Some Midwives

Although discussions of midwifery recently emphasized how they were considered lower in status than licensed medical professionals, they were still vital in a community. Subsequently, we do know the names of a few. (Although Trotula was often referred to as a midwife, she never discussed childbirth in any of her works.)

Many of the midwives whose names have come down to us are known because they were employed by nobles who kept records, or tax records that name professions along with the person taxed.

England in the 14th century names a few women in poll tax records as midwives. Felicia Tracy in Canterbury was one, as were Matilda Kembere and Margery Josy in Reading.

Royals wanting help in birth from someone experienced in the matter hired Asseline Alexandre in the 1370s to aid the Duchess of Burgundy in her pregnancies. At least one French queen hired a midwife named Bourgot L'Obliere.

On the Iberian Peninsula, King Carlos III of Navarre (1361 - 1425) brought the Muslim midwives Blanca and Xenci from Toledo to be a part of his court for the health of his wife, Queen Eleanor. She successfully bore several children (including Blanche I), so the move was a good one.

Muslim midwives continued to be employed at this court. King Carlos' daughter Blanche, who became queen of Navarre, was attended by a mother-daughter pair of midwives called doña Fatima and doña Haxa.

One name of a midwife, unfortunately, survived in records because she was put on trial. The Jewish midwife Floreta, widow of Aquinon d'Ays, was brought to trial in Marseilles in 1403. The charge was that she performed a procedure that caused the patient's haemorrhaging and death. Although we do not know the final outcome of the trial, trial records list her defense, and the statements of other women present, all Christian. It has been called an instance of anti-Semitism at a time and in a place where it was not hitherto noted.

The man who brought midwives to help his wife seems like a devoted, loving husband. But that may not exactly have been the case for Carlos III. Let's find out more about him next time.

Midwife Regulations

As mentioned yesterday, midwifery was one of the few professions that was not considered worthy of a guild early on. That may be partially because guilds generally required some literacy and the women who became midwives likely had little to no formal education. Also, men neglected issues of women's health

Lack of a guild meant no regulation, no "entrance exam," no oversight or laws involved. This could be a benefit, since a woman acting as a midwife was "under the radar" of any interference. She was called in by the family to help in their time of need. Her position in the community was as a trusted neighbor whose presence and experience was a comfort, and worthy of compensation by the family of the mother.

As formal medical education was developed during the rise of universities, those practicing in the field of health without formal education started being criticized.

Early in the 13th century, female health workers, long accustomed to the trust and respect of their patients, began to face opposition. Barred from most European universities because of their gender and thus denied academic training in medicine, they were considered ineligible as healers, and those who persisted often met with capricious, even harsh punishment. [source]

The next century saw some municipal acceptance of midwives. The accounts of Bruges have an item in 1312, for example: "Communal expenses – Two midwives who were called to see a newborn infant found in front of the city walls on Christmas Eve, 20 solidi." What to do with an abandoned baby? Call a couple of midwives who could be trusted to care for a newborn, and give them 20 solidi for its care.

Requiring a license granted by an institution did not become widespread until the 15th century. Regensburg in 1452 is the earliest known example, and of course it established a hierarchy with men at the peak. Besides municipalities and guilds and universities, the Church also was interested in having a hand in what a midwife did.

The Church's involvement was to ensure that newborns were properly baptized:

Ecclesiastical and municipal authorities each recognized that they could rely on midwives as representatives, both in the birthing chamber and on the witness stand. Midwives preserved the life of the mothers and children, and both groups agreed that they should preserve the life of a baby over a dying mother. They both recognized that emergency baptism was a vital responsibility for the midwife as well. [source]

Midwives were willing to accept this relationship:

It was in the midwives’ best interest, therefore, to carve out a niche for themselves as agents of both ecclesiastical and municipal officials. As midwives became limited in some ways, therefore, their agency, increased. Midwives became important tools of ecclesiastical authorities. [source]

As midwifery evolved into a more formally recognized role in society, some midwives made names for themselves and wound up in historical records. I'll introduce you to a few tomorrow.

Midwifery

As mentioned recently, since questions of health were managed almost entirely by men, questions about specific women's health issues were neglected or left to women in an informal manner. When Guy de Chauliac mentioned midwives in his great work on surgery, it was only a mention: he declined to express details because the field was dominated by women. 

Men were not even allowed into the room when a woman was giving birth. In fact, "One Henne Vanden Damme, for having hid behind a staircase to eavesdrop upon his wife, she being in labour of childbirth, which thing doth not befit a man, for the said eavesdropping was fined 15 livres." [source]

Later in the Middle Ages there was regulation of midwifery, but midwives, unlike doctors, were not associated with any formal training. In fact, some of the early manuals produced on midwifery—by the rare individuals in the profession who were literate—do not even demonstrate current medical knowledge.

Midwives never formed into guilds, as other professions did with regularity. So far as we know, the qualifications for becoming a midwife were gained from on-the-job experience. Even Trotula, the famous female doctor and professor of medicine in Salerno, discussed many female conditions—even cosmetics—but not the subject of childbirth.

According to Joseph and Frances Gies:

During labor the midwife rubs her patient's belly with ointment to ease her travail and bring it to a quicker conclusion. She encourages the patient with comforting words. If the labor is difficult, sympathetic magic is invoked. The patient's hair is loosened and all the pins removed. Servants open all the doors, drawers, and cupboards in the house and untie all the knots...

When the baby is born, the midwife ties the umbilical cord and cuts it at four fingers' length. She washes the baby and rubs him all over with salt, then gently cleanses his palate and gums with honey, to give him an appetite. [Life in a Medieval City, pp.60-1]

Some historians have noted that the regulation of midwifery started generally around the same time as persecutions for witchcraft. This is, of course, not true in all countries, but it would be difficult to miss the similarity between two different practices of trying to place controls on a segment of society that was in a position of potential harm, either through neglect (on the part of midwives) or design (on the part of witches).

Tomorrow I'll talk about regulation, and why the Church was interested in rules and regulations for midwives.

Jewish Female Physicians

Female doctors were not unknown in medieval Europe. I've written before of Trotula, for instance, and of course there were midwives. The practice of midwifery was naturally dominated by women; in some cases  men were not even allowed in the room during childbirth. Even if they were, they did not necessarily involve themselves directly in the process. One medieval Jewish medical text, in the section on childbirth, has the physician direct the midwife to "massage the orifice of her womb" with herbs rather than do it himself.

But Jewish women were not just midwives. Many of them learned and practices medicine thanks to their families. Jews were not allowed to attend Christian universities, so they could not earn medical degrees in the normal way. Anyone could, however, "test out" by passing an exam and earning a license to practice medicine. Jews—female as well as male—did this by learning from mentors and family members who were physicians.

Two examples were Hava from Provençal, mentioned in the 1320s for her medical ability, and Virdimura, who earned her medical license in 1376 in Sicily. In both cases, we know that their husbands were physicians (in Hava's case so were her sons), and so medicine was clearly the "family business." Mayrona, from Provençal, appears in 40+ documents starting in 1342 as a holder of a licentia curandi et practicandi, a "license to practice medicine."

Jews were more likely to be familiar with Greek and Arabic, as well as Latin and Hebrew, and therefore had access to more medical texts than their Western European counterparts who knew Latin but did not have as many opportunities to learn other languages, and also may not have had the motivation to read texts written by non-Christians. Female Jewish doctors were accepted in Paris, Florence, and Naples as well as Sicily. They were also respected enough to become teachers of medicine as well: Sara of St. Giles was a Jewish doctor who in 14th-century France took on a Christian pupil.

I cannot in truth say that female doctors were accepted everywhere, and tomorrow I'll share some of the less-tolerant stories of this topic. See you then.

Midwives

When Guy de Chauliac mentioned midwives in his great work on surgery, it was only a mention: he declined to express details because the field was dominated by women; men were not even allowed into the room when a woman was giving birth. In fact, "One Henne Vanden Damme, for having hid behind a staircase to eavesdrop upon his wife, she being in labour of childbirth, which thing doth not befit a man, for the said eavesdropping was fined 15 livres." [source]

Later in the Middle Ages, there was regulation of midwifery, but midwives, unlike doctors, were not associated with any formal training. In fact, some of the early manuals produced on midwifery—by the rare individuals in the profession who were literate—do not even demonstrate current medical knowledge. Midwives never formed into guilds, as other professions did with regularity. So far as we know, the qualifications for becoming a midwife were gained from on-the-job experience. Even Trotula, the famous female doctor and professor of medicine, discussed many female conditions but not the subject of childbirth.

According to Joseph and Frances Gies:

During labor the midwife rubs her patient's belly with ointment to ease her travail and bring it to a quicker conclusion. She encourages the patient with comforting words. If the labor is difficult, sympathetic magic is invoked. The patient's hair is loosened and all the pins removed. Servants open all the doors, drawers, and cupboards in the house and untie all the knots.
...
When the baby is born, the midwife ties the umbilical cord and cuts it at four fingers' length. She washes the baby and rubs him all over with salt, then gently cleanses his palate and gums with honey, to give him an appetite. [Life in a Medieval City, pp.60-1]

Some historians have noted that the regulation of midwifery started generally around the same time as persecutions for witchcraft. This is, of course, not true in all countries, but it would be difficult to miss the similarity between two different practices of trying to place controls on a segment of society that was in a position of potential harm, either through neglect (on the part of midwives) or design (on the part of witches).