The only training available for women who wished to acquire a sound knowledge of midwifery was by apprenticeship; this, if the mistress was skilled in her art, was valuable up to a certain point, but as no organisation existed among midwives it was not possible to insist upon any general standard of efficiency, and many midwives were ignorant of the most elementary circumstances connected with their profession. In any case such an apprenticeship could not supply the place of the more speculative side of training, which can only be given in connection with schools of anatomy where research work is possible, and from these all women were excluded.
As has been said, many women who entered the profession did not even go through a form of apprenticeship, but acquired their experience solely, to use Raynold’s words, “by haunting women in their labours.” In rural England it was customary when travail began, to send for all the neighbours who were responsible women, partly with the object of securing enough witnesses to the child’s birth, partly because it was important to spread the understanding of midwifery as widely as possible, because any woman might be called upon to render assistance in an emergency.
Several handbooks on Midwifery were written in response to the demand for opportunities for scientific training by the more intelligent members of the profession. One of the most popular of these books, which passed through many editions, was published in 1671 by Jane Sharp “Practitioner in the art of Midwifery above 30 years.” The preface to the fourth edition says that “the constant and unwearied Industry of this ingenious and well-skill’d midwife, Mrs. Jane Sharp, together with her great Experience of Anatomy & Physick, by the many years of her Practice in the art of Midwifery hath ... made them ... much desired by all that either knew her Person ... or ever read this book, which of late, by its Scarceness hath been so much enquired after ... as to have many after impressions.” The author says that she has “often sate down sad in the Consideration of the many Miseries Women endure in the Hands of unskilful Midwives; many professing the Art (without any skill in anatomy, which is the Principal part effectually necessary for a Midwife) meerly for Lucres sake. I have been at Great Cost in Translations for all Books, either French, Dutch or Italian of this kind. All which I offer with my own Experience.”[[625]]
Jane Sharp points out that midwives must be both speculative and practical, for “she that wants the knowledge of Speculation, is like one that is blind or wants her sight: she that wants the Practice, is like one that is lame & wants her legs.... Some perhaps may think, that then it is not proper for women to be of this profession, because they cannot attain so rarely to the knowledge of things as men may, who are bred up in Universities, Schools of Learning, or serve their Apprenticeship for that end and purpose, where anatomy Lectures being frequently read the situation of the parts both of men and women ... are often made plain to them. But that objection is easily answered, by the former example of the Midwives amongst the Israelites, for, though we women cannot deny that men in some things may come to a greater perfection of knowledge than women ordinarily can, by reason of the former helps that women want; yet the Holy Scriptures hath recorded Midwives to the perpetual honour of the female Sex. There not being so much as one word concerning men midwives mentioned there ... it being the natural propriety of women to be much seeing into that art; and though nature be not alone sufficient to the perfection of it, yet further knowledge may be gain’d by a long and diligent practice, and be communicated to others of our own sex. I cannot deny the honour due to able Physicians and Chyrurgions, when occasion is, Yet ... where there is no Men of Learning, the women are sufficient to perform this duty.... It is not hard words that perform the work, as if none understood the Art that cannot understand Greek. Words are but the shell, that we oftimes break our Teeth with them to come at the kernel, I mean our brains to know what is the meaning of them; but to have the same in our mother tongue would save us a great deal of needless labour. It is commendable for men to employ their spare time in some things of deeper Speculation than is required of the female sex; but the art of Midwifery chiefly concerns us.”[[626]]
Though the schools of Medicine and Anatomy were closed to women, individual doctors were willing to teach the more progressive midwives some of the science necessary for their art; thus Culpeper dedicated his “Directory” to the midwives of England in the following words:—“Worthy Matrons, You are of the number of those whom my soul loveth, and of whom I make daily mention in my Prayers: ... If you please to make experience of my Rules, they are very plain, and easie enough; ... If you make use of them, you wil find your work easie, you need not call for the help of a Man-Midwife, which is a disparagement, not only to yourselves, but also to your Profession: ... All the Perfections that can be in a Woman, ought to be in a Midwife; the first step to which is, To know your ignorance in that part of Physick which is the Basis of your Act.... If any want Wisdom, let him ask it of God (not of the Colledg of Physitians, for if they do, they may hap to go without their Errand, unless they bring Money with them).”[[627]]
Efforts made by Peter Chamberlain to secure some systematic training for midwives drew upon himself the abuse, if not persecution, of his jealous contemporaries. In justifying the course he had taken he pleads “Because I am pretended to be Ignorant or Covetous, or both, therefore some ignorant Women, whom either extream Povertie hath necessitated, or Hard-heartedness presumed, or the Game of Venus intruded into the calling of Midwifry (to have the issues of Life & Death of two or three at one time in their hands, beside the consequence of Health and Strength of the Whole Nation) should neither be sufficiently instructed in doing Good, nor restrained from doing Evil?... The objection infers thus much. Because there was never any Order for instructing and governing of Midwives, therefore there never must be.... It may be when Bishops are restored again, their Ordinaries will come in to plead their care. Of what? Truly that none shall do good without their leave. That none shall have leave, but such as will take their Oath and pay Money. That taking this Oath and paying their Money with the testimonie of two or three Gossips, any may have leave to be as ignorant, if not as cruel as themselves, ... but of Instruction or Order amongst the Midwives, not one word.”[[628]]
The danger which threatened midwives by the exclusion of women from the scientific training available for men, did not pass unnoticed by the leading members of the Profession. They realised that the question at stake did not concern only the honour of their Profession, but involved the suffering, and in many cases even the death, of vast numbers of women and babies who must always depend on the skill of midwives and urged that steps should be taken to raise the standard of their efficiency. Mrs. Cellier[[629]] pointed out “That, within the Space of twenty years last past, above six thousand women have died in childbed, more than thirteen thousand children have been born abortive, and above five thousand chrysome infants have been buried, within the weekly bills of mortality; above two-thirds of which, amounting to sixteen thousand souls, have in all probability perished, for want of due skill and care, in those women who practise the art of midwifery.... To remedy which, it is humbly proposed, that your Majesty will be graciously pleased to unite the whole number of skilful midwives, now practising within the limits of the weekly bills of mortality, into a corporation, under the government of a certain number of the most able and matron-like women among them, subject to the visitation of such person or persons, as your Majesty shall appoint; and such Rules for their good government, instruction, direction, and administration as are hereunto annexed.”
Mrs. Cellier succeeded with her proposal, in so far that His Majesty agreed to unite the midwives into a Corporation by Royal Charter, but there the matter rested.[[630]]
In France women were more fortunate, for a noted school of midwifery had already been established at the Hotel Dieu in Paris, at which every six weeks dissections and anatomies were especially made for the apprentices of the institution, both past and present.[[631]] Before entering on their profession the French midwives were required to pass an examination before the chirurgeons. Their professional reputation stood so high that Pechey alludes to one of them as “that most Famous Woman of the World, Madam Louise Burgeois, late Midwife to the Queen of France. The praises that we read of all those that ever heard of her are not so much a flourish as truth; for her reasons are solid experiences, and her witnesses have been all of the most eminent Persons of France: and not only of her, but as we have already exprest, of the most excellent known Men and Women of this Art of other Countries.”[[632]]
According to Mrs. Cellier, English midwives were for a time examined by the College of Surgeons, but as their records for the years in question are missing there is no means of ascertaining the numbers of those who presented themselves for examination. She says that Bishops did not “pretend to License Midwives till Bp. Bonner’s time, who drew up the Form of the first License, which continued in full force till 1642, and then the Physicians and Chirurgeons contending about it, it was adjudged a Chyrurgical operation, and the Midwives were Licensed at Chirurgions-Hall, but not till they had passed three examinations, before six skilful Midwives, and as many Chirurgions expert in the Art of Midwifery. Thus it continued until the Act of Uniformity passed, which sent the Midwives back to Doctors Commons, where they pay their money (take an oath which it is impossible for them to keep) and return home as skilful as they went thither. I make no reflections on those learned Gentlemen, the Licensers, but refer the curious for their further satisfaction to the Yearly Bills of Mortality, from 42 to 62; Collections of which they may find at Clerkshall. Which if they please to compare with these of late Years, they will find there did not then happen the eight part of the Casualities either to Women or Children, as do now.”[[633]]