Excavations


... nothing is more essential to public interest than the preservation of public liberty.

- David Hume



Saturday, June 25, 2022

A Brief History of Midwifery … and Abortion

Etymologically and historically, four words or roles have been closely related.  These are woman, witch, midwife and healer.  In the transition from female control to male control, two periods stand out as landmarks.  From the fourteenth to the seventeenth centuries in Europe medicine emerged as a predominantly male professional discipline, and the traditional female lay healer was suppressed.  In the nineteenth and twentieth centuries the female control of reproduction, which had largely persisted despite the rise of male medicine, was eroded with the inclusion of obstetrics in the curricula of professional medical training.  There are thus two ‘takeovers’.  One concerns general medicine, the other obstetrics specifically.  In the change of both takeovers, the change affected the upper and middle classes and only slowly permeated downwards to working class culture.

Women have a long history as community healers in pre-industrial Europe and colonial America. The ‘good woman’, ‘cunning woman’ or ‘wisewoman’ was the person to whom people turned to in times of illness; she represented the chief medical practitioner available to a community living in constant poverty and disease.  In the literature of the period male healers are not mentioned so frequently as female healers; the bulk of lay healing was done by women.  There is good reason for this.  The role of housewife in pre-industrial society encompassed a much broader range of functions than it does today.  Healing the sick was work that devolved not only upon the upper-class ladies of households, but also upon the lower-class wives of the community.  In their role as healers these women had knowledge of anatomy, astronomy, psychotherapy, and pharmacology.  They knew and used pain-killers, digestive aids, anti-inflammatory agents, ergot (an important midwifery drug), belladonna and digitalis (today still used in the treatment of heart disease).  Moreover their work was highly valued.  In pre-industrial England the female practitioner was widely trusted above her male counterpart, whose main treatment consisted of letting blood. ‘Also for Goddys sake be war what medesyns ye take of any fysissns at London; I shal never trust to hem’ wrote Margaret Paston to her husband.  Sir Ralph Verney gave his wife similar advice, telling her to ‘give the child no phisick but such as  midwives and old woman … doe prescribe; for assure yourself they by experience know better than any physitian how to treat such infants’.  Such references to lay female healers occur frequently in letters and diaries of the period.  Doubtless this attitude favouring the female healer also made sound economic sense; the services of male doctors were more expensive.[1]

Not surprisingly, modern histories of medicine do not acknowledge its female beginnings.  The witch-healer is dismissed as an undiagnosed hysteric.  No doubt once witch-hunting was under way, witchcraft did acquire the function of feminine protest (although of course the label ‘hysteric’ remains highly political).  But the witch’s healing role did not in the first instance evolve as a feminist rebellion.  Interestingly the so-called hippocratic oath, which is part of the official code of medicine today, probably itself contains a reference to the woman-healer-midwife.  The clause ‘I will not give to a woman an abortive remedy’ has always puzzled historians because it contradicts the liberal abortion policy prevailing in Greece at the time (the fourth century B.C.).  The alternative explanation is suggested by one medical historian, Noel Poynter; he suggests that the abortion clause is in fact an admission of restrictive practice aimed at avoiding demarcation disputes.  Obstetrics and gynecology was the province of female midwives in Greek society, and some of these midwives were highly trained physicians and surgeons.  Literary evidence indicates that they were skilled abortionists and also knowledgeable about effective contraception.

Until the seventeenth century, liberal attitudes towards abortion persisted in Europe.  Abortion in the first six to twelve weeks of foetal life was sanctioned by the Church, since theological doctrine did not allow the foetus a soul at conception, but only some time after (opinion varied as to the exact time).  In 1620, a male doctor [Girilamo Fabrici] published a book called On the Formation of the Foetus in which he argued that a baby’s rational soul enters it in the three days after conception.  The legal and religious objections to abortion in many countries date from this time, and in others there was a hardening of anti-abortion opinion.[2]

The Rights and Wrongs of Women (1976)

[1] Ann Oakley “ Wisewoman and Medicine Man: Changes in the Management of Childbirth” in  The Rights and Wrongs of Women, eds. Juliet Mitchell and Ann Oakley (Harmondsworth, Middlesex: Penguin, 1976), pp. 23,24.

[2] Ibid., p. 30.

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