In virtue of this reasoning, and I should be much more glad of finding myself mistaken (knowingly I am sure I am not so) than that it should be but too much verified by matter of fact, I shall here submit a case to the reader for his own decision on the probability, and I dare swear, that among the female readers especially, I may chance to have, there will be more than one, who, on her own personal experience, could attest the existence of such a case, or at least has the strongest grounds of presumption of it.
A Woman then, lingering in a severe labor, and urged by her pains naturally to wish the speediest end of them, is yet by another superior promptership of nature desirous of meriting the sweet name of mother, and is inclined of herself not to think it over-purchased by a little more patience. In this crisis, much must depend on the judgment, and consequently on the advice of the assistent practitioner, male or female. If a midwife, besides the tenderness constitutional to her sex, her natural fears for the mother especially, not without a due share of concern for the child, where there is a possibility of saving it without too great a risk to the parent, besides the superior execution of her art in points of the manual function, she is moreover bound in all duty to see one labor come to its issue before she undertakes another; for the sake of which, she cannot well, if she would, without instruments, prematurely force a delivery by such violent, dangerous and so often destructive means. She will then in course encourage and inspirit her charge with patience, and use all the blandishments, soothing methods imaginable to comfort, relieve, and strengthen the resolution and spirit of the lying-in-woman. Now, a man-midwife, well paid, will perhaps in that cold unaffectionate manner, with which a duty that has no foundation but in interest is ever performed, exhort to endurance that patient whom his dexterity is insufficient to relieve, that patient whose pains are perhaps for the greatest part his own fault. But should he, during some lingering labor, be called elsewhere, to a more rich employer, or should one from whom he has greater expectations, require an attendance from him incompatible with his duty to his prior employer, is not here a temptation to make a quick dispatch with his instruments? A temptation to which it is at least doubtful whether a man, actuated by interest, may not be over-inclined to yield. It may even byass him, without his perceiving it himself. A man’s determining motive, when it is not of a very justifiable nature, is often skreened even from himself by a more specious one. Such, in the present case, is the saving the mother, oftenest by destroying, and sometimes by only galling, bruising, or maiming the child, when the mother rarely escapes her share of the suffering. How many mothers have pathetically interceded, and interceded in vain, for a respite of execution, when the operator has in a peremptory tone cut short their instances, by telling them in a magisterial way, that he knew best what to do, and could not answer for the patient’s life, if the operation was longer delayed! What reply has a poor woman, weak by nature, oppressed by pain, and subdued by her prepossession to oppose to such an argument of necessity, of which her own life appears to be the favored object? What husband, what friends, but must unhesitatingly subscribe to so just a preference as that of the mother and the child? Not that I would insinuate here, that such a dilemma does not sometimes though certainly very rarely exist: but is it not to be feared, that it is too often rather lightly taken for granted that it does exist? May it not be presumed, that the instruments are brought oftener into use than is necessary, for the sake of a dispatch, of which the child is almost ever the victim, and not unseldom the mother herself, who is always hurt, and sometimes irreparably damaged? May it not be justly suspected, that the abuses of Art have occasioned to many women an appearance of barrenness, from the reality of which kinder Nature had in fact exempted them?
But as if ignorance, inability, impatience, interestedness, were not all of them sufficient motives for the forcing use of these instruments, Dr. Smellie has unmeaningly added another, which alone must, to the greatest number of the men-practitioners, prove a greater excitement than all the others put together, if it be true, that Vanity has so great a predominancy over the human heart as it is generally imagined to have. But let us first quote him: the inference will follow.
“(P. 265.) at any rate, as women are commonly frightened at the very name of an instrument, it is adviseable to conceal them as much as possible, untill (mind pray that UNTILL) the character of the operator is established.”
(P. 273.) “Though the forceps are covered with leather, and appear so simple and innocent, I have given directions for concealing them, that young practitioners BEFORE their characters are fully established, may avoid the calumnies and mis-representations of those people who are apt to prejudice the ignorant and weak-minded against the use of any instrument, though never so necessary, in this profession; and who taking the advantage of unforeseen accidents which may afterwards happen to the patient, charge the whole misfortune to the INNOCENT OPERATOR.”
Here I appeal to every reader of common-sense, to every reader who knows any thing of the human heart, whether it can be imagined that any man-midwife, who is called in to the aid of a lying-in woman, will choose to appear in the character of a young practitioner, or of such an one, as that his character is not enough established to dare to use instruments, for fear of after-reflexions. Is not there, if but in this lesson of the Doctor’s, couched a strong temptation for a man-practitioner not indeed to produce openly and barefacedly his apparatus of instruments, but to be very uncautious of concealing them? Since the reason for concealing them, that of the women being apt to be frightened at them, stands coupled with another reason, the fittest in the world to work a contrary effect to both; by piquing the vanity of the operator to suffer them to be seen, and what is worse yet, to the using them only that they might be seen, especially if to this motive of ostentation you add, that if these instruments being the very grand and capital point of their imaginary superiority to the women-practitioners; over whom every occasion of using them seems to the men a kind of triumph.
But while it is to the novices in the art, that Dr. Smellie recommends more especially the concealment of these same terrifying instruments, the good Dr. does not seem aware, that an advice much more honest and humane might be given to the women, for whose benefit the instruments are supposed to be invented, which is, not to employ young practitioners or novices, not in short to employ those whose character was not fully established, since they might, in order to pass for adepts, or at least for no novices, be too apt to embrace occasions of florishing those same instruments with less necessity, if possible, than the great men themselves of the profession.
In the mean time, this curious injunction to the young practitioners, while the old ones are by that distinction implicitly allowed more openness in using the instruments, reminds me of the caution of the Regent-duke of Orleans, who taking monsieur de St. Albin[[18]], a natural son of his, that was in priest’s orders, to task, for some irregularities, of which certain bishops had complained, said to him in their presence, “Sirrah, could not you stay till you were a bishop?”
But whatever may be the motives of recourse to instruments, and there are other possible ones which I have omitted, certain it is, that in this nation they are more frequently employed than even in France, where that pernicious fashion first took birth. And yet in this very nation it is, that the men-practitioners themselves own, that the less they are used the better. Now will they, to solve this contradiction of their practice to their doctrine, plead that the labors of the women here are, in general, more difficult than they are in France? Common sense and truth will however furnish a juster solution: men-midwives are more employed here than in France, where the women-practitioners are still respected, and less driven out of practice, consequently instruments are less frequently used. For I will not pay the men-operators of this country so ill a compliment, as to excuse them, by saying they are less dexterous at the manual function than those of France, and therefore the more obliged to have recourse to those instruments, of which they themselves have so ill an opinion, though indeed not a so thoroughly bad one as they deserve.
In the mean while they may well proceed triumphing in their career, notwithstanding all the fatal trips they make in it, while, if they did not even run it in the dark, they have so much learned dust ready to throw into the peoples eyes whom it is so much their interest to blind. No wonder then, that since, in the more severe cases, in the preternatural labors, they so often receive from well-meaning employers both pay and thanks for the greatest mischiefs, owing to their errors both of omission and commission, they should, in the less difficult, and which are by much the most frequent ones, where no tragic accidents have happened, have credit given them for a merit, to which their pretentions are so little examined. For this they are indebted to the overflow of a gratitude at a loss for a living object and from an impatience of doubt mistaking that object so grosly, as well as to that same prepossession’s continuing, from which they were preferably employed. Hence it is, that one might often hear women, who had not even suffered a little by their practice, from the want of knowing, that by their practice it was they did not suffer less, very sincerely say, “Dr. such an one attended me in my lying-in —— He delivered me very well.” —— Or, “I have been lain for four or more children by a man-midwife, and never had room to complain.” All which proves no more than what may very well have happened, that Nature has been too favorable to them, for even the untoward assistence of a man, in the office of a midwife, entirely to frustrate her beneficence. I do not here add the weight that fashion throws into the scale of prejudice, reserving to treat of that separately.