This is a piece that was originally intended to be a chapter of my PhD thesis. It traces the shift from the female oriented approach to birth support of the village midwife to the formation of the male dominated medical field of obstetrics.
Throughout history women’s reproductive powers have been revered, envied and feared. Subsequently women’s bodies have been worshipped, demonised and made targets of abuse (Corea, 1985; Kittay, 1984). Radical feminists including Gena Corea and Robyn Rowland have argued that technological “solutions” to infertility are a contemporary expression of an historic male fascination with female procreative power and desire to control human reproduction (Corea, 1985; Rowland, 1984). The industrialisation of reproduction can, likewise, be attributed to this desire for greater control over the reproductive process. The following article will provide an historical account of the rise of the industrialisation of reproduction. Such an investigation demonstrates that the attitudes and practices of today’s fertility specialists, and obstetricians, have roots in the witch-hunt era.
This article will trace the male professionals’ increasing involvement in reproduction to the late twentieth century, beginning with the victimisation of midwives and female healers, and the successive demise of midwifery that took place following the witch-hunts of the fifteenth to the seventeenth century.Medical Woman & Reproduction
From the fifteenth to the seventeenth century, the western world was gripped by, what has been referred to as, the witchcraze (Daly, 1978, 179). This was manifested as a series of campaigns against witchcraft in Western Europe and North America. “Deviant” women, or women who posed a potential threat to patriarchal institutions such as the Church, were targeted by elite, male professionals including priests, theologians, lawyers, and physicians (Daly, 1979, 182, 195). Thousands of women were raped, tortured, and brutally murdered. So extreme was the witchcraze that in 1585 two villages in Trier Germany were left with only one female resident (Ehrenreich and English, 1978, 2005, 39). Feminists such as Professor Marianne Hester have described the witchcraze as a deliberate campaign of terror against women, a means of social control and of violently enforcing female oppression (Hester, 1992, 108). Feminist analyses of the witchcraze have demonstrated that the persecution of witches served particular male interests. One such interest was the elimination of female competition in the healing arts and midwifery.
Women played a fundamental role as healers prior to the rise of modern medicine, and were particularly knowledgeable about women’s fertility and reproduction (Ehrenreich and English, 1976; Oakley, 1977, 19). Women were “doctors without degrees”, as feminist theorists Barbarach Ehrenreich and Deidre English state:
Women have always been healers. They were the unlicensed doctors and anatomists of western history. They were abortionists, nurses and counsellors. They were pharmacists, cultivating healing herbs and exchanging the secrets of their uses. They were midwives, travelling from home to home and village to village. (Ehrenreich and English, 1976, 19).
Elsewhere Ehrenreich and English have described women’s traditional role as healers as a socially constructed talent that stemmed from their valuable work as mothers, charged with caring for their families: ‘[healing] combined wisdom and nurturance, tenderness and skill.’ (Ehrenreich and English, 1978, 2005, 38). During the witchcraze much of women’s medical knowledge was lost because female healers and midwives were targeted by witch-hunters. These women were particularly vulnerable to accusations of witchcraft because they possessed exceptional knowledge regarding fertility and the reproductive process. This knowledge was believed to be beyond human comprehension (Karlsen, 1998, 9). These women could cure illnesses, alleviate suffering, save the lives of mother and infant despite a difficult birth, and they knew of ways to control fertility, feats that often proved too difficult for their male contemporaries. According to historian Carol Karlsen this indicated to witch-hunters a supernatural, thus evil, understanding of the processes of life and death (Karlsen, 1998, 141). For example in 1648 Margaret Jones, a New England midwife, was accused of being a witch because the health of those who disregarded her medical advice deteriorated:
[S]he would use to tell such as would not make use of her physic, that they would never be healed, and accordingly their diseases and hurts continued, with relapse against the ordinary course, and beyond the apprehension of all physicians and surgeons. (Emphasis added) (Winthrop, 1908a, 344).
Jones’ crimes included possessing the ability to heal the sick, and confidence in her medical skills. That Jones warned her patients their suffering would continue if they did not heed her advice was seen as evidence she was a witch, as it suggested she had psychic abilities (Winthrop, 1908a, 344). Further evidence Jones was a witch was the fact that she possessed superior medical knowledge over competing male doctors. Jones knew her healing methods were successful, and that conditions left untreated would worsen. When her knowledge proved true it was ‘beyond the apprehension of all physicians and surgeons’. The author of this passage goes on to state that Jones knew things: ‘…which she had no ordinary means to come to the knowledge of’ (Winthrop, 1908a, 344). According to this author to possess such knowledge, which physicians and surgeons had yet to comprehend, Jones must have been a witch. Thus it can be surmised that Jones was accused of witchcraft because her medical knowledge was greater than that of male doctors.
While witches were foremost accused of causing harm to persons and property (Karlsen, 1998, 6), the witch’s ability to heal was an equally grievous crime, as stated by an English witch-hunter:
[W]e reckon all good Witches, which do not hurt but good, which do not spoil and destroy, but save and deliver…It were a thousand times better for the land if all Witches, but especially the blessing Witch, might suffer death. (In Ehrenreich and English, 1976, p28-9).
Likewise a Cambridge preacher claimed: ‘if death be due to any…then a thousand deaths of right belong to the good witch’ (Daly, 1979, 193). Through healing, the witch demonstrated a supernatural understanding of the human body, reproduction, and the forces of nature, knowledge that belonged to God alone (Karlsen, 1998, 141). In John Winthrop’s journals from 1630 to 1649 he writes of a midwife who decided to leave the region; ‘and indeed it was time for her to be gone, for it was known, that she used to give young women oil of mandrakes and other stuff to cause conception.’ (Winthrop, 1908b, 268). This midwife’s expertise in reproductive health was considered evidence she practiced witchcraft. This is further illustrated by “The Bull”, Pope Innocent VIII, who stated in one of his sermons: ‘[witches] hinder men from performing the sexual act and women from conceiving’ (in Kramer and Sprenger, 2000, xliii). In their infamous witch-hunting manual The Malleus Maleficarum, acclaimed witch-hunters Heinrich Kramer and James Sperger state; ‘the greatest injuries to the [Christian] Faith as regards the heresy of witches are done by midwives’ (Kramer and Sprenger, 2000, 140). However, religion was but one rationale for accusations of witchcraft against midwives and female healers. Feminist investigations of the witchcraze have revealed the presence of economic motivations.
In Patriarchy and Accumulation, Maria Mies argues the witchcraze was a fundamental process to the rise of capitalism and modern science. (Mies, 1986, p83-8). The witchcraze took place during a period of massive social change (Hester, 1992, 135). Society was being restructured from theocracy to secularism, and feudalism was being replaced with a system that depended on wage-labour (Hester, 1992, 135). For Mies, the witchcraze served this new economic system through the promotion of certain values. In this system the state was obligated to provide enough workers for the economy, as such Jean Bodin (a prominent sixteenth century economist and judge) demanded the state persecute female healers and midwives because they were responsible for abortions, infertility, and sexual intercourse that did not result in conception (Mies, 1986, 83, see also Forbes, 1966, 117). There were also direct financial gains to be made by individuals who abetted the witchcraze.
Authorities paid for the discovery, arrest and trial of witches, as such there was a plethora of self-appointed witch-hunters. These men travelled across regions in search of witches, and in some cases were paid in advance by villages seeking to prevent their coming (Mies, 1986, 86). Wealthier families could afford to buy off authorities if one of their members were accused (Mies, 1986, 85). Once she was “found” guilty of witchcraft the witch’s family was forced to pay for the cost of the trial. This included: compensation for the lawyers, judges and executioners work, the bill for the alcohol and food consumed during the trial, and the cost of the firewood that their family member would be burnt to death with (Mies, 1986, 85). Mies also states; ‘Begging monks wandered around and sold pictures of the saints which, if swallowed by the buyers, would prevent them from being afflicted by witchcraft’ (Mies, 1986, 86). The invention of the printing press also expanded the educated man’s capacity to acquire profits during the witchcraze (Daly, 1979, 190-1). This period saw the development of an entire literary genre devoted to popularising witch-hunt propaganda, known as “devil books” (Daly, 1979, 192). The witchcraze was indeed a lucrative business for enterprising men.
Female healers and midwives’ knowledge could enable women to control their fertility, and this was seen as a threat to patriarchal institutions such as church and state (Oakley, 1977, p25, 26). While eradicating these women could grant church fathers more power and aid the formation of the capitalist economic system, it was also an important process for the establishment of modern medicine. With the elimination of female competition the space and demand for male doctors could grow.
Radical feminist Mary Daly argues that the witchcraze was a method employed by elite men to take ownership of a body of knowledge that had belonged to women. (Daly, 1979, 194). The healing arts, and in particular midwifery, had been the domain of women for centuries (Oakley, 1977, 19; Rich, 1986, 135). According to nineteenth century feminist historian Matilda Joslyn Gage, women accused of witchcraft were in fact the most advanced scientists of their day (Gage, 1972, 243). These women were healers who learned the value of herbs, and how to treat different ailments based on their personal research (Ehrenreich and English, 1973, 30). So great was the knowledge these women acquired that Paracelsus, a famous scientist, burnt his pharmaceutical book claiming he had learned more from “sorceresses” (Ehrenreich and English, 1976, 33). In a similar vein to female healers, midwives were empiricists whose extensive knowledge concerning the reproductive process was owed to personal experience and observation (Donegan, 1978, 9). Reproduction had been a field of women’s expertise and a “mystery” to men. This began to change at the time of the witchcraze, when professional men such as bishops and physicians became concerned about the knowledge and practices of female healers and midwives.
That midwives were particularly vulnerable to accusations of witchcraft cannot be disregarded. Historian Thomas Rogers Forbes cited a textbook published in 1595 that stated midwives were frequently targets of witchcraft accusations (Forbes, 1966, 117). Many of the tasks inherent to a midwife’s work were deemed witchcraft by the authorities, including: providing contraception, abortion, and administering drugs to alleviate labour pains (Ehrenreich and English, 1978, 2005, 40). Furthermore midwives were expected to take oaths promising not to use spells to assist them in their work. This demonstrates there was a belief that a link between midwifery and witchcraft existed (Forbes, 1966, 131-32).
Midwives worked from the basic premise that birth was a natural physiological experience, and indeed the majority of births proceeded without complication (Donegan, 1978, 9; Kobrin, 1966, 351-2). Prior to men’s routine practice of midwifery, childbirth, across the western world, was a social event of which the birthing woman was the focus. Regardless of the time of day, upon hearing a woman had gone into labour a group of women from her area would join her, including her midwives. Together the women would eat and drink, making childbirth a festive occasion. (Donnison, 1988, 14, 45). The midwife’s priority was providing support and comfort to the birthing woman, in fact the word midwife means: “with-woman” (Aveling, 1872, 1). Her supportive role did not cease upon the delivery of the infant. Midwives cared for both mother and child post-birth, they assumed the necessary household duties the new mother would otherwise have been expected to carry out, and could spend a week attending her. (Ehrenreich and English, 1978, 2005, 103; Kobrin, 1966, 351-2; Oakley, 1977, 19-21).
The church’s initial interest in reproduction during the middle ages, stemmed from anxiety over life and death, fertility, and sexual morality. Such matters were believed to be God’s concern, and religious men sought to bring these issues under ecclesiastical jurisdiction (Donnison, 1988, 14; Rich, 1986, 136.). The midwife’s knowledge regarding the process of reproduction was perceived as a threat to church leaders because the interpretation of God’s divine knowledge had supposedly been allocated to men (Rich, 1986, 136). Childbirth could not remain a female dominated festivity, as this awarded too much power to women (Oakley, 1977, 25-6). As such religious men argued childbirth provided the perfect opportunity for witches to work their magic, pledging the lives of innocent infants to Satan. Thus the church’s first priority was to regulate midwives practice, ensuring they would do the work of God, and making them answerable to elite men of the faith.
At different times during the middle ages there were a number of laws issued by the Church regarding the regulation and registration of midwives. In England, as of 1512, any person seeking a licence to practice midwifery was examined by their local Bishop, unless they had previously graduated from a University (Donnison, 1988, 18-9). Generally midwives were expected to prove they were of “good character”, and prevent a woman from giving birth in secret, which was likely to occur if a woman was bearing an “illegitimate” child. They were expected to ensure an unwanted child was not disposed of, promise to call on a physician at the first sign of difficulty, and refrain from using instruments to assist a labouring woman. Across Europe midwives were made to vow never to use sorcery, incantations or chant to ease a birthing woman’s pain (Donnison, 1988, p18-9; (Forbes, 1966, 131-32). The church was strict on this final item and in 1591 a Scottish woman was put to death for crimes including: ‘seiking help att the said Anny Sampsoune, ane notorious Wich, for relief of [her] payne in the tyme of the birth of [her] twa sonnes’ (In Forbes, 1966, 125-26).
Baptism was of particular concern to church leaders because it was felt they had a moral obligation to protect unborn children (Forbes, 1966, p130-32). Thus midwives were expected to exercise baptismal responsibilities in the absence of a minister. The importance the church assigned to christening infants was so extreme that midwives were sometimes expected to insert a syringe of holy water into a pregnant woman’s uterus in order to conduct a baptism in utero (Rich, 1986, 134). Even the tragic death of a birthing woman did not shake the church’s commitment to this religious ritual. In such cases midwives were instructed to perform caesarean sections, extracting the infant from the mother’s lifeless body in order that the child be christened (Donnison, 1988, 16).
In Germany during the 1400s midwives seeking to practice independently were sometimes expected to subject themselves to an examination by a physician, whose knowledge of reproduction had primarily been gained from ancient texts rather than experience (Donnison, 1988, 18). However it was a midwife’s character, rather than her expertise or skill, that was considered the most important feature when applying for a license. Bishops and Priests emphasised the importance of character because they expected midwives to be pious and faithful christians who would serve the Lord and the church above the women they cared for. In a similar vein, physicians intended for midwives to exhibit feminine qualities, particularly obedience to male doctors. This was still the case in the seventeenth century, as evidenced by Dr William Sermon, physician to Charles II:
As concerning their persons, they must be neither too young nor too old, but of an indifferent age, between both; well composed, not being subject to diseases, nor deformed in any part of their body; comely and neat in their apparel; their hands small and fingers long, not thick, but clean, their nails pared very close; they ought to be very cheerful, pleasant, and of a good discourse…they must be mild, gentle, courteous, sober, chaste, and patient; not quarrelsome nor cholerick;…As concerning their minds, they must be wise and discreet; able to flatter and speak many fair words, to no other end but only to deceive the apprehensive women, which is a commendable deceipte, and allowed, when it is done, for the good of the person in distress. (Aveling, 1872, 42-3).
In outlining this feminine character for midwives, male physicians cleverly created a space within midwifery for men. Physicians were not expected to be “comely and neat”, or “able to flatter.” A deliberate sex-role distinction had been created in a field that had previously been the exclusive province of women. This was further demonstrated by Dr John Maubray in 1724 who wrote that a midwife ‘…ought not to be too Fat or Gross…SHE ought to be Patient and Pleasant; Soft, Meek and Mild…and freely submit her Thoughts to the discerning Faulty of the more Learned and Skilful,’ (emphasis original) (Cutter and Viets, 1964, 13). A dichotomy had been created within reproductive care, but this was not limited to character.
While midwives were encouraged to service poor women in labour, no such expectation was pushed upon their male counterparts. Midwives were expected to be patient and let nature run its course, but doctors sought to speed up the birthing process, intervening with procedures and eventually instruments. Midwives were prohibited from using instruments, and were thought to be of use only during uncomplicated labours. Once a labour was deemed abnormal or complicated, the “meek” and “patient” midwife was to obediently call for a male physician, who could actively control the process. This shall be explored at greater length shortly.In the early 1600s a new faction of medicine had been recognised by the western world and the word “man-midwife” had entered the English language (Donnison, 1988, 23). The transition from midwives attending the majority of births to men-midwives (who later became known as obstetricians) was a gradual process that met with resistance from midwives, members of the general public and male physicians alike. Despite this struggle, those responsible for the witchcraze had set in motion a campaign that discredited midwives and female healers. This subsequently led to the demise of women’s centrality in the healing arts and reproduction, the increased involvement of men in midwifery, and the creation of yet another male dominated profession: obstetrics.
Medical Man & Reproduction
There were those who believed midwifery was a profession that naturally fell to women. In 1671 Jane Sharp, a midwife with over thirty years experience, argued that midwifery was rightfully the business of women (Donegan, 1978, 28). All the text-books and lectures in the world could not teach men the valuable knowledge midwives had accrued over centuries, through their observations and experiences as women, in her words: ‘It is not hard words that perform the work, as if none understood the Art that cannot understand Greek.’ (Donegan, 1978, 28). “Man-midwife” was thought to be a contradiction in terms by many male physicians who felt midwifery was beneath other medical disciplines (Donnison, 1988, 53). This was demonstrated in 1827 when Sir Anthony Carlisle, who would become the President of the Council of the College of Surgeons in England, wrote a letter to The Times suggesting that man-midwifery was an affront to educated men. Routine midwifery cases were the “proper vocation” of women (Donnison, 1988, 57-8).
In addition to the view that midwifery was the natural occupation of women and beneath male doctors, there was a social taboo against men’s admission to the birthing chamber. Men’s presence during labour came at the cost of women’s modesty (Donegan, 1978, 167-77). The social taboo against men’s involvement in the birthing process was so great that when called upon, men-midwives would sometimes crawl on all fours into the room a woman was labouring in so as not to be detected by her. Kneeling at the foot of her bed, the man-midwife would carry out his examinations beneath her bed sheets. In the interests of protecting women’s modesty, men-midwives frequently practiced their art blind, only their hands venturing underneath their patients bedding. This posed serious risks for the safety of woman and child, and no doubt, would have led to a number of preventable mistakes (Donnison, 1988, 24).
Before the advent of the man-midwife, childbirth was understood to be a natural process, and the role of the birth attendant was to support the woman in labour, and allow nature to take its course. This view began to shift upon men’s entrance into midwifery. Instead, it was thought that the midwife was most suited to normal births, and abnormal cases were decidedly the province of men. Dr Percival Willughby (1596-1685) wrote: ‘…let midwives know that they bee Nature’s servants’ (Aveling, 1872, 40). Men could obtain degrees in medical practice and they were trained in using surgical tools, thus it was argued that men were naturally better able to manage complicated labours. As one physician wrote:
MEN…being better versed in Anatomy, better acquainted with Physical Helps, and commonly endued with greater Presence of Mind, have been always found readier or discreeter, to devise something more new, and to give quicker Relief in Cases or difficultpreternatural BIRTHS, than common MIDWIVES generally understand. (Cutter and Viets, 1964, 12. Emphasis original) or
Many male physicians, including R. Kinglake, Thomas Ewell, and S.W. Fores, considered men’s involvement in normal childbirth cases unnecessary (Donegan, 1978, 172-77). Under the pseudonym John Blunt, Fores wrote:
I think it as presumptuous for a midwife to attempt either [craniotomies or caesarean sections], as it is ridiculous for a man, or a boy, to be seen sitting at the tail of a modest woman, who has a natural labour. (In Donegan, 1978, 172).
Doctors such as Fores, however, had an ulterior motive for arguing that natural labour belonged to midwives. As mentioned above a sex-role distinction had been created to legitimise men’s involvement in the birthing process. If it was natural for midwives to be patient, and take a non-interventionist approach to childbirth, it followed that the role of men-midwives was to take action and work to control nature. By creating this dichotomy of normal cases for women versus complicated cases for men, man-midwives attempted to naturalise their superiority in understanding and “managing” childbirth over women. These men took it upon themselves to “educate” midwives, which predominantly involved teaching midwives how to identify the precise moment at which to surrender their responsibility to a male practitioner (Donegan, 1978, 40).
Once this dichotomy had been accepted by the public, man-midwives began spreading exaggerated stories that suggested pregnancy and childbirth are inherently dangerous. They encouraged women to see the reproductive process as something to fear, something that required a highly trained man-of-science to control and protect them from (Donnison, 1988, 40; Kobrin, 1966, 353, 359). This was not their only method for attempting to boost business. They also launched a vicious campaign against midwives, taking every opportunity to discredit their work. Moreover, men-midwives cleverly sought to win the favour of nurses, often by generously tipping them. Once persuaded, nurses joined men-midwives in defaming midwives (Donnison, 1988, 40). Unsurprisingly from the 1720s onwards men-midwives were increasingly called to attend natural childbirth cases (Donnison, 1988, 34).
As aforementioned, midwives were expected to attend the poor. This is illustrated in an eighteenth century oath midwives took before admission to the profession, in which the first item states:
You shall swear first, that you shall be diligent and faithful and ready to help every woman labouring with child as well the poor as the rich; and that in time of necessity you shall not forsake the poor woman to go to the rich (Aveling, 1872, 90).
While this is a reasonable expectation of any health care provider, the same was not asked of men-midwives. In fact many doctors, once established, delegated their midwifery commitments to less experienced physicians, as midwifery was known to be a time consuming practice that often impeded upon doctors’ personal and professional schedules (Donnison, 1988, 82-3). Another tactic men-midwives employed to avoid attending some labouring women was to charge prohibitive rates to their patients (Donnison, 1988, 83). Once their medical practices were secure, these doctors could choose which of their female patients they would assist during childbirth, a choice deemed unacceptable for midwives (Donegan, 1978, 185).
Men-midwives were often selective in which cases they attended. Dr John Maubray, a prominent London man-midwife, warned doctors not to attend birthing women who they knew were facing ‘the greatest Danger’ (Donegan, 1978, 80) because it could be detrimental to their businesses if these women were to die while in a doctors care (Donegan, 1978, 80). Maubray’s primary concern was that doctors might be blamed if something were to go wrong while attending a birth (Donegan, 1978, 80). This, in turn, could cost a practitioner his reputation, resulting in the loss of business. However there were men-midwives, including Dr Edmund Chapman, who rejected Maubray’s suggestion, and argued that doctors needed to recognise such deaths were an occupational hazard (Donegan, 1978, 80). Nevertheless it is apparent that there was a double standard concerning profit making from the reproductive process.
Despite the obvious business and profit motivations of men-midwives outlined above, the image of the “money-hungry” midwife was frequently evoked by male physicians to damage the reputation of women in the profession. Dr Willughby claimed that midwifery had been the chosen profession of ‘ye meanest of ye women…for the getting of a shilling or two’ (Cutter and Viets, 1964, 50). Similarly in 1872 Dr J.H. Aveling wrote: ‘It would seem that women too frequently began to practise midwifery more for the purpose of earning a livelihood than for any special aptitude they possessed for the art.’ (Aveling, 1872, 98). In fact there were few women for whom midwifery was a full-time occupation. Unlike male doctors, midwives could not rely solely on their medical skills and reproductive knowledge for financial stability, and often worked multiple jobs (Donegan, 1978, 25). However, many young male doctors found midwifery was an attractive occupation for strategic business reasons. By attending the birth of a child the man-midwife could become general practitioner to an entire family (Donnison, 1988, 35; Oakley, 1977, 33). That a midwife might profit from her work, was viewed with suspicion by man-midwives who, arguably, refused to do the same work unless substantial personal gains could be made.
Accusations of profiteering were but one of many slanderous claims man-midwives made against their female competitors. There were a host of unbecoming traits charged at midwives, and remnants of these malicious myths survived well into the twentieth century. During the rise of man-midwifery the most prevalent of these was the stereotype of the drunken midwife. According to Jean Donnison, author of Midwives and Medical Men, one male doctor referred to midwives as: ‘“doting dram-drinking matrons”…[who] had lost every womanly quality but weakness of understanding and the wretched prejudices of the old wife’ (Donnison, 1988, 44). Culturally, the consumption of alcohol was central to festivities, and childbirth during this period was still treated as a festive occasion (Donnison, 1988, 45). Therefore it was not unreasonable for the women attending a labouring woman to drink in celebration. That midwives upheld the custom of going to a woman’s home to celebrate the birth of her child by: sitting with her, eating, drinking and making conversation, earned midwives the derogatory nickname: “gossips” (Donnison, 1988, 45).
Physicians engaged in further name-calling, claiming that midwives were: ‘ignorant cruel old beldames’ (Donnison, 1988, 44). It was difficult for midwives to dispel this public image as much of their contributions to the profession were stolen by male doctors who later published the women’s knowledge as their own (Rich, 1986, 141). Furthermore midwives’ insights were frequently disregarded as “old wives’ tales”, devoid of practical scientific meaning (Rich, 1986, 141).
Midwives were often portrayed as unintelligent, and many doctors have suggested that the demise of midwifery was the result of men’s intellectual superiority and medical skill over women. Dr Aveling asserted that midwives were too dim-witted to improve their profession. He asked ‘is it not the duty of [midwives] stronger brother’s and of the whole nation to assist them?’ (Aveling, 1872, 169). Aveling argued sensible birthing women would prefer a man-midwife because he possessed greater skill, judgment, and decorum than his female contemporaries (Aveling, 1872, 157). He stated:
Generally speaking, a midwife’s occupation consists more especially in attending to the wants and comfort of her patient, the actual labour being a physiological process to be watched rather than interfered with. It is true, however, that more than this is sometimes required. Sudden emergencies, demanding prompt action, will occur, and it is therefore necessary that she should be able to discover early anything unnatural in a confinement calling for more skill than she possesses. Unusual intelligence cannot be expected in so large a body of women; average mental capacity, however, and a natural aptitude for the occupation should be required. An ordinary midwife can never be a practitioner ranking in education and position with medical men. (Aveling, 1872, 171). (Emphasis added).
These disparaging perceptions of midwives and their work lingered even in the twentieth century. In 1937 Dr A.J. Rongy declared the state of the obstetric profession “backward” and attributed this to the fact that women had for so many centuries maintained a monopoly over the reproductive process (Rich, 1986, 139). Walter Radcliffe echoed Rongy ten years later. In his comprehensive history of the obstetric forceps, Radcliffe wrote of midwives:
[They were] ignorant women for the most part, who brought to their calling many of the crude methods used in the farmyard, and a fog of superstitious notions which the intervening centuries have not yet completely dispelled. (Radcliffe, 1947, 3).
Radcliffe does not consider the substantial lack of knowledge and experience male doctors of the same period had with matters of reproduction. Doctors knew very little about birth because they had few opportunities to witness a normal labour (Donegan, 1978, 25). Furthermore, the church had forbidden post-mortem dissections, leaving physicians and surgeons with a limited understanding of the female anatomy (Rich, 1986, 135). It is interesting to note that Radcliffe mentions “the farmyard”, insinuating that midwives were not serious professionals, for he fails to acknowledge the number of man-midwives who decided to take up midwifery after working as tailors, barbers, and butchers (Wagner, 1994, 9). In England in 1823 there was a case where a man who worked fourteen hour days in a woollen mill also practised midwifery in his spare time (Donnison, 1988, 57). Elizabeth Nihell, a prominent eighteenth century midwife stated: ‘for I know myself one [man]…who, after passing half his life in stuffing sausages, is turned an intrepid physician and man-midwife.’ (Aveling, 1872, 122). These men, according to Nihell, could not be considered more serious professionals than midwives.
In a similar vein to Radcliffe, in 1971 writer Edward Grossman praised medical men for taking control of the reproductive process, claiming: ‘midwives relied on the cunning of their (dirty) hands.’ (Grossman, 1971, 40). In fact it was predominantly male physicians whose dirty hands caused an epidemic that resulted in the unnecessary deaths of thousands of women, as shall be explored in greater detail shortly. Grossman’s notion that midwives were unclean stems from the name-calling tactics employed by man-midwives to defame the female competition. For centuries it was not uncommon for midwives to be referred to as “ignorant”, “incompetent”, even “hopelessly dirty” (Ehrenreich and English, 1973, 51). In one instance midwives were vilified as all of the above and called: ‘relics of a barbaric past’ (in Ehrenreich and English, 1978, 2005, 105).
While these efforts to discredit midwives assisted man-midwives in gaining public support for their access to the birthing chamber, ultimately it was Louis XIV who gave these men the greatest advance. In 1663 Louis and his lover Louise de la Valliere were expecting the birth of their child. The king had Julien Clement, a male surgeon, attend the birth as opposed to the customary midwife. It is thought that Louis did this in an attempt to keep publicity of the birth minimal. When the birth was successful Louis rewarded Clement for his work with the title “Physician Accoucheur.” Subsequently the French nobility began to mimic royalty by employing accoucheurs instead of midwives. This practice eventually spread across Europe and by the following century had been adopted by many wealthy British families (Donegan, 1978, 19; Radcliffe, 1947, 21; Rich, 1986, 139).
In the seventeenth century Dr William Smellie, also known as the “father of British midwifery”, wrote a history of man-midwifery which praised the work of the French accoucheurs. According to Smellie, the French men-midwives had a great advantage over the British, as they could study hundreds of birthing women at the infamous Hotel Dieu. This institution was originally established in the seventh century as a house for the sick, which came to admit pregnant women during the rise of men’s involvement in midwifery. French doctors had the opportunity to gain greater skill and knowledge by “attending” the women in labour at this institution, because, as Donegan notes ‘….the women were in no position to object.’ (Donegan, 1978, 19). The pregnant women who went to the Hotel Dieu were poverty stricken, and could not afford to be attended in their homes.
Despite Smellie’s claims that French man-midwives were advanced compared to the British, it is unlikely that the doctors working at the Hotel Dieu gained an understanding of natural labour. In the eighteenth century male doctors still knew very little about normal childbirth, and were generally involved in complicated and abnormal cases (Donegan, 1978, 18). The women giving birth at the Hotel Dieu were destitute. Their pregnancies were complicated by ill-health caused by under-nourishment, and diseases common to the poor at that time, such as rickets, which often resulted in women developing misshapen pelvises. (Donegan, 1978, 26). The Hotel Dieu could only have exacerbated these health problems, for conditions were far from sanitary. The wards were poorly ventilated and ridiculously overcrowded, in some cases there were four patients to one bed. There was little privacy as visitors, hawkers and beggars came and went amongst the sick. The mortality rate was one in five and it was not uncommon to find the corpse of a once sick patient still sharing a bed with the living. While there was a separate maternity ward, overcrowding often meant pregnant women would be forced to share a bed in one of the sick wards (Radcliffe, 1947, 22). It was in these conditions that the French men-midwives were able to educate themselves, with access to hundreds of poor birthing women’s bodies, and publish what Smellie called “polite literature” that would advance the state of man-midwifery (Donegan, 1978, 19).
While the work of these accoucheurs and the birth of Louis and Louise’s child furthered the man-midwife’s cause, historians, doctors, and feminists concur that it was the invention of the obstetric forceps that gave men their final triumph in taking control of the birthing process. The forceps were described by Aveling as the ultimate “weapon” that finally enabled men to win the “battle” for the dominion of midwifery (Aveling, 1872, 86). Feminist sociologists Lesley Doyal, Sheila Rowbotham and Ann Scott state:
…the invention of the midwifery forceps enabled male professionals to claim that a surgical instrument must be used by a man. Midwives were then seen as providing an inferior service. Midwifery could thus be narrowed in scope, down-graded and confined to the women of the poor.’ (In Ehrenreich and English, 1973, 13).
With the forceps men-midwives found a means to legitimate their entry into midwifery. Indeed the forceps would be used for more than just this. They would serve as the symbol of man’s scientific triumph over the previously uncontrollable womanly field of reproduction, and “evidence” of men’s superiority in obstetrical care.
The forceps were most likely the invention of Peter Chamberlen the elder (1560-1631) (Cutter and Viets, 1964, 44). The instrument operated like a large set of tongs, and the first design resembled a pair of oversized scissors. The instrument was comprised of a handle, and two rounded metal blades, that were designed to clasp an infants’ head once inserted into the vagina. For generations the instrument was a great secret, passed down through the generations of doctors and man-midwives within the Chamberlen family (Radcliffe, 1947).
Peter Chamberlen’s work in midwifery attracted attention as it acquired an air of mystery. At each birth he and his brother Peter the younger (1572-1626) (Cutter and Viets, 1964, 44), who was also a man-midwife, arrived carrying a large chest between them, the contents of which were always hidden. Not even the labouring women they practised on caught a glimpse of, what we now know were, the first obstetric forceps. Often these birthing women were blindfolded in the interests of protecting the Chamberlen’s secret (Rich, 1986, 143). It was rumoured that whatever was hidden in that chest made the Chamberelen’s capable of delivering even the most difficult of labours.
Peter Chamberlen the younger had a son, also named Peter, who followed the family tradition of practicing midwifery. The third Peter Chamberlen owed much of his success to his Uncle’s royal connections. At the age of seventy Peter Chamberlen the elder had attended Queen Henrietta Maria, wife of King Charles I, when her first pregnancy miscarried (Radcliffe, 1947, 14). At this time he decided to share his responsibilities with his nephew. His professional success caused the young doctor to become full of his own importance and in 1634 he appeared before the Royal College of Physicians with a proposal to form an institution that would instruct and license midwives, with himself in charge (Radcliffe, 1947, 13-4). The same proposal had been put forward by his uncle and father in 1616 and had been rejected (Cutter, 1964 #284, 46, Donegan, 1978, 27; Donnison, 1988, 26).
The young man-midwife, like his father and uncle before him, was seeking a monopoly over the practice of midwifery. Understandably Chamberlen’s proposal met with significant objection from English midwives. Over sixty midwives organised a petition against the proposal. They argued it would lead to a decline in the quality of midwifery because a training and licensing institution headed by men-midwives such as Chamberlen would have a vested interest in making midwives dependent upon their male competitors (Donnison, 1988, p26-7). They also drew attention to the fact that men-midwives were not qualified to teach midwifery because they lacked experience in normal child-birth cases. Chamberlen could not instruct the midwives how to better care for and support the women they were attending. Thus, they felt he had little to offer unless pregnant or post-partum women were the focal point of his lectures (Cutter, 1964, p48-9; Donegan, 1978, 27).
At the College’s inquiry it came to light that Chamberlen had already begun organising midwives, many of whom complained he had forced them to take lessons from him at his house (Cutter, 1964, 48; Radcliffe, 1947, 14). Furthermore the midwives who had said they supported the proposal had been bribed with food and wine (Donnison, 1988, 27). Chamberlen had even threatened to deny midwives his services should they require him in an emergency (Cutter, 1964, 48-9; Donnison, 1988, 27). The midwives campaign was successful, not only was Chamberlen’s proposal rejected by the College, but he was told he needed to seek a license in midwifery from the proper authorities (Donegan, 1978, 27; Donnison, 1988, 27; Radcliffe, 1947, 14).
In 1670 Hugh Chamberlen, son of the third Peter Chamberlen, another man-midwife, travelled to Paris. It was an opportune time for him to be in France, as it had been just seven years since Louis XIV had set in motion the popularisation of male birth attendants. Chamberlen attempted to sell his family’s secret to Julien Clement, and while Clement did not accept his offer for ten thousand crowns in exchange for the secret, the French accoucheurs were intrigued. Dr Francis Moriceau requested Chamberlen prove the worth of his instrument. Moriceau found a suitable challenge at the aforementioned Hotel Dieu (Radcliffe, 1947, p21-2). There, a twenty-eight year old crippled woman laboured. She had suffered from rickets earlier in life, and her pelvis was deformed. It had been four days since her waters broke when Moriceau examined her. After inserting his fingers into her vagina and reaching upwards to feel where the infant was positioned, Moriceau found that the birth passage was constricted, so much so that: ‘he was unable to move his fingers within.’ (Radcliffe, 1947, 23). He decided against performing a caesarean section, as it could prove fatal for the mother. Instead he called on Chamberlen to test the Englishman’s skill.
Upon his arrival Hugh Chamberlen apparently boasted he would reach success within forty-five minutes (Cutter, 1964, 51; Radcliffe, 1947, 24). In what was to follow the unfortunate woman giving birth would endure three hours of constant labour while Chamberlen inserted the forceps into her vagina, attempting to clasp her child’s head and wrench the infant from her body (Radcliffe, 1947, 24). It is important to remember this occurred over a century before the advent of anaesthetics (Radcliffe, 1947, 56). Hence the woman Chamberlen was set the task of proving himself on, suffered his manipulations, atop of her natural labour, with nothing to ease the pain. Furthermore Chamberlen was working at a time when protecting women’s modesty was a priority, and as such it is likely that he conducted this procedure without looking at what he was doing, her body and his hands and forceps beneath the bed sheets.
In addition to this trauma, the woman’s birth would have been treated like a visual spectacle by the doctors at the Hotel Dieu, keen to see what Chamberlen was made of (Radcliffe, 1947, 23). The woman in labour died the following day, with her child still in her womb. In an attempt to save the infant, Moriceau performed a post-mortem caesarean. Regrettably the child also died, and Moriceau reported that the woman’s uterus had been torn and perforated which he blamed on Chamberlen (Cutter, 1964, 51; Radcliffe, 1947, 24).
Despite his failure in assisting the poor woman at the Hotel Dieu, and in selling the forceps, Chamberlen still managed to personally gain from this experience. On his return to Britain he took with him a copy of Moriceau’s text Diseases of Women with Child, which he translated from French to English. This text proved to be a bestseller and earned the translator considerable profit. Chamberlen did not give up attempting to acquire fame and fortune from his family’s secret, and inserted self-aggrandising footnotes into Moriceau’s book:
…[M]y father, brothers and myself (though none else in Europe as I know) have, by God’s blessing and our own industry, attained to and long practised a way to deliver women in this case without any prejudice to them or their infants; though all others (being obliged for want of such an expedient to use the common way) do and must endanger, if not destroy, one or both with hooks. By this manual operation a labour may be dispatched (on the least difficulty) with fewer pain and sooner to the great advantage, and without danger, both of woman and child.
I will now take leave to offer an apology for not publishing the secret I mention-viz., there being my father and two brothers living that practise this art, I cannot esteem it my own to dispose of, nor publish it without injury to them; and I think I have not been unserviceable to my own country, although I do but inform them that the fore-mentioned three persons of our family and myself can serve them in these extremities with greater safety than others. (In Radcliffe, 1947, 25)
Personal interest was clearly Chamberlen’s number one priority. While claiming to know a brilliant method that he had no doubt would save the lives of countless women and children, he went on to say he could not share his knowledge because of the repercussions it might have for his family. Yet this was written after he attempted to sell the family secret to Clement and Moriceau in Paris. Chamberlen’s excuse for keeping the forceps a secret: loyalty to his father and brothers, also conveniently served to keep business all in the family. If women giving birth should require this procedure, he assured readers all they need do is call on one of the Chamberlens.
The Chamberlen’s brand of midwifery was profit motivated. Each of the Chamberlen man-midwives saw their profession as a means for personal gain. Hence they kept a secret, which they believed would be of tremendous benefit to all birthing women and their children, for nearly a century. In direct contrast midwives shared and exchanged their knowledge and experiences with one another (Ehrenreich, 1976; Oakley, 1977), for they understood that in so doing they could better care for women in labour. In the older female model of midwifery the pregnant woman was at the core. With the entry of the male medical professional, midwifery was transformed into another branch of the male dominated field of medicine. Once it was conceptualised as a surgical event birthing women were no longer the heart of midwifery, they became the object upon which a doctors' instrumental skill was exercised. The invention of the obstetric forceps led to the doctor becoming the most important person in the reproductive process.
Hugh Chamberlen did eventually find a buyer for his family secret, a Dutch surgeon named Roger Van Roonhuysen. However, Chamberlen fooled the surgeon, selling him one half of the instrument, while he took out Swedish and Danish patents on his forceps (Cutter, 1964, 52; Rich, 1986, 144). Like the Chamberlen’s, Van Roonhuysen kept the secret, sharing it only with those who were wiling to pay a substantial amount. One of Van Roonhuysen’s pupils complained that despite teaching him midwifery, his instructor never revealed the instrument to him. Years later a man-midwife sought to obtain a midwifery licence from the licensing council, of which Van Roonhuysen was a member. Despite passing the examination this doctor was not granted a licence because he failed to pay for the privileged knowledge of the secret instrument (Radcliffe, 1947, 30-1).
In 1733 the first account of the forceps was published in an article by Dr. Edmund Chapman (Radcliffe, 1947, 38). After this publication the forceps became the man-midwife’s greatest “weapon”. At this time the term man-midwife began to be superseded by the title “obstetrician” (Radcliffe, 1947, 56). It became rare for a man attending a birthing woman to do so without the accompaniment of the forceps, and ‘…most surgeons found the forceps too tempting a tool to leave in their pockets or bags, and used it on every opportunity’ (Radcliffe, 1947, 56). Newer models were developed and numerous obstetricians from the 1750s onwards attempted to further their names and careers by fashioning their own instrumental design (Cutter, 1964, 55-69; Radcliffe, 1947, 56). Walter Radcliffe, who wrote a history of the Chamberlen’s forceps, noted that from the latter half of the eighteenth century onwards a school of thought had developed within medicine that believed ‘the power of the human hands was not sufficient’ for “assisting” in the delivery of infants (Radcliffe, 1947, 64).
Despite many obstetricicans enthusiastic use of the forceps, they weren’t immediately welcomed into midwifery. Within the public there was a degree of fear regarding the new instrument. Evidence of this can be found in a statement made by Dr William Dewees, who claimed that obstetricians had taken to frequently mentioning difficult, dangerous and rare cases in childbirth, to encourage the belief that forceps were a necessity (Donegan, 1978, 186). Dr James Blundell criticised obstetricians who had made routine use of the forceps stating: ‘Some men seem to have a sort of instinctive impulse to put the lever or forceps into the vagina’ (Donegan, 1978, 187; Donnison, 1988, 60). Necessity could not have been the driving force behind an obstetricians routine use of the forceps, as midwife Sarah Stone, who attended over three hundred births in one year, stated that she had only found use for instruments on four occasions in her entire career (Aveling, 1872, 109). In his lectures on midwifery Dr William Hunter would proudly show his pair of forceps, rusted from disuse. He cautioned students that the life-saving potential of the instrument was outweighed by the risks it posed to the safety of mother and child (Donnison, 1988, 43).
The most outspoken critic of the obstetric forceps was Elizabeth Nihell. In her 1760 text A Treatise on the Art of Midwifery, Nihell accused surgeons of putting their own interests ahead of birthing women by unnecessarily introducing instruments to childbirth in order to hasten the process (Donnison, 1988, 44; Rich, 1986, 147). She also stated that when, in haste, these men-midwives made errors that resulted in the harm of mother and/or infant they disguised their mistakes with ‘a cold of hard words and scientific jargon’ (in Donnison, 1988, 44). It was also common for a man-midwife who had been called to a birth by the midwife to blame her for his mistakes. In one instance a midwife called a practitioner to attend a difficult labour, but he declined, sending instead a younger, less experienced and cheaper doctor. This doctor used forceps when the case did not necessitate it, which nearly led to the death of the infant. The midwife helped the doctor conceal his mistake only to have him place the blame on her. Consequently the family employed this doctor as their family physician (Donnison, 1988, 48).
Nihell argued that the obstetric forceps gave men-midwives an opportunity to show-off their skill and convince the public that birth was a surgical operation. She also observed that making use of forceps in a delivery gave man-midwives a tangible excuse for charging a higher fee for his attendance (Donnison, 1988, 44). On the issue of profit motivation in obstetrics, Nihell was particularly insightful. She highlighted that until significant gains could be made from midwifery, men’s interest in the field had been minimal:
…the nobility of this art is only begun to be sounded so high by the men, til they discover the possibility of making it a lucrative one to themselves…The art with all its nobility was for so many ages thought beneath the exercise of the noble sex; it was held unmanly, indecent, and they might safely have added impracticable for them. (Nihell in Rich, 1986, 148).
Nihell was not alone in making such an observation. In the 1790s S.W. Fores argued that doctors often chose to use forceps to make a profit and force childbirth to better suit their schedules (Donegan, 1978, 172.). Nearly a century later Thomas Manley, a doctor belonging to the New York State Medical Association, suggested obstetricians could demand more money if they used forceps and other “artificial aids” to hasten women’s labour (Donegan, 1978, 187-88). The percentage of instrumental births in Britain at the beginning of the twentieth century was greater in areas where doctors were paid extra for using instruments, rather than an all-inclusive fee (Oakley, 1977, 47).
With the development of the obstetric forceps men-midwives pushed open the doors to the birthing chamber. The promotion of this equipment was used to convince the public that reproduction should be viewed as a surgical procedure, the domain of the male medical professional. For, as Avelling stated ‘…a surgical instrument must be controlled by the hand of a surgeon, as a sword must be wielded by a solider’ (Aveling, 1872, 120). But the forceps were just the beginning. In the centuries that followed further developments, such as the lying-in room or maternity ward and the professionalisation of obstetrics, would lead to reproduction becoming completely medicalised.
It was inconvenient for the busy and economising obstetrician to attend his labouring patients in their homes, as midwives and female healers had previously done. The doctor was better accommodated by the lying-in room, where many birthing women could be housed simultaneously. The maternity ward, as it later became known, was initially developed to serve obstetricians educational pursuits. Women, who could not afford otherwise (Group, 1980, 165), were brought into hospitals to give birth so that doctors could access groups of pregnant and birthing bodies to examine, and experiment with, for the purpose of expanding their profession (Oakley, 1977, 33-4). This was to have disastrous effects for women, most notably the advent of puerperal, or childbed, fever.
The merits of personal hygiene had yet to be discovered within medicine and as such doctor’s hands carried bacteria from one patient to the next. An epidemic swept Western Europe in which thousands of women needlessly died of childbed fever, that is, the transference of germs from doctors unclean hands into women’s bodies. In the Vienna Lying-In hospital in the 1840s the incidences of maternal death as a result of childbed fever were so high that women were buried two to a coffin (Rich, 1986, 152), and:
In the French province of Lombardy in one year no single woman survived childbirth; in the month of February 1866 a quarter of the women who gave birth in the Maternite Hospital in Paris died. (Rich, 1986, 151).
While midwives also lacked important knowledge about hygiene at this time, they had the benefit of not handling sick, dying or deceased patients before attending birthing women. Eventually the origins of puerperal fever were identified and carbolic washings of hands and sanitation of maternity wards were put into effect (Cutter and Viets, 1964, p99-143), by which stage many women had needlessly perished. In the meantime childbed fever was considered “evidence” that reproduction was a dangerous phenomenon (Rich, 1986, 152), a belief that served obstetricians in legitimating their examination and control of childbirth.
Shifting birth from the home to lying-in hospitals was a move most convenient for obstetricians. Once inside this new birthing institution the needs of the doctor remained paramount. While midwives working in women’s homes waited on nature, obstetricians used instruments to save time (Donnison, 1988, 46). In the interests of speeding up childbirth doctors would rush the expulsion of the placenta by “sweeping” the uterus with their hands. This led to haemorrhaging and inversion of the uterus (Donegan, 1978, 188). Sometimes it was more convenient for the obstetrician to unnecessarily prolong a woman’s labour to give himself time to complete other tasks. In such a case he would draw blood from the labouring woman in order to slow the birthing process (Corea, 1985, 255; Donegan, 1978, 188). Another significant consequence of birth being transferred into the hospital was the conceptualisation of reproduction as a medical condition (Group, 1980, 169). This has been fundamental to the medicalisation of reproduction and the obstetric profession’s triumph over midwifery.
By the nineteenth century the art of healing, developed and practiced by women, had been taken-over and replaced with the medical profession, a body of knowledge that men claimed ownership of, and practiced for a fee (Ehrenreich and English, 1978, 2005, 49-53). Those who wanted to work in obstetrics faced the challenge of trying to convince the public their attendance at births was not only necessary, but worth paying for. Thus obstetricians argued that pregnancy and childbirth were not normal physiological conditions, but like any other medical illness or operation, they required professional monitoring and control (Kobrin, 1966, 353, 359, 360).
The professionalisation of obstetrics that occurred during the nineteenth century, in Western Europe and North America, was simply the recognition of man-midwifery as a legitimate branch of medicine. This increased male involvement in the reproductive process resulted in a number of fundamental changes, and a legacy that remains evident in contemporary obstetric care. These changes included: the exclusion of women from recognised medical practice (Group, 1980, 167), a shift from a majority of home births to hospital births (Corea, 1985, 305; Group, 1980), the pacification of women during the birthing process (Corea, 1985, 306), and the re-conceptualisation of pregnancy and childbirth as traumatic medical problems that require the expertise of an obstetrician (Group, 1980, 166; Kobrin, 1966, 352-53). The medicalisation of reproduction had commenced.
The medicalisation of reproduction refers to a process whereby conception, pregnancy and childbirth are perceived as medical problems that require the control of a highly trained specialist. The Brighton Women and Science Group aptly summarise this phenomenon in their discussion of the nature of childbirth:
Childbirth has changed more and more rapidly over the years, from being a personal, all-woman, shared event to being a pathological state from which women will recover, under correct supervision and care. The desire to create better, safer, facilities for labouring women has turned into a system whereby women are processed through pregnancy and after, according to some “average” pattern. Childbirth has become another illness for which we need treatment and cure, rather than a personally and socially meaningful event. (Group, 1980, 166).
The anxiety surrounding pregnancy and childbirth in the contemporary western world is a culturally specific phenomenon (Donegan, 1978, 10). Prior to the development of the obstetric profession, birth was not seen as an ailment that required treatment or management by a medical professional.
Men’s involvement, and successive control, of the reproductive process was not accidental. Neither was it a natural progression, owed to their superior skill or knowledge. It was a deliberate campaign, carried out through a series of strategic actions throughout the western world that date back to the witch-hunt era. Through the persecution of “witches”, the defamation of midwives, and the creation of the obstetric profession, medical men actively sought a monopoly over reproductive health-care. The legacy of these medical men remains central to women’s experiences of reproduction today.
The industrialisation of reproduction can be traced to men’s entrance and subsequent take-over of midwifery. It was during this take-over that the reproductive process first became a profit making enterprise. From the outset this industrialisation has had a negative impact on women. Their valuable work as healers and midwives was vilified and destroyed in the interest of eliminating competition and creating a market for male birth attendants. Their health and safety were put at risk so that men, who were new to this ancient art, could expand their knowledge and test their new instruments. Reproduction, a previously significant personal experience for women, was turned into an “infective malady” (Oakley, 1977, 33) that required the active management and control of a physician. Women were no longer the centre of the reproductive process, they had been replaced by the medical professional and his technology.
Aveling, J. H. (1872). English Midwives: their history and prospects. J. And A. Churchill.
Corea, G. (1985). The Mother Machine: reproductive technologies from artificial insemination to artificial wombs, 1st edn. Harper & Row.
Cutter, I. S. and Viets, H. R. (1964). A short history of midwifery. W.B. Saunders Company.
Daly, M. (1979). Gyn/Ecology: the metaethics of radical feminism. The Women's Press.
Donegan, J. B. (1978). Women & men midwives : medicine, morality, and misogyny in early America. Greenwood Press.
Donnison, J. (1988). Midwives And Medical Men: A History of Inter-Professional Rivalries and Women's Rights. Historical Publications.
Ehrenreich, B. and English, D. (1976). Witches, Midwives and Nurses: a history of women healers. Writers and Readers Publishing Cooperative.
Ehrenreich, B. and English, D. (1973). Complaints and disorders; the sexual politics of sickness, [1st edn. Feminist Press.
Ehrenreich, B. and English, D. (1978, 2005). For Her Own Good: two centuries of the Experts' advice to women, Revised Edition edn. Anchor Books.
Forbes, T. R. (1966). The Midwife and the Witch. Yale University Press.
Gage, M. J. (1972). Woman, church, and state. Arno Press.
Grossman, E. (1971). The Obsolescent Mother: a scenario. The Atlantic 227, 39-50.
Hester, M. (1992). Lewd women and wicked witches: a study of the dynamics of male domination. Routledge.
Karlsen, C. F. (1998). The Devil in the Shape of a Woman: witchcraft in colonial New England. W.W.Norton and Company.
Kittay, E. F. (1984). Womb Envy: An explanatory concept in Trebilcot, J. (Ed), Mothering: Essays in feminist theory, Rowman and Allanheld, p 94-128.
Kobrin, F. E. (1966). The American Midwife Controversy: a crisis of professionalization. Bulletin of the history of medicine 40, 350-63.
Kramer, H. and Sprenger, J. (2000). The Malleus Maleficarum: The notorious handbook once used to condemn and punish "witches". The book Tree.
Mies, M. (1986). Patriarchy and Accumulation on a World Scale: women in the international division of labour. Zed Books.
Oakley, A. (1977). Wisewoman and Medicine Man: changes in the management of childbirth in Mitchell, J. and Oakley, A. (Eds), The Rights and Wrongs of Women, Penguin Books.
Radcliffe, W. (1947). The secret instrument: (the birth of the midwifery forceps). Heinemann Medical Books.
Rich, A. (1986). Of woman born: motherhood as experience and institution, 10th anniversary edn. Norton.
Rowland, R. (1984). Reproductive technologies: the final soclution to the woman question? in Arditti, R., Klein, R. D. and Minden, S. (Eds), Test-Tube Women: what future for motherhood?, Pandora Press, p 356-369.
The Brighton Women and Science Group. (1980). Technology in the Lying-in-Room in Brighton Women and Science Group, Birke, L., Faulkner, W., Best, S., Janson-Smith, D. and Overfield, K. (Eds), Alice through the microscope : the power of science over women's lives, Virago, p 165-81.
Wagner, M., M.D., M.S.H. (1994). Pursuing the Birth Machine: the search for appropriate birth technology. ACE Graphics.
Winthrop, J. (1908a). Winthrop's Journal: history of New England 1630-1649. Charles Scribner's Sons.Winthrop, J. (1908b). Winthrop's Journal: history of New England 1630-1649. Charles Scribner's Sons.