony and credible certificates that you the said Elizabeth Chapman are apt and able, cunning and expert, to use and exercise the office, business, and function of a Midwife, We therefore by virtue of Our Power Ordinary and Episcopal, Do admit and give you power to use and exercise the said office, business, and function of a Midwife in and through our Diocese and Jurisdiction of Rochester, with the best care and diligence you may or can in this behalf, indifferently both to poor and rich, as also to perform and accomplish all things about the same, according to your oath thereupon given you upon the Holy Evangelists, as far as God will give you Grace and enable you. In witness whereof we have caused the Seal of our Chancellor to be affixed to these presents this Twenty-first day of July, in the year of our Lord, One thousand seven hundred and thirty-eight, and in the seventh year of our Translation."
Van Blarcom, Carolyn Conant. The Midwife in England, Being a Study in England of the Working of the English Midwives Act of 1902. Wm. F. Fell Company, 1913.
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