Midwife’s Apprentice Author’s Note by Karen Cushman
As long as there has been a woman giving birth and another to help her, there have been midwives. In developed countries today, most births take place in hospitals attended by doctors. This is not so throughout the world and certainly was not true in the past. Until the twentieth century, the overwhelming majority of women giving birth did so at home attended by other women.
The woman who made a profession of helping women in labor was called a midwife, from Middle English words meaning “with woman.” Sometimes the midwife was the oldest woman in the village or the one who had the most children. Sometimes a woman could get no other work, because she was poor or ignorant or dirty, so she hired herself out as midwife for women who could afford no other help. Lucky women were attended by a midwife with a deep commitment, skill, and training through experience or apprenticeship, and with patience, judgment, and clean hands.
Different times and different places saw midwives differently, as almost-doctors or as almost- witches. In medieval England, midwifery was a less than honorable profession, mostly because it was practiced by and on women. Midwives worked unsupervised and unregulated into the sixteenth century, when Henry VIII’s efforts to centralize and supervise the medical profession resulted in the registration and regulation of midwives.
Medieval midwifery was a combination of common sense, herbal knowledge, and superstition, passed from woman to woman through oral tradition and apprenticeship. Things were done the way they had long been done, with little innovation or progress. This “women’s knowledge” was considered reliable and valuable, as illustrated in this book by the inclusion of Jane Sharp’s information in Magister Reese’s great encyclopaedia.
Midwives in general used their common sense to help the woman in labor relax, to comfort and soothe her physically and emotionally, to call on all the natural and magical agents at their disposal, and to assess when things were going badly. Some, like Jane Sharp, were experienced enough to know when and how to interfere. Others just tormented the struggling woman with their meddling. Medieval common sense knew nothing of germs, little of anatomy, and all too much of magic and superstition.
Herbs were the only medicines available to the medieval midwife. They were selected, picked, dried, and prepared according to ancient recipes and rituals, which took into consideration where and when the herbs were picked, what their leaves or flowers looked or tasted like, and the influence of the ruling planets. Plants under the influence of Mars, used to treat complaints of organs under the influence of Mars, were usually ineffective, as were those given to stanch blood or increase mific because their flowers looked like drops of blood or milk. But many herbs actually were effective, such as birthwort for inducing contractions, lady’s mantle to stop bleeding, wormwood to relieve pain, and hops for their calming effect. The derivatives of some herbs used by midwives are used in medicine today: belladonna to calm spasms and cramps, smut rye to stimulate uterine contractions, henbane and poppy for relief from pain.
Superstitions included the use of relics, water from holy wells, charms, and magic words. Snail jelly for childbirth fever and eel liver to ease labor were considered useful, as were precious stones—notably jasper, emerald, and ruby—either held in the mother’s hand or crushed into powder and mixed in wine. If these practices helped, it was not through magical intervention, but because of the calming and strengthening effect of the midwife and mother’s faith in their efficacy.
No matter how skillful and conscientious she was, a midwife was really only of help in a normal delivery. No amount of magic stones or herbal syrups could correct a serious problem, such as a woman’s small or deformed pelvis or a child in a position making passage through the birth canal impossible. Many mothers and children died in childbirth during the Middle Ages, the result of poor nutrition and care, the number of unskilled midwives, and the inadequate state of medical knowledge.
With the increased participation of doctors in the birth process, midwives fell into disrepute, but since the 1960s, there has been renewed interest in midwifery in this country and elsewhere. The midwifery profession is now regulated, and individual midwives are licensed. Today’s midwives offer women much more than clean hands, magic stones, and snail jelly. Midwives can be men or women; some are nurses also; some deliver babies at home and others in hospitals. In France, a midwife is sage femrne, wise woman; in Denmark, jordernoder, earth mother; among Yiddish-speaking Jews, vartsfroy, waiting woman; in Hawaii, pale keiki, protector of the child. Throughout the world midwifery continues to exist alongside medicine for women who choose to continue the tradition.