Susan Cohen - The Midwife

A seated woman giving birth aided by a midwife and two other attendants. In the background, two men are looking at the stars and plotting a horoscope. Woodcut, about 1583.

THE EARLY DAYS

The role of the midwife, attending to and assisting women in childbirth, has been recorded since time immemorial, but the traditionally female practice was unregulated, and was not officially recognised as a profession in Britain until the Midwives Act was passed in England and Wales in July 1902. This was undoubtedly a turning point, but was just the beginning of a long process, fraught with difficulties and debate, during which midwifery developed to become the highly skilled branch of nursing, open to men and women, which is recognisable today.

For centuries, practitioners were a motley crew, ranging from the handywoman, epitomised in the nineteenth century by Charles Dickens character, Sairy Gamp, to the careful, knowledgeable and empathetic midwife. Handywomen, who typically acted as midwife, monthly nurse and the layer-out of the dead, were commonly unhygienic, illiterate and frequently dangerous, but were all that was available to poor women. The best and the safest birth attendants, engaged by the more discerning and educated in society, learnt their craft from their mothers or an elder, served lengthy apprenticeships and, in turn, passed their knowledge onto the next generation. Flora Thompsons fictional rural midwife, old Mrs Quinton, in Lark Rise to Candleford, was one such woman, who recognised a rare crisis and the need to call the doctor. She took pride in her work and was valued by the local doctor, who appreciated the important role she played in the community.

Childbirth was viewed as a natural process, with ordinary married women or widows acting as midwives or handywomen. They helped their neighbours give birth and provided practical help with childcare and domestic tasks; in return they earned a modest livelihood. Most midwives were, like their patients, educationally disadvantaged. Even if they were literate, as women they were denied the opportunity to learn anatomy, attend lectures or read the specialist books traditionally written in Latin and Greek. Mrs Jane Sharp was one of the earliest midwives to put her wealth of experience to practical use by publishing the first English textbook for midwives in 1671: The Midwives Book, which was also aimed at mothers and fathers, and provided advice on conception, pregnancy, the birth itself and postnatal care, along with anatomical illustrations and descriptions of difficult births. Another midwife, Mrs Sarah Stone of Taunton, whose book A Complete Practice of Midwifery followed in 1737, was intended to ignite the confidence of even midwives of the lowest capacity so they could deliver their women, without calling in, or sending for, a Man, in every little seeming difficulty.