Midwife

“ Now a midwife has no such shame; she pretends to no extraordinary skill in physic or surgery; she knows her art, and will not presume to transgress its bounds; she would think herself accountable if she did: and even that very tenderness and sensibility, upon which nature has founded her patience, will make her cautious how she pushes that patience too far. ”

“ What I should like you to do would be to take me to a midwife’s. We can easily go without attracting any notice at the first ball at the opera.”
“Yes, sweetheart, but that step is not necessary, and it might lead to our betrayal.”
“No, no, in this great town there are midwives in every quarter, and we should never be known; we might keep our masks on all the time. Do me this kindness. A midwife’s opinion is certainly worth having.” ”

“ Yes, an ignorant midwife, without perhaps anatomy enough to know where the pineal gland is, or without so much as having heard the name of the ossa innominata, and with purely her expertness, and with that sort of knowledge she has at her fingers ends, will give you a more useful and practical account of matters, as they go, where it is sometimes so infinitely important to know how they go, than the most learned anatomist that ever dissected a corpse, brandished a forceps, stuck a crotchet into a child’s brain-pan, or tore open a living woman. ”

“ And the truth is, that there can be few men in the world, but what, the more tender lovers they are of the women, but must be only the more disgusted, the more impatient of the midwife’s preparatory part of her office, which is however the most important one, both as to the prevention of pain, and to the safety of the delivery. ”

“ There 154are a thousand little tender attentions suggested by nature, and improved by experience, that a midwife can employ both preventively and actually to the mitigation of her charge’s pain; attentions which, if even they ever entered into a man-midwife’s head, could not be accepted but with repugnance, I will not say only by a modest woman, but by any woman at all. ”

“ Certain it is, that the bad situation of the uterus often occasions a severe and difficult labor. A midwife therefore, from the very first of the labor-pains, cannot bestow too much attention to the giving such preventive or actual aid as I have proposed. Nothing, on these occasions, is more dangerous than delay. The pretious moments of operation must not be lost, least the child, coming to engage itself, should throw us into an embarrassment yet greater than the first. ”

“ Thus the name of a midwife may subsist after the reality shall have perished, and the world so often deceived by mere names, may not perhaps discover this annihilation till long after it is effectuated, or till it is too late to repair the damages, which will hardly fail of discovering it to them. Of good midwives there never were too many; but they are now much too few; though still not more rare in proportion than those of the men-midwives, who may be called good, comparatively to so many of them as are dangerously superficial. ”

“ Concerning many of the practical facts of the later months of pregnancy and actual birth, and the succeeding weeks of recovery, the properly trained midwife seems on the whole wiser than the average general practitioner, wiser even than the specialist who may come at a crisis, but who does not watch his patient through the succeeding weeks. ”

“ The massage is said to take place at the beginning of a lunar month. The midwife is eminently the most important personage in all that concerns birth. She is not necessarily a priestess, but is usually a relative of the prospective mother. She is always a woman of advanced age who has had abundant experience, and "has never lost a case." She is reputed to be versed in many secret medicines and devices necessary for the cure of any ailment proceeding from natural causes and connected with childbirth. I always found the midwife very reluctant to disclose the secrets of her profession. ”

“ A midwife, duly qualified by Nature and art, with a shreudness and delicacy of the touch, is, when requisite, capable of giving, in virtue thereof, a just account of a woman’s condition. She is enabled to make faithful reports to the physician, and inform him of the needful concerning the state of his patient, where any co-incidence of pregnancy sollicits his attention. By the same means she can distinguish the true labor-pains from the false ones ”

“ There is, humanly speaking, no fear but her strength will return; her pains must not be irritated, nor herself harrassed with ineffectual interference. Nature will come to herself again: the situation will, by her benign energy, change for the better, and become favorable enough, for the midwife to be able to assist her in the due time with a manual operation, that will terminate happily her delivery. ”

“ Thence it has happened, that where an ignorant midwife has, through her unskilfulness, 301or for whatever other reason, been wanting in predisposing the passage, or lapsed the critical moments of the manual aid, so that she really is or pretends to be out of her depth, by the exigence being beyond her ability; the man-midwife is called in, who, with his instruments, forces that delivery, which might, if justice had been done to the patient, have proceeded in a natural way, with much less pain and danger. ”

“ A midwife, for example, may be a very safe and a very good one, without knowing whether the uterus is a hollow muscle, or purely a tissue of membranes, arteries and veins: but if that ascertainment is necessary, she must wait for it till the anatomists have settled among them that point, which, like many other capital points of anatomy, is not however yet done. ”

“ For the birth itself, the mother should be in experienced hands, preferably those of a highly trained and certified midwife or maternity nurse such as Queen Charlotte’s or the London Hospital supplies, one who is experienced in all that has to be done in normal, healthy circumstances, and who can detect at once any necessity for specialized help. ”

“ Although the easiness of the art of midwifery might have been, among the ancients, a motive for intrusting it to women, they also doubtless had a regard for natural propriety, which suggested that the infant, on coming into the world, should be received into the hands of a midwife, to pass into those of a nurse, and from the hands of the nurse into those of a governess, who should prepare him to receive from men a masculine education. ”

“ If, on the other hand, the initial examination does not disclose any abnormality, the midwife is simply asked to allow the nurse to visit the patient at regular intervals, in a supervisory way, and to have the patient report to the clinic doctor for his periodic observations and advice. The intelligent midwives, who speak English, are usually co-operative, but the others are sometimes suspicious and persuade their patients to refuse the nurse’s supervision. ”

“ And here I even officiously seize on an occasion that rises to me out of the very bowels, I may say, of my subject, of selecting for one proof of the danger of adopting innovations offensive to Nature, a 188point of such near analogy to midwifery, as that of nursing children, the care of whom, next to that of the mothers, is the true midwife’s tender province. ”

“ She may easily see, feel and discern those cases in which nature calls the physician in aid to the midwife; nature, who seems to have placed such boundaries between those professions, as nothing but interest, presumption, or ignorance of nature, could ever render their union in one person supposable: tho’ the quality of physician may not indeed exclude that of the surgeon, but rather implies, at least, the theory of surgery. ”

“ In short, once more, a woman in labor requires a midwife to lay her, not an anatomist to dissect her, or read lectures over the corpse, he will be 103most likely to make of her, if he depends more on the refinements of anatomy, than on the dexterity of hand, and the suggestions of practical experience and common sense. ”

“ A circumstance not much to be wondered at, considering the endearment of such an office as that of a man-midwife, and the ascendant it must serve to give them over the heads of families, even in points where a midwife can have no shadow of pretention, for interfering. ”

“ INSTRUCTION TO THE NURSE MIDWIFE. When I use the term nurse midwife I mean a nurse that has some knowledge of midwifery, that can be called to attend to women near the time that she expects to be confined, and that can remain in attendance for two weeks or more if it is desired or necessary. Sometimes a woman would, if possible, have a skilled nurse with her a 148week or more before confinement, especially because she would thereby avoid sending for the physician unnecessarily, and because she would be less likely to detain him for a long period of time. ”

“ It is then in those cases where nature is slow, as she sometimes is, in her operation, and often so, for the greater good of the patient, so conformed perhaps, that a quicker expulsion would only destroy her, that the midwife, not only uses all patience consistent with safety of life to the mother especially, but inculcates patience to her suffering charge. ”

“ A doctor must be in charge of every case, and if one has not been engaged when the nurse gets there, she sees to it that one is procured. The only exception is in cases delivered by midwives, in which instances the nurse gives any necessary care and supervision, having it clearly understood that if any abnormality occurs, she will first notify the midwife and then the midwife or the nurse will immediately call a doctor. ”

“ The long experience I have of this manual help, which has never failed of success with me, warrants my averring, that there is little or no danger, in these cases, to women, provided the midwife employs herself dextrously to clear them while time serves. ”

“ We are now to consider the Midwife in the capacity of a woman not only brimful of medicinal knowledge, but possessed of many secrets, which the mere physician or apothecary could never penetrate. As a doctress, she possessed a very high reputation for all complaints incident to children and females; and where herbal skill failed, unlike the mere scientific man of diplomas, she could set physical causes and effects aside, and have recourse at once to the supernatural and miraculous. ”

“ One of these is located in each particular district, having a given number of inhabitants, and after a woman has been a certain number of hours in labor, the child not being yet born, the midwife is required by law to call in the obstetric surgeon. Thus it is, I repeat, that man’s superiority over woman’s, in ability to perform great and difficult operations, is recognized even in China. ”

“ We have proved, by the admission of men-midwives themselves, that the great majority of cases of midwifery would do well under the eye of a nurse, and that skilled midwives would be a benefit in every community. ”

“ Such a man-midwife can never have thoroughly made himself master of the course of the fluids, nor of the order of their circulation. Their relation 121to the solids, and the efficacy of medicines upon both, can hardly be sufficiently known to a man, who must have been too much employed in trying to form a hand never to be formed, and in attendances on the practice of his midwifery, to acquire those collateral requisites for the effectual multiplication of his professions. ”

“ Neither must she wait till the labor-pains are over, before she sets her hands to work, as I have just before observed. On the contrary, it is in the time of the throws that she must operate, and when they are on the decline, terminate the delivery. The midwife therefore should not barely content herself with watching the time of the pains, but should also admonish, at every one of them, her patient to second them with all her strength, in order that the child may advance the more under their stronger protrusion. ”

“ Instead then of the dangerous self-sufficiency of these complex smatterers, you have in a plain midwife, supposing her regularly bred, and duly qualified for her profession (for I am no more an advocate for ignorance in the women than in the men) one, who, being called in time, will 125duly consider, and observe the constitution of the person that wants her assistence. ”

“ Whoever then will but consider that greater aptitude of organization in the women for fineness of that sense of touching, will allow, that I beg no question, when I aver, proverbially, but truly speaking, that if one hundred points of qualification were requisite to constitute this capital faculty of TOUCHING, a midwife already possesses, in the but being a woman, ninety-nine of them, the sure and certain gift of Nature: and the remaining one from Art, may with great ease, with a little instruction and experience, be acquired. ”

“ This plainly proves, that many of those gentlemen are weak enough to imagine, that the man-midwife implies the physician, though the greatest physicians that ever were never dreamt of such an absurdity, 123as that the physician implied the midwife, whose master and instructor he rather is, in points highly useful indeed at times to her profession, but in which that profession does not consist. ”

“ The manual labor to which they are constantly subjected, and their hardy habits generally, tend powerfully to invigorate their bodies, and although they are, during pregnancy, exempted from the more laborious parts of duty, they are always habitually active. Nature is their only midwife; and according to Dr. Rush, “each woman is delivered in a private cabin, without so much as one of her own sex to attend her. After washing herself in cold water, she returns soon to the usual employments of her station;” ”