In the 16th and 17th centuries, a delivery room could be a noisy place. Childbirth was a social event, and birthing chambers were often full of women (friends, relatives, servants, midwives…), celebrating and helping the one giving birth. However, whenever I picture this scene, I remember how important it was to me that my birthing environment be calm and quiet.
Today, there is much discussion about the effects a tranquil environment can have on the person giving birth. The French royal midwife Louise Bourgeois (1563-1636) agreed. To her, one of the main tasks of the midwife was to make sure that before and after childbirth, the room was calm and relaxing, gently serving the one giving birth:
‘Your only task is to do things properly, and serve those who call you in, following their wishes […] A midwife’s gentleness produces better results than harshness’. (Instruction à ma fille II, 23)
Louise Bourgeois believed midwives should be patient, cautious, and reassuring. Most of her treatments were gentle, and she only intervened in extreme cases: ‘I advise letting nature take its course’ (Observations diverses, II, 49).
Her approach was unhurried, without unnecessary or distressing interventions or regular internal examinations to check how the labour was progressing. Midwives should help the one giving birth manage it by providing moral support and allowing them to choose how it would unfold. For instance, she believed the best way to give birth was lying on a bed. However, Bourgeois wrote that
‘I have often noticed that one of the most important things for a woman in labour is finding the best position for her comfort and that of the child’. (Observations, I, 97)
Therefore, according to Bourgeois, the midwife should be flexible. People who wanted to move, walk around, and climb stairs should be respected; moreover, depending on their constitution, Bourgeois would suggest more vertical positions for delivery (such as kneeling, on a birthing chair, standing up), or horizontal ones (such as on a bed). But she was against forcing anything:
… ‘this discomfort [childbirth] is so extreme that the one suffering should be accommodated a little. I am often sorry to see women being forced by mother or relatives […] so that it makes their condition twice as bad’. (Observations, I, 98)
As the midwife to queen Marie de Medici, Bourgeois delivered her six children, including the future king Louis XIII, bringing this mindset to the French court. She was a highly educated and ambitious midwife who wrote multiple medical books when it was very rare for women to be published. Bourgeois was the first midwife to write about her ‘art’ in print.
This was no small feat. In Bourgeois’ time, university physicians, surgeons, midwives, and other medical practitioners competed in the medical marketplace for patients, who could change providers if they were not satisfied with the service. While most births were attended by women (including a midwife), surgeons might be called in particularly complicated cases. Bourgeois advocated for mutual respect between midwives and other medical practitioners, who had different kinds of expertise. Bourgeois herself delivered more than 2000 babies, performed minor surgeries, and was present at autopsies, working alongside physicians. She was confident about manually extracting a retained placenta and a child through a podalic version but argued that ‘handling’ the person giving birth should be the exception – not the norm.
Reading her instructions to aspiring midwives, it is clear how Louise Bourgeois was a departure from other midwifery manuals of the time. Contemporary authors such as Eucharius Rösslin, Ambroise Paré, and Jacques Guillemeau all favoured constant activity on the midwife’s part. They advised frequently checking the child’s progress, lubricating the birth canal, and pressing the belly to help the baby be born.
We should be careful not to make generalisations, however. For instance, some male writers advocated breaking the waters if the birth was not happening by itself, while others did not. What they did have in common was an expectation that midwives should ‘supervise’ the one giving birth, ‘order’ them and manipulate their bodies. They also shared a sense that midwives were ‘imprudent’, ‘obstinate’ people who needed to be themselves guided by medical men.
Louise Bourgeois had read medical texts and was married to a barber-surgeon; moreover, she wrote within the humoral theory framework of the time. Yet her work was a break from tradition. She occupied a liminal space, close to learned medical practitioners, yet apart from them because of her gender and field of expertise. This is evident in her case histories, which showcase both the midwife’s vulnerability and the limitations of male practitioners. Her ambivalent relationship to medical men is symbolic of midwifery’s shift in this period, which saw a gradual medicalisation (and indeed ‘masculinisation’ of childbirth). Bourgeois respected other practitioners (even if she criticised them) and expected to be valued as well:
‘I have had the honour of delivering all the Queen’s children, and I was not contradicted by the King nor her, nor by any physicians or ladies’ (Observations, II, 51).
Bourgeois likely exaggerated to make her point that midwives’ knowledge should be acknowledged. According to her,
‘… to know the secrets of women’s conditions, it is crucial to have worked with midwives and to have been present at multiple deliveries, as your great Master and legislator Hippocrates did, [since he] on the point of women’s conditions consulted midwives and relied on their judgement’ (Apologie, 19).
There is a clear sense of the increasing encroachment of medical men into midwifery, and Bourgeois protested this marginalisation of midwives. To her, childbirth should continue to be a social event requiring support rather than a medical one requiring treatment.
Louise Bourgeois was not a typical 17th-century midwife. She received 900 livres for her deliveries at court (18 times what average midwives received for the same service). While she was not a ‘regular’ midwife, her ambivalence about medical men was not an isolated case. Bourgeois strove to belong to learned circles while demanding midwives’ knowledge be respected and recognised. To her, the relationship between a midwife and her client should be based on trust. But that did not only mean that the patient should trust the midwife, but also that both should trust nature and respect the ‘natural’ way childbirth unfolds. Bourgeois was not shy about intervening, when necessary, but those instances were rare and not the way deliveries usually happened. Therefore, the midwife’s primary role was to support the one giving birth while nature took over, which involved offering nourishment, reassurance, and making sure the birth room was calm. Times have surely changed but she still strikes me as someone I would be happy to have by my side while giving birth!
*All French translations are my own.
Louise Bourgeois, Observations diverses (Paris: 1609).
Louise Bourgeois, Instruction a ma fille (Paris: 1617).
Louise Bourgeois, Apologie de Louyse Bourgeois (Paris: 1627).
Louise Bourgeois, Recueil des Secrets (Paris: 1635).
Jacques Guillemeau, De l’Heureux accouchement des femmes (Paris: 1609).
Ambroise Paré, Deux Livres de chirurgie (Paris: 1573).
Eucharius Rösslin, Der Rosengarten (Strasbourg: 1513).