A Treatise on the Art of Midwifery / Setting Forth Various Abuses Therein, Especially as to the Practice With Instruments: the Whole Serving to Put All Rational Inquirers in a Fair Way of Very Safely Forming Their Own Judgement Upon the Question; Which It Is Best to Employ, in Cases of Pregnancy and Lying-in, a Man-midwife; Or, a Midwife

by Elizabeth Nihell

But to that conclusion in favor of the men-midwives, from the supposed superiority of their success to that of the women-practitioners, contained in the objection I am now answering, I have further to oppose an argument drawn from matter of fact, to which I should imagine it difficult to find a satisfactory reply. This argument then consists in a fair appeal to Experience herself.

I have before observed, that in the Hôtel-Dieu at Paris, there are no men-practitioners suffered, for I do not include the surgeon-major, who is absolutely no more than an officer for the form-sake. Consequently there are no instruments ever employed in the delivery of the women admitted to that hospital. It is true they are extremely well taken care of; all necessaries are found them by that noble charity; but yet it cannot be thought, that the same abundance of ease and conveniences can be afforded, as by those persons, generally speaking, who employ men-midwives. This distinction I mention for the sake of the allowance justly to be made in the calculate I am about to propose. Notwithstanding however the superiority in this point on the side of men-midwives practice, notwithstanding the grief of mind from various causes, as well as the bad constitution of the bodies of many of those indigent wretches, prior to the reception into that hospital, notwithstanding other easily conceivable disadvantages; notwithstanding all these, I say, take any given number of patients, delivered purely by the midwives of that hospital, without the intervention of one man-practitioner, and especially without instruments, and to that given number, oppose an equal one of women attended from the first of their labor to their delivery by the men-midwives, and see on the side of which sex, in the operators, there will be found the greater number of those who shall have done well, or suffered least.

I am the more emboldened to propose such an experiment from my own certain knowledge. I have seen more than two thousand women delivered under my eyes, at the Hôtel-Dieu at Paris, some of whose cases must be readily imagined to have been severe or preternatural ones. Yet all of them were delivered by our midwives and apprentices without the aid of a man-practitioner; nor an instrument so much as thought of. And in all this number I can safely aver, there were but four who died upon their lying-in; and that not from any fault of the midwife’s art; but one from the complication of a dropsy, the other three, who were daughters to honest tradesmen, sunk under the shock of grief and shame at the being deserted by the men who had brought them into that condition. They died, in short, of their desire to die. Yet the children all did well.

This is a fact that does not require the being believed upon my word. The known practice at that hospital, and the registers regularly kept, will attest the truth of this computation. And here, I appeal to every intelligent reader’s own sense, to his own knowledge of things, whether it is unfairly presumed, that in the same number of two thousand women, delivered by the men-practitioners, they could show a roll so innocent, so free from fatal mischief or damage to their patients, to mother and to child. Let any parents, or who may hope to be parents, or are concerned but for the interest of mankind in population, weigh but the force of this argument, purely drawn from a matter of fact, of which there can be so few who are not, in some measures, judges enough to decide upon their own knowledge, or at least on strong grounds of belief or conjecture. In such a number as two thousand women delivered by the men-operators, how many, by what I know, and by what many others must know as well as I, must have perished, or been torn, ruptured, grievously hurt, or irreparably damaged! How many innocent infants must have lost their little lives, in proof of that superiority of practice in the men to the women! Or rather, in proof of that infatuate credulity, which has prevailed in favour of an innovation so unauthorized by nature, by common sense, or by experience!

Objection the Thirteenth.

Say what you will, the fashion will predominate. It is now the fashion to prefer men-practitioners of midwifery to midwives. You will oppose the torrent in vain.

ANSWER.

The conclusion against me that I shall oppose the torrent in vain, is a very just one. As to myself, I ought to expect that I should oppose it in vain, if the decision of the public was to turn upon any thing of so little authority as my private opinion, especially in a point where it is so justly liable to the suspicion of its being byassed, both by private interest, and partiality to my own sex. I readily then grant that my own opinion should go for nothing. But what ought to go for a great deal is my reader’s own judgment, formed upon his own reason and knowledge. But that is not all. I have some dependence on Nature and common sense recovering their rights, from this preference of the men-midwives which shocks both, being, in truth, nothing more than a fashion, not even of the growth of this country, but transplanted from a neighbouring one, whose follies are unhappily so contagious, though for the most part so despicable. How a few interested men, for want of business in their own professions, transplanted this baneful exotic here, where it has met with such undue cherishment has already been touched upon.

But then as this unnatural preference has all the folly and whim of fashion in it, it may be hoped, that it will also have all the instability and transitoriness of one. Time that confirms the dictates of Nature destroys the fictions of opinion. But in points where Nature is herself attacked or injured, inconveniencies and damages never fail of following thereon, enough to oppose the duration of them. The numbers of lying-in women (thanks to beneficent Nature) rather not destroyed than duly assisted by the men-operators, can neither atone for those who perish, sometimes the mother, sometimes the child, sometimes both, while none of them are but sufferers in some degree; nor long blind a public, that has so much interest not to be imposed upon in a matter so essential to it, by false pretences, or by an injurious and interested degradation of the midwives, who at the worst can hardly be so bad as the very best of the men, in the capital point of their business, the manual function. The oftenest greater danger, and always the greater pain, under men-operators than under the midwives hands will, sooner or later, determine the parties concerned to open their eyes on their greatest interest, in a point of such infinite importance to them.

Granting then to Fashion all the power it really has, and a greater one it is, than for the honor of human kind, can well be imagined, still, it not only has its limits of extension, but duration. It is only for the truth of Nature to be universal and eternal.