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What Made a 17th-Century Midwife Good at Her Job?

Percivall Willughby (1596–1685) despised the midwives of his time. In his 1670s book, Observations in Midwifery, he intended to ‘inform the ignorant common midwives’, whose brutal methods were responsible for so many deaths – according to him. Although his book wasn’t published until almost two centuries later, Willughby was writing in a period in which male practitioners were gradually taking over the role of midwives in Britain (or at least trying to). Many of his contemporaries wrote similar accounts, no doubt motivated by asserting their claim on the medical marketplace, although Willughby’s writing is particularly striking. According to him,

‘midwives will pull, stretch, or hale their [the mothers’] bodies, or use any violence to enforce the womb, in hopes of a speedier delivery. Such strugglings and doings make a difficult, painful, and long labour.’

But was any of that true? What made a 17th-century midwife good at her job? And can we trust men like Willughby?

Challenging Bias in 17th-Century Midwifery

Well, until fairly recently, most people did believe these accounts by male midwives. Traditional midwives were depicted as stereotypically ignorant, poor, superstitious, and unskilled. Perhaps the main reason for that is that the first historians of midwifery in Britain were physicians – not trained historians – who tended to take male medical practitioners of the past, such as WiIllughby, at their word. This, of course, also reflected the biases of these 19th-century writers, who struggled to see women (whether in the present or the past) as skilled and capable at what they considered ‘male activities’.

Fortunately, social historians have spent decades deconstructing this stereotype thanks to a wealth of primary sources, including records kept by the midwives themselves, their clients, and the licensing authorities. So, what made a 17th-century midwife good at her job?

Ethical Standards for 17th-Century Midwives

Perhaps the best way to answer this question is to look at how midwives were licensed, which was the responsibility of the Church of England. Midwives swore oaths, which often included:

  • Making their services available to both rich and poor women (whom they often attended for free)
  • Reporting information on the father of the baby and suspected bastardy
  • Not engaging in witchcraft
  • Baptising infants who probably wouldn’t survive
  • Notifying the ecclesiastical authorities of any baptisms performed
  • Not ‘switching’ babies
  • Not procuring abortions
  • Maintaining patient confidentiality
  • Not using instruments or mutilating babies in the womb
  • Making sure that stillborn babies were buried properly
  • Cooperating with other midwives and instructing their deputies (apprentices)
  • Reporting midwives who didn’t conform to these guidelines

As you can see, these injunctions have much to do with professional ethics, both from a medical and religious perspective, but they also highlight the importance of helping fellow midwives, of cooperating in difficult deliveries as well as instructing the new generations of midwives. Midwives should be of ‘good character’ and practising Christians, active in their communities and parishes. Still, you might be thinking that none of these criteria seems to take skill into consideration.

The Path to Becoming a 17th-Century Midwife

In 17th-century Britain, most midwives practised for long periods before obtaining their licenses. They usually started as a deputy to an older, more senior midwife, in order to gain experience. They attended deliveries and helped their mentors for years before working on their own, with these informal apprenticeships lasting from four to ten years. So, when midwives applied for their licenses, it wasn’t unusual for them to have decades of experience, especially since the licensing process was so expensive, and so they might need time to save for their application fees.. Besides gaining experience through practice, midwives were usually married women or widows, often with children themselves, which only added to their empirical, ‘bodily’ knowledge about childbirth and female health. (Read about the all-female early modern world of childbirth here.)

What is perhaps most telling about these midwives and their careers was the way their clients spoke about them. You see, besides being a ‘good Christian’, swearing to their oath, and undergoing informal apprenticeships, midwives were expected at their licensing to give evidence of their skill, which normally involved their clients testifying in their favour. Many women would come forth and praise their midwives to the licensing authorities, sometimes dozens of them, describing how many times they had been delivered and how capable the midwife was. Of course, the higher these clients were on the social scale – say, a gentlewoman – the more these testimonies would weigh in the midwife’s favour. They might include passages like these:

‘…she [the midwife] is not only helpful to the rich and those that can pay her but also to the poor’.
‘…she had the blessing to be a means for the safe delivery of others whose names are here subscribed and many others…’
‘[she has] good skill, experience and success in midwifery and has safely delivered several women in childbed with good success…’

Community Esteem and Expertise of 17th-Century Midwives

So, what made a 17th-century midwife ‘good’ was a mix of their good character, skill, piety, ethics, and involvement in their communities. Although the licensing system wasn’t perfect, it ensured standards of good conduct and practice as well as ascertained practical skills through clients’ testimonies and legitimised deputy midwives’ apprenticeships. Midwives were commonly well-known and respected in their communities, by people of all social groups. Besides their clients’ accounts of their skill, midwives were often called to testify as ‘experts’ in early modern courts, such as in the case of women ‘pleading the belly’ (declaring they were pregnant to avoid execution). (You can read more about the ‘Jury of Matrons’ here.) But midwives would also testify in bastardy cases or when someone was accused of rape, which indicates how they were perceived by their communities as medical ‘experts’.

Moreover, as midwives started to publish midwifery manuals, in no small measure to assert their authority over the world of pregnancy and childbirth, which they perceived as increasingly threatened by male practitioners, some midwives became widely known. That’s the case of Jane Sharp (1641-1671), the best-selling yet mysterious English author, and Louise Bourgeois or Boursier (1563-1636), the French royal midwife. In their writings, we get a glimpse of an early modern midwife’s life; they were aware of their responsibilities and committed to caring for women as part of a sisterhood.

Resisting the Narrative: Reevaluating the Skills of 17th-Century Midwives

Despite what man-midwives like Percival Willughby wrote, 17th-century midwives were generally very skilled and experienced, as hundreds of testimonies, letters, and journals tell us (including some accounts by physicians themselves!). Most of them followed an informal apprenticeship and this all-female network allowed them to cooperate and learn from each other. It wasn’t rare for a midwife to call a colleague to help in a complicated delivery; this wasn’t seen as a failure, but rather how a midwife should proceed. Midwives weren’t poor, ignorant, and dangerous practitioners. Rather, they were known for their patience, skill, kindness, and, crucially, for their knowledge, which derived from practical experience.

Yet it is telling that this negative stereotype of midwives as ignorant and unskilled persisted. With the medicalisation of childbirth and the rise of male midwives and their tools, such as forceps, traditional midwives were gradually replaced, and male practitioners eager to cement their new role were quick to decry them. As for Victorian physicians interested in the history of medicine, they believed their predecessors’ accounts and didn’t question how capable midwives actually were and whether man-midwives might have had an economic interest in degrading them.

As a historian, it is difficult to ignore the mounting evidence of 17th-century midwives’ skill and professionalism. Personally, having met midwives and been safely delivered by one myself, it seems hard to believe their depiction of midwives as violent and brutal. Lastly – and ironically-, it is likely that much of Willughby’s knowledge about childbirth (as well as many other man-midwives’) came directly from the midwives they so disparaged in their writings, who often instructed them, such as Willughby’s own daughter. But that’s a matter for another day.

References:

Louise Bourgeois,  Observations diverses (Paris: 1609).

Jane Sharp, The Midwives Book (London: 1671).

Percival Willughby, Observations in Midwifery (Warwick: 1863).

Further Reading:

David Cressy, Birth, Marriage, and Death: Ritual, Religion, and the Life-Cycle in Tudor and Stuart England (Oxford: 1997).

Doreen Evenden, The Midwives of Seventeenth-Century London (Cambridge: 2000)

David Harley, ‘Ignorant Midwives – a persistent stereotype’, The Society for the History of Medicine Bulletin 28 (1981), pp. 6-9.

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Maternal Mortality and “The Mother’s Legacy to Her Unborn Child”

Content Warning: Childbirth pain and death

Giving birth in early modern Europe was a dangerous rite of passage, one which most women would go through, and some would not survive. Women were largely defined by their domestic roles as wives and mothers: going through childbirth often changed a woman’s social status, as matrons were usually more respected, in no doubt thanks to their lived experiences giving birth and caring for their families. Yet many women feared childbirth. Besides the promise of pain, the possibility of either or both mother and baby not surviving could be daunting, which made some expectant mothers write to their unborn children, in case they were never able to meet them.

The Social and Spiritual Complexities of Childbirth in Early Modern Europe

Those about to give birth would pray to be able to endure the suffering of childbirth and its unavoidable pain. According to the Bible, as daughters of Eve, all women were cursed with pain, to atone for the original sin:

‘I will greatly multiply your pain in childbirth; In pain, you will bring forth children’.
Genesis 3:16

So, childbirth pain was more than natural and physiological: it was God-given. And, although midwives knew many ways of speeding the delivery and alleviating pain, many women would pray to be able to endure it and survive the birth. Elizabeth, Countess of Bridgewater (d. 1666), wrote down the prayer she would utter as her time approached:

‘Lord Jesus since thou art pleased my time is come, to bring forth this my babe, thou hast made in me, give me a heart full of all truth and obedience to thee and that I make take this height of pain patiently, without grudging at thy holy will and pleasure […] O Lord hear, O Lord forgive, and suffer me not to accompany my sins in the deep, but part us, and make me become a new creature, and if it be by thy will, O God, that I should be no more in this world, Christ raise me to life everlasting in the true belief of thee, who art my only saviour: Amen.’

Elizabeth asked for the strength to face the expected pain, but, knowing how perilous the journey was, she also asked to survive. For those interested in history, it is easy to find many examples of women dying in childbirth. Just think of Henry VIII’s wives: two of the six died following difficult deliveries, Jane Seymour and Catherine Parr, who by then was married to Thomas Seymour. Yet these famous cases might give us an inaccurate picture of early modern childbed deaths. Most women survived childbirth with few complications and recovered well.

Famously, in the 1612 Child-Birth, or The Happy Deliverie of Women, Jacques Guillemeau wrote how of a thousand births, ‘there is scarce one found that is amiss’. That number was probably closer to 1% in Elizabethan and Jacobean England, but still, dying in childbirth was not as common as we tend to believe. (You can also watch a video in which I talk about statistics here.) However, that did not mean that women did not fear the perils of childbirth.

Maternal Letters and Prayers: A Legacy for the Unborn Child

It was not uncommon for expectant mothers to write wills as their time approached, as well as letters to their unborn children, in case they survived, and the mothers did not. That is exactly what happened to another Elizabeth, a Jacobean gentlewoman called Elizabeth Joceline (1595–1622), who died at 26 years old, nine days after giving birth to a daughter. The text she wrote before the delivery was published posthumously and called The Mothers Legacie to her Unborn Child. And it’s just heartbreaking.

Elizabeth wrote of her happiness at being pregnant; the book is joyful and full of advice for her unborn child. Elizabeth was clearly determined to be the best mother she could be. So, she advised the child to pray often, respect sacred days, be charitable, and avoid temptation. She was very much a woman of her time, and so, she also issued specific advice depending on gender: girls should be raised to be obedient and, eventually, good mothers – presumably, just like she had been. It was not necessary for them to learn much else, although that could be valuable – if they were virtuous:

‘I desire her bringing up may bee learning the Bible, as my sisters doe, good housewifery, writing, and good works: other learning a woman needs not; though I admire it in those whom God hath blest with descretion, yet I desired not much in my owne, having seene that sometimes women have greater portions of learning than wisdom […] But where learning and wisdom meet in a vertuous disposed woman she is the fittest closet for all goodnesse. She is like a well-balanced ship that may beare all her saile. […] I pray God give her a wise and religious heart, that she may use it to his glory, thy comfort, and her own salvation.”

Elizabeth goes on to say that, if the baby is a girl, her daughter might think that Elizabeth had died in vain delivering her, highlighting the usual preference in families for sons. Yet that was not the case:

‘…thou shalt see my love and care of thee [a girl] and thy salvation is as great, as if thou wert a sonne, and my feare greater”.

As a woman, Elizabeth understood what awaited her unborn daughter; she was full of empathy for her future daughter. The Mother’s Legacy allows us a glimpse into the intimate life and thoughts of an early modern mother-to-be. It is perhaps the best example of how conscious early modern women were of the perils of childbirth and how, despite that, many of them were able to feel joyful and hopeful.

This book was reprinted multiple times, well into the 19th century, and read by countless women. Once more, just like the Countess of Bridgewater’s private prayer, this text delineated a model of fortitude based on faith for all expectant mothers. Fulfilling the role expected of her by a patriarchal and Christian society, even after death, Elizabeth was an ideal early modern mother: she thought of her child and family above all else. It is particularly hard not to feel emotional when reading her advice to her husband about how to select a nurse to breastfeed their child in case Elizabeth died, especially because we know he needed to do so, just over a week after the birth.

References:

Jacques Guillemeau, Child-Birth, or The Happy Deliverie of Women (London, 1612).

Elizabeth Joceline, Mothers Legacie, to her Unborne Childe (London, 1624).

Further Reading:

David Cressy, Birth, Marriage & Death: Ritual, Religion, and the Life-Cycle in Tudor and Stuart England (Oxford, 1999).

Roger Schofield, ‘Did the Mothers Really Die? Three Centuries of Maternal Mortality in ”The World We Have Lost”’, in The World We Have Gained: Histories of Population and Social Structure, edited by L. Bonfield, R. Smith, and K. Wrightson (Oxford, 1986), pp. 231-60.

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A Grip on the History of Forceps in Medicine

Content Warning: Discussion of childbirth, obstetric violence, maternal and infant mortality.

On a cold winter evening in 1600, Peter Chamberlen the Younger found himself attending to a labouring woman on the outskirts of London. The mother-to-be had been in labour for over 48 hours, and the situation was dire. Despite his wealth of experience, Peter feared that both the mother and child might be lost. With time running out, he made the fateful decision to use a secret tool that he and his brother, Peter Chamberlen the Elder, had been developing: a pair of obstetrical forceps. Miraculously, the mother gave birth to a healthy baby boy, much to the relief and amazement of everyone present. Little did they know that this life-saving tool, hidden away in a locked box, would revolutionize childbirth and save countless lives in the centuries to come. Just to give you an idea, today in the UK around 7% of deliveries in the NHS involve the use of forceps.

At the same time, the history of forceps highlights the gradual transition of birth from a ‘natural’ to a ‘medical’ event, with physicians competing with midwives and taking over childbirth. The rise of forceps is very closely connected to the creation of the field of obstetrics. To make things even more interesting, for decades this tool was surrounded by secrecy, making us question who should have access to medical knowledge. So, let’s try to get a grip on the history of forceps.

The Origins of Forceps

The earliest known references to forceps can be traced back to the ancient Egyptians, Greeks, and Romans, with physicians like Hippocrates and Galen mentioning the use of forceps-like instruments in their writings. The word forceps itself comes from the Latin formus (hot) and capere (to grab). But these early tools were very rudimentary compared to the later, more anatomically refined designs that emerged in the early modern period.

The history of forceps became inextricably linked to the Chamberlen surgeons, especially the brothers mentioned above, Peter Chamberlen the Elder (1560-1631) and Peter Chamberlen the Younger (1572-1626). The Chamberlen family were French Huguenots who emigrated to England in 1569 and became prominent in their field. (Still, no one really knows which of them created the design for their famous forceps.) Peter the Elder served as a physician to Queen Anne, the wife of King James I, and later to Queen Henrietta Maria, the wife of King Charles I. His younger brother was appointed the royal physician to both King James I and King Charles I. But it was their newly designed forceps that cemented their fame.

A Family Secret

For over a century, the design of this tool was a closely guarded secret since the Chamberlen brothers realised how their forceps set them apart from other medical practitioners, be they midwives, physicians, or surgeons. Before forceps, the situation was difficult for babies who were stuck in the birth canal. Sometimes surgeons were called to remove them with hooks, often in pieces, in the hope of saving the mother.

When the Chamberlens were called to attend difficult births, the brothers brought their forceps in a large (and locked) box. No one was allowed to see the instrument, not even the person giving birth. The labouring mother was usually blindfolded, and all others present were removed from the room. As soon as the baby was born, the secret tool was hidden away in its box once more.

What made the Chamberlen forceps so unique was its unique, ‘gentler’ design: the blades were curved (imagine soup ladles), to conform to the baby’s head, minimising the risk of injury during the extraction. Crucially, the blades could be locked together at the handles with a spring, after being inserted separately, facilitating the delivery. Plus, being made of steel, their forceps were easy to clean.

The Chamberlens’ Detractors

Rumour had it that the Chamberlens had the highest success rates for delivering the baby safely and the mother surviving. Many women believed that they had higher chances of a safe birth with their help, which made the brothers highly sought-after and, unsurprisingly, deeply resented by their competitors. One of their critics even wrote a poem against them ending in:

‘To give you his character truly compleat
He’s Doctor, Projector, Man-Midwife, and Cheat.’

The Chamberlen brothers were members of the Guild of Barbers and Surgeons, who were never highly regarded by physicians since they hadn’t formally read medicine in Oxford or Cambridge. The Chamberlens were also not popular among midwives. In 1634, Peter had petitioned the king to create a Midwives Corporation which, of course, he intended to run. That did not go well with midwives.

Forceps and Secrecy

It probably didn’t help the Chamberlens’ popularity that they refused to share their secrets with other medical practitioners. Keep in mind that this was a time before patents to protect their design and they would make no money from sharing it. Still, when you think about how many people could have been spared if they shared their secrets, it’s hard to sympathise with the Chamberlens. Hugh Chamberlen was unapologetic:

‘My fathers, brothers,and my self […] have, by God’s blessing, and our Industry, attain’d to, and long practis’d a Way to deliver Women in these cases without any Prejudice to them or their infants. […] I will not take apology for not publishing the Secret I mention we have to extract Children without Hooks. […] I do but inform that the fore-mention’d three Persons of our Family, and my Self, can Serve them in these Extremities, with greater Safety than others.’

Meaning that, if you wanted a safe delivery, you better hire a Chamberlen, which meant you had to live in London and be able to afford their fees. Otherwise… well, too bad for you!

Openness at Last

The secret design remained hidden within the Chamberlen family for generations. In 1670, Hugh Chamberlen travelled to Paris to sell the design to the French doctor Francois Mauriceau, one of the most well-known ‘man-midwives’ of the time. You might be wondering how come the Chamberlens were willing to share their design. Well, Mauriceau won a bet. Chamberlen needed to prove that a forceps delivery was quick and safe, otherwise, Mauriceau would have the right to buy the secret.

Mauriceau chose the woman on whose body they would decide their wager: she had rickets and a malformed pelvis. Both mother and baby died following a horrific delivery in which Chamberlen perforated the woman’s womb and Mauriceau attempted a caesarean section. We know next to nothing about her, the woman who died over a bet between two medical practitioners. In the end, the sale wasn’t made, and Chamberlen returned to England.

According to legend, he eventually moved to the Netherlands, where he sold the design to a local doctor. However, the story goes, this ‘forceps’ was only composed of one half, and was, of course, useless. Hugh Chamberlen’s son, also named Hugh, eventually allowed the design to be made public in England in the early eighteenth century. There is even a monument to him inside Westminster Abbey.

But where did the original forceps go? Well, it was hidden (probably by Peter Chamberlen) under the floorboards of his Essex home, where it was found in 1813, by the mother of the family then living there. By then, many competing designs had been created by other obstetricians.

After the Chamberlens

Forceps opened the door to a flood of innovations and ‘birth gadgets’, including the (to me, very silly) ‘self-operated forceps’. Can you imagine trying to use forceps on yourself while giving birth?!

Post-forceps, medical men were increasingly present in the birth room. The Chamberlens became known as ‘man-midwives’, helping popularise this concept. Other changes followed; midwives were used to attending people giving birth on birth stools or chairs, but physicians preferred their patients lying down so that they could use their tools more easily.

Forceps became popular for many reasons, including that physicians believed that some elite women were ‘too fragile’ to push. However, their use was contentious from the beginning. Just take a look at this passage from a poem against forceps, penned by John Maubray, the author of the Female Physician:

[Forceps] Kill many more INFANTS than they save and ruin
Many more WOMEN than they deliver
[…] I would advise you to practice Butchery rather than MIDWIFERY…

Following the height of their popularity in the nineteenth and early twenty centuries, their use gradually faded, especially as caesarean sections became more widespread. Still, the history behind forceps begs one of the most crucial questions in the social history of knowledge: who should have access to knowledge? Crucially, it also asks the (always feminist) question: who should make decisions about our bodies?

References:

John Maubray, The Female Physician (London: James Holland,1724).

Francois Mauriceau, The Diseases of Women with Child, translated and annotated by Hugh Chamberlen (London: T. Cox and J. Clarke, 1793).

Further Reading:

A.    C. Banks, Birth Chairs, Midwives, and Medicine (Jackson: University Press of Mississippi, 1999).

K. Das, Obstetric Forceps: Its History and Evolution (Leeds: Medical Museum, 1993).

B. Hibbard, The Obstetrician’s Armamentarium (San Anselmo, CA: Norman, 2000).

R. H. Epstein, Get me Out: A History of Childbirth from the Garden of Eden to the Sperm Bank (New York: Norton, 2010).

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‘Unnatural Mothers’: The Surprising History of Abandoned Children

CONTENT WARNING

Discussion of Violence against Children.

When I was around four years old, I was terrified of the tale of Hansel and Gretel. How could a mother just abandon her children in the woods, even if the family had nothing to eat? Somehow that seemed even worse than the fact that a grandmotherly figure would trap those same children and try to eat them. It’s probably telling that I never thought much about the father in the story. In the Brothers Grimm version, he protests at the idea of leaving the children: yet the mother does it anyway. In any case, in a patriarchal society in which mothers are constructed as loving and caring, her abandoning the children was much more shocking.

Two decades later, I came across Elena Ferrante’s L’amore molesto (Troubling Love) when I was studying Italian. I was struck by the visceral, ambivalent, deeply felt story of the relationship between a mother and her daughter. Ferrante would go on to publish several other novels, including the famous series My Brilliant Friend, in which she continued to investigate motherhood, in all its beauty and ugliness. Again, I was equally disturbed and enthralled by these ‘unnatural’ mothers who had such complicated feelings towards their children.

In my research, I found several stories of ‘wicked’ mothers, who killed or abandoned their children. I will write more abound infanticide another time, as it is a fascinating topic in its own right. (You can read a little bit about its connection to midwives here and in artistic representations here.)  And don’t even get me started on stepmothers! For now, though, I’d like to think about early modern mothers who chose to abandon their children, as I find their ambivalence intriguing. Fairy tales such as Hansel and Gretel are a good starting point. As the story tells us, it was out of necessity that the children were abandoned: the parents could not afford to feed them.

This is an interesting clue about the socio-economic reasons behind this abandonment. Historians have long argued that in premodern times, having children out of wedlock was a cause of deep shame, that would earn women humiliation and contempt. So, if you were an unmarried woman who fell pregnant, you might want to hide the pregnancy, give birth in secret, and abandon the baby as soon as possible. Or so the story goes. This is a valid and reasonable hypothesis, and I believe it explains the situation in which many people found themselves. Yet it is not the only nor, I would argue, the most prevalent reason why children were abandoned.

Let’s go back to Hansel and Gretel, as we all know the story. Their age is never specified, but I would assume they were between four and six years old. The same goes for Little Thumbling and other similar tales: these were not babies. They were not left because the mother wanted to hide their existence. While fairy tales offer plenty of symbolical and psychological explanations (which were later developed by wonderful novelists such as Ferrante), they are also full of real-life concerns. A literal reading of fairy tales can be useful. Children were abandoned because there was not enough bread to feed them. It is not surprising that the number of foundlings increased when economic conditions were dire, when the prices increased (such as the cost of bread), and when winter was particularly long and difficult. Going back to the children’s age, although there were many infants among them, most foundlings were older babies, not newborns. This disproves the idea of secret births out of wedlock being the rule. As I have recently written, newly delivered mothers tended to have a lying-in period of at least a month, during which they did not leave the house, making the abandonment of children difficult. 

When parents decided to abandon their children, be that because of the child’s illegitimate status or the family’s poverty, where did they leave them? Again, Hansel and Gretel comes to mind, along with many other stories. Surely their parents didn’t intend for them to be found and cared for in the middle of the woods? It sounds more like they were not to be found. Children (and especially babies) left in the woods or other inhospitable places such as privies or the street were the exception: these were likely attempts at infanticide. If you needed to abandon your child and wished for someone to find and take care of them, there were many better places to choose. Archival documents attest to their being found in churches, hospitals, in front of aristocratic houses, and next to convents: places where they were likely to be quickly discovered and taken care of. Many of these children were clean, healthy, and well-dressed, often accompanied by notes stating their names and whether they had been baptised or not.

If we think of London between the 16th and 18th centuries, the population was rapidly growing. It is estimated that around one thousand abandoned children were found in the city every year. Parishes had their own networks of nurses and foster mothers who could take care of children, but often that was not enough. The foundation of the aptly named Foundling Hospital in London in 1739 (and the several others that followed it) indicates the increase in abandoned children, and how authorities sought to deal with the situation. These children are often easy to find in the archives since many were named according to the parishes where they were found and later baptised. Babies left at Temple Church, for instance, usually had ‘Temple’ as a surname. (It makes you wonder about the adorable Shirley Temple’s family origins, doesn’t it?)

Still, the problem of abandoned children persisted. If we exclude the issue of illegitimate children, there were many socio-economic reasons why people could choose to abandon their children. Extreme poverty, as in Hansel and Gretel’s case, was one of them. But premodern mothers could be unexpectedly faced with difficult circumstances. Widowhood during or right after pregnancy (or when the husband simply left) could make a woman unable to care for her child. In a time in which few legal provisions existed to help these women, what options were there? Yet, if a foundling’s mother was discovered, it was likely that she would face punishment (anything from the pillory to imprisonment). 

Historians are usually quick to say that things are a little bit more complicated than people might think. We also love to say that, actually, this isn’t something new… and then we embark on long monologues. Children were (and are) abandoned by their parents for multiple reasons, including societal pressures such as a woman’s marital state, or deeply psychological and individual reasons. Yet we might miss the forest for the trees when we focus too much on individual mothers. If Hansel and Gretel’s parents had plenty of food for everyone, would they still have left the children alone in the woods? I wonder. If modern motherhood wasn’t so all-encompassing and consuming, would women such as Elena Ferrante’s protagonists struggle so much? I wonder about that, too.

Hansel and Gretel embody many of our societal and individual fears, not least that the people we assume will take care of us might abandon us to our own luck. Yet they also suggest that systemic, socio-economic problems might be behind unimaginably difficult choices such as abandoning a child. Who knows, maybe many of these ‘unnatural mothers’ in our past were simply people who couldn’t find an alternative, who couldn’t afford to feed their children. Maybe we should be sympathetic to those who leave their children in the woods – who knows what they might be trying to save them from?

References:

Patricia Crawford and Sara Mendelson, Women in Early Modern England (Oxford: Oxford University Press, 1998).

Valerie Fildes (ed.), Women as Mothers in Pre-Industrial England (London: Routledge, 2013).

Ralph Houlbrooke, The English Family, 1450–1700 (London: Longman, 1984).

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Giving Birth in 17th-century England: A Tentative List

What to do, what to buy, what to organise, what to cook, what to read… I made so many lists when I was pregnant that it would take a new list to organise them all! Expectant parents are bombarded today with information about how to prepare for the arrival of a baby. Yet childbirth itself has never been more medicalised and arguably out of families’ control. But what about the past, before social media, Amazon wish lists, and insipid hospital food? Here’s a list of how to prepare for a new baby in 17th-century England.

Caveats: I have considered an ‘average’ English family, composed of a married woman and man of middling social status (think of the husband as a yeoman or merchant). The things listed here would usually follow this order, but each community and family had specific practices. Like all lists, this is non-comprehensive but should give you an idea of what life was like for new parents at this period.

1. Confirming the Pregnancy and Spreading the News

Unlike today, a missed period was not usually thought to automatically indicate pregnancy. It wasn’t until quickening that pregnancy was confirmed (when foetal movement could be first felt). From then on, people could announce the news. Some mothers might prepare in case childbirth didn’t go smoothly, although that wasn’t very common. (You can read more about writing to the unborn child here.)

2. Engaging a Midwife

Most people lived close enough to a midwife to have her help in the delivery. For the ones living in cities, there was a choice of practitioners. Friends’ recommendations, price, and reputation were all considered when a midwife was hired.

3. Hiring a Nurse

A temporary nurse would be hired to help around the house for the month following the delivery. She would help take care of the baby and mother, but her main role was to perform the domestic duties left unfulfilled by the one who had just given birth.

4. Inviting the Gossips

In the final months of the pregnancy, the expectant mother would issue invitations to her female relatives, neighbours, and friends, to attend her birth as her ‘gossips’, or ‘god-sibs’ (siblings in God). The women she chose would help her and the midwife, by making food, keeping company, and supporting her during the birth. The mother could expect at least half a dozen gossips.

5. Preparing the Birth Chamber

As the birth approached, the family would make sure to have the essential items for the delivery: candles, extra linen, a straw pallet bed, maybe a birth stool or chair, swaddling bands for the newborn baby, food and drink for everyone involved in the birth, herbal medicines, and (hopefully) the midwife’s fee. Before the Reformation, relics could be used, as well as rosaries, crucifixes, prayer books, and birth girdles with images of the Virgin Mary or St Margaret. (You can read about an amazing 15th-century birth girdle here.) The expectant mother would also seek the blessing of her local priest for a safe delivery.

6. Summoning the Midwife and Gossips

When labour began, the husband, perhaps helped by a servant, would go from door to door calling the gossips and midwife to come to attend his wife during the delivery. (This was later called ‘nidgeting’.)

7. Enclosing the Mother

If she wasn’t already in confinement, the gossips and midwife would move the labouring woman to a separate space from men as soon as they arrived. This was usually already set up, at least in part. Windows would be shut and covered by curtains or makeshift fabrics, to keep the daylight and the air out. Keyholes would be blocked so that no air came through them either. Candles would be lit as well as a fire. A birthing stool would be available (often brought by the midwife) for the use of the labouring woman.

8. Nourishing the Mother

The gossips would make sure that the person giving birth received nourishment (often under the midwife’s advice). They would offer her warm drinks made of wine, especially caudle, which contained sugar, spices, and eggs. (Check out this 14th-century recipe for caudle!)

9. Delivering the Baby

Midwives’ techniques varied greatly, but they were usually highly experienced. They might examine the woman to see how the birth was progressing and suggest which position would work best for the delivery. They could also manually remove the placenta after the birth if so needed. If the baby was unresponsive, the midwife would probably be the one to revive it. The midwife or a gossip would tie and cut the umbilical cord.

10. Cleaning and Swaddling the Baby

One of the gossips would probably be responsible for washing and swaddling the infant. Swaddling was deemed essential for babies in this period, to make sure their limbs grew correctly. It was also thought to keep babies calm and to make life easier for the one taking care of them, as it helped babies sleep.

11. Showing the Baby to the Mother and Breastfeeding

After the baby was ready, the mother would finally be able to see it. Breastfeeding would be encouraged unless the family was wealthy enough to hire a wet nurse. In that case, she would probably have been engaged earlier, around the same time as the nurse. Breast milk could be used to treat abscesses in the mother following childbirth, as well as eye or skin conditions in the newborn baby. (I wrote about breastmilk as medicine here.)

12. Lying-In

After the delivery, the mother’s lying-in period would begin. This would last for around 3 to 5 weeks and be comprised of three phases.

  1. In the first stage, she would be in her bed, and the room would remain darkened. The mother’s vulva would be washed with herbal solutions, but her sheets usually wouldn’t be changed. She would not perform any household duties. A nurse, hired for the lying-in period, would help around the house.
  2. In the second stage of lying in, she would be able to sit up and move around the room, and her bedclothes would be replaced. This was when close female friends would usually visit her. It was a time of female sociability and bonding. Caudle would be offered to visitors as well.
  3. In the final stage of her lying-in, the mother would be able to move around the house, but not leave it. More visitors would drop by, including men. Light household duties could now likely be performed by the mother.

Significantly, it was usually the person who had given birth who decided when to move from one stage of lying-in to the next.

13. Baptism

During the lying-in period, the baby would usually be baptised, without the parents’ presence. The godparents (usually three people) would act in their place, and the baby would be welcomed to the community.

14. Tipping the Midwife

At or right after the baptism, the godparents and gossips would usually tip the midwife for the safe delivery of the child. The father of the child would typically have paid and tipped the midwife after the birth.

15. Resuming Sexual Activity

It was inadvisable for sex to take place until the lying-in period was completed. Once the month was over, however, husband and wife could go back to sleeping together. (Of course, it’s impossible to know how much this injunction was followed.)

16. Churching

After her lying-in period was complete, the mother should only go outside the house after having been ‘churched’. (She usually wore a veil on the way to church to go around this unpractical norm.) Escorted by her gossips, the mother would go to church and kneel in a specific area separate from others, often called a ‘childbed pew’. During the service, the woman would thank God for her safe delivery. Specific Psalms would be said (116, 121, or 127), as well as the Lord’s Prayer (Kyrie Eleison). She would then make offerings to the priest and clerks and would be welcomed back to the community. This ceremony was much contested during the Reformation – but that’s a topic for another day!

Giving birth in 17th-century England was a process of separation, transformation, and reincorporation full of specific customs. Gender was a crucial aspect of these practices: the woman giving birth was separated from men and surrounded only by those of her sex and finally, reintegrated into society. Significantly, this was a female collective ritual, that inverted the usual power dynamics within families. In a patriarchal society such as 17th-century England, that was no small feat. This female world assured that, after birth, the mother’s body belonged to her, not her husband, at least for a while. She wouldn’t fulfil her domestic or sexual duties. This is why I find the female culture of childbirth so fascinating: it is a form of resistance, a fight for autonomy – even if short-lived.

(If you’re interested in this subject, I had a lovely talk with the wonderful doula Carly Lokrheim last year comparing past and present childbirth. You can watch it on YouTube.)

Further Reading:

David Cressy, Birth, Marriage, and Death: Ritual, Religion, and the Life-Cycle in Tudor and Stuart England (Oxford: Oxford University Press, 1997).

Amy Licence, In Bed with the Tudors: The Sex lives of a dynasty from Elizabeth of York to Elizabeth I (Gloucestershire: Amberley Publishing, 2012).

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‘Let Nature Take its Course’: In Defence of ‘Gentle’ Midwifery

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.

References:

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).

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‘Before she was in labour, she gave birth’

As Christmas approaches, we are bombarded with images of the birth of Jesus Christ – or rather, with depictions of mother and child after the delivery. Indeed, while there are modern reimaginings of what this scene might have looked like, there are few earlier representations of Mary’s labour. How might that scene have looked? How did people conceptualise Jesus’ birth in the past, and how was it different from other births?

For centuries, women had been taught that painful childbirth was the result of ‘the curse of Eve’. This divine curse defined pain as a God-given bodily experience to the one giving birth:

‘I will greatly multiply your pain in childbirth, In pain you will bring forth children’. (Genesis 3:16)

As daughters of Eve, women shared her punishment for the fall, which was childbirth pain. However, if painful births were the result of the loss of innocence, Mary’s birth could not have involved pain, since hers had been a virgin conception. Indeed, Mary was understood to have been blessed with a pain-free childbirth: no loss of virginity implied no blood, and no pain:

‘Before she was in labour, she gave birth; before her pain came upon her, she delivered a son. Who has heard such a thing? Who has seen such things?’ (Isaiah 66:7)

So, Mary ‘skipped’ the labour phase, as she was exempt from the curse of Eve:

‘for preserving her virginal integrity inviolate she brought forth Jesus the Son of God without experiencing any sense of pain’ (Catechism of the Council of Trent, Part 1: The Creed, Article III).

How was it possible to just ‘skip’ labour, though? St Augustine discussed the physiological process of Jesus’ miraculous birth:

‘In conceiving thou wast all pure, in giving birth thou wast without pain. I answer that, the pains of childbirth are caused by the infant opening the passage from the womb. Now, it has been said above, that Christ came forth from the closed womb of His Mother, and, consequently, without opening the passage. So, there was no pain in that birth, as neither was there any corruption; on the contrary, there was much joy therein for that God-Man was born into the world’ (Summa Theologica Q28,A2, Replies to Objections, and Q35,A6).

So, maybe the reason why there were so few depictions of the Virgin giving birth was that it was difficult for people to conceptualise such a quick, unique birth, in which one goes from being pregnant to holding a baby almost instantly, as if by magic – or a miracle.

In any case, church scholars have spent centuries discussing the puzzling details of Jesus’ birth, and artists have focused on depicting the new family rather than the birth itself. Contemporary artists such as Natalie Lennard, however, render this scene closer to us, highlighting the physicality of giving birth. By representing Mary’s birth as a bodily experience, Lennard arguably renders the miraculous closer, by adding a physical dimension to what some of us see as sacred.

Merry Christmas to all who celebrate it, and happy holidays to those who do not! May we all enjoy a little bit of magic this season, and hope for a better year ahead.

(The Latin translations are mine.)

#BirthUndisturbed

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