Midwifery

“ It is then to be observed, that during a woman’s pregnancy, and before the labor-pains 230come on, one of the principal points of midwifery is, what is called the art of Touching. Thence are derived the surest prognostics for preparation, and especially from the signs it affords of rectitude or obliquity of the Uterus. I have already offered reasons needless to repeat, why the men can never arrive at the excellence of skill in the women in this particular. ”

“ 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. ”

“ The making then the surgeons art a pandar to a sordid interest, by the incorporation of midwifery with it, is, in fact, engrafting on a noble stock, a scion of another one, both which would bear very well separate, but, thus joined, can produce nothing but a vile poisonous fruit. ”

“ But where there is a complicated case, dependent on the physician’s art, then the trusting to those men-dabblers in midwifery is a folly that may be fatal to both 133mother and child, or, at the best, the delivery will have been rendered more painful, more laborious, more big with danger, for those precautions having been neglected, which can be so little supposed to occur to the common run of men-midwives in cases foreign from their rote of practice. ”

“ Midwifery is the art of aiding women in childbirth. In some mode—rude, simple, or complex—it has been practiced in all ages of the world. According to the records of medicine, however, the great mass of the human family has been born and brought up without the aid of the so-called obstetrical science of modern times. The ruder nations anciently, as well as the savage nations in later times, appear to have exhibited, practically at least, a much greater confidence in the prophylactic and healing powers of nature than we see among the more civilized and enlightened portions of our race. ”

“ 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. ”

“ I wish, therefore, to be understood, that I speak in strong terms against the foolishness of the cry we so often hear against man-midwifery. On the other hand, too, let it be understood, that I never have and never shall object to female midwives; the more of them the better, if they become properly qualified, and women choose. ”

“ I do not however charge all the men-midwives with so much modesty, as to confine their striking out of midwifery into physic, to the women lying-in, or to the time of their lying-in, since there have not been wanting some who, with equal ignorance, but superior effrontery, have intrepidly hoisted, the standard of a general knowledge of physic, and having originally insinuated themselves into families in the character of men-midwives, have easily maintained their ground in them afterwards on the foot of physicians. ”

“ Have not some of our modern authors, especially the male-practitioners, who in these later times have treated of midwifery, added new and worse errors of their own to those bequeathed to us by the antients, whom they have insulted, as they themselves will probably one day be, but with more reason, by their successors, if the world should continue blind enough for them to have any in this profession? ”

“ Nothing being more agreeable to Nature, to Reason, to Experience, than that the method of practice of a skilful midwife is not only the most easy and gentle, the least painful, but assuredly the most safe both for mother and child. This is what the most severe examination will to those, who give themselves the trouble of making it, establish, in contempt of that fashion, by which so pernicious an error, as that of preferring men-practitioners, has acquired more credit and influence than so salutary and demonstrable a truth, as that for which I am contending. ”

“ It is sometimes supposed that childbirth was an easier process in former generations than it has become since the developments of modern civilisation. The question has a direct bearing on the profession of midwifery, but it cannot be answered here, nor could it receive a simple answer of yes or no, for it embraces two problems for the midwife, the ease and safety of a normal delivery and her resources in face of the abnormal.
No one can read the domestic records of the seventeenth century without realising that the dangers of childbed were much greater then than now ”

“ But, in fact, the men, that is to say, those of that sex who have the best understood all the refinements of anatomy, all the variety of female distempers, never that I can learn, attempted to invade the practical province of midwifery. The immortal Harvey, Sydenham, the great Boerhave, Haller, and numbers of others who have written so usefully upon all the objects of midwifery, have never pretended or dropped a hint of the expedience of substituting men-midwives to the female ones. ”

“ Wherever a case occurs to a midwife, so complicated as to be above her reach, her interest, her reputation, her duty, all conspire to prescribe to her a timely application to a regular physician. She communicates her doubts or difficulties to him, who, at the same time that he receives a just information from her of the state of things, combines it with his own knowledge of the human constitution. ”

“ The same thing has also been observed in hundreds of cases of midwifery, both in natural labor and when instruments have been used. In numerous instances the female has been put to sleep, and safely delivered, without knowing or feeling anything whatever, during the whole time ”

“ While thus briefly tracing out the history of midwifery in modern times, and the causes which led to its practice passing from the hands of women into those of men, I have not paused to mention, in due chronological order, those women who, in the last three centuries, have been distinguished for a knowledge of the other branches of Medicine and Surgery. ”

“ To midwifery he devoted special attention, and he accumulated many valuable and interesting observations, chiefly of a statistical character. He left behind him notes of upwards of 2,700 cases of midwifery which he had attended, and he published in the ‘Edinburgh Medical and Surgical Journal’ a paper on the results of his midwifery practice. ”

“ Why, by parity of reasoning, should not the men-practitioners in midwifery be preferable to the midwives, since a man has 107to his manual function superadded a theory superior to that of the women, who, it is confessed, stand sometime in need of calling in the physician to their assistence? As a man then will have laid in a stock of medical knowledge, peculiarly adapted to the exigencies and disorders incident to women during their pregnancy and lying-in, he must consequently excel the midwife, or the physician singly considered ”

“ The same centuries of tradition which had, officially, reserved the practice of medicine for men, had assigned to women the exclusive control of the practice of midwifery. It was assumed that midwifery did not require the assistance of medical art,—that the woman in labor traversed a purely physiological crisis, and required only the attendance of kindness, patience, and native sagacity,—all obtainable without scientific knowledge, from her own sex. ”

“ Endeavor here to get a knowledge of midwifery that will qualify you to attend ordinary cases of natural labor, and enable you sometimes to give medicine when needed, and when there are no physicians in attendance; but understand that there are many times when the only proper thing for you to do is to send for a physician or experienced accoucheur. ”

“ Many a man who to-day undertakes prescribing for a fever, for a fit, a convulsion in a lying-in woman, only because he appears in the character of a man-midwife, would have been ashamed the day before he had taken up that business to give himself out for a physician. He would have been afraid of ordering any thing for her if she was not his patient, as to lying-in, and would not, even after assuming the profession of midwifery, perhaps order any thing for the same woman, out of the time in which his office is supposed necessary. ”

“ 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. ”

“ There is one department of medicine that we think belongs to women, and women alone. It is midwifery. In the feudal times many ladies of rank and wealth prescribed and measured out medicines for their tenants, and many women practised midwifery. It is proved by Dr. Saul Gregory, of Boston, founder of the New England Female Medical College, that the practice of male physicians in the department of midwifery is not only injurious, but destructive of human life. ”

“ His residence in the country, and the celebrity he had acquired as an obstetrician, accorded him frequent opportunities of witnessing the ignorance of midwives and country practitioners upon this important branch and determined him to issue a treatise with plain, practical directions for the management of natural labors. In the year 1807 he published "A Compendium of the Theory and Practice of Midwifery," intended chiefly for the use of midwives and young practitioners. ”

“ The surgeons must look on these professors of midwifery as a kind of amphibious beings, hard to define, whose claim exhibits rather the deformity of a preternatural excrescence, or wen growing out of the chirurgical art, than the becomingness of a natural member of it. ”

“ The art of midwifery then, in its management by women, carries with it, in the recommendation of order, modesty, propriety, ease, diminution of pain and danger, all 456the marks of the providential care of Nature. ”

“ Depend upon it, friends, there are only two things that can induce men to practice midwifery; and these are, first, that it may be necessary for a man so to do, in order to get his living; and, secondly, if he be a benevolent man, he will most gladly relieve suffering, if he can be the means of doing so. And do not physicians, almost to a man, the world over, attend the poor in childbirth, gladly and willingly, when they know they are to receive from them no pay whatever, except such as God gives them? ”

“ Meddlesome midwifery is bad, and I am quite sure that meddlesome breast-tending is equally so. A nurse, in her wisdom, fancies that by rubbing, by pressing, by squeezing, by fingering, by liniment, and by drawing, she does great good, while in reality, in the majority of cases, by such interference she does great harm. ”

“ It was the universal practice in Europe until the middle of the 16th century, as it is to-day in the East, that women should be attended in confinement only by those of their own sex. From that period more attention was given to the practice of midwifery by the medical profession (see Obstetrics) , while in continental Europe, towards the close of the 17th century, special schools were instituted for the proper training of midwives. But it was not until well on in the 19th century that any supervision or regulation was imposed on those who acted as midwives. ”

“ They are themselves for every thing that is worth reading in their writings indebted, both to the physicians and surgeons, whose arts they have despised enough to think, they may be well enough learnt collaterally and subordinately to the mechanical operation of midwifery, as well as obliged to the midwives, to whom they ought at least to go to school, tho’ sure to rail at their ignorance the minute after being taught by them. ”

“ It was (says M. Astruc) at the first delivery of Mademoiselle de la Valliere, and for the safer keeping of the secret. It was feared that the presence of a midwife in the palace, where suspicion reigned already, would furnish fresh food for the malign curiosity of the courtiers; to impose on them they made use of a surgeon whose practice attached him to the court. For the rest, it cannot be denied that there have been, in every age, men who studied or taught the art of midwifery. We have treatises on midwifery of very ancient date, written by physicians. ”

“ And thus, through the courage and great skill in obstetrics of Queequeg, the deliverance, or rather, delivery of Tashtego, was successfully accomplished, in the teeth, too, of the most untoward and apparently hopeless impediments; which is a lesson by no means to be forgotten. Midwifery should be taught in the same course with fencing and boxing, riding and rowing. ”

“ The following is the practice of midwifery, as I observed it among the native tribes, more particularly those inhabiting the Yas, Murrumbidgee, and Tumat countries.
When a female is in labour she leaves the camp alone, and, should any assistance be required, she calls another female to her. When the child is born, the afterbirth, or placenta, is separated from the navel-string, or umbilical cord, by scraping or rudely cutting it with a shell, and the cord is left pending to some [128] length from the abdomen of the infant. ”