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

It is then no wonder that there should still, in all the books and observations hitherto given on this matter, exist a void lamentably unfilled; and as this void evidently consists less in the theory than the practice, the superior qualifications, and natural endowments of the women for the manual operation, point out the fitness of the greater dependence on them for the filling up what, humanly speaking, can be filled up of that void.

Let the physicians, the surgeons instruct the midwives in so much of anatomy as is necessary to their function; let them afford them, either in writing or verbally, their guidance and direction in the consequences or occasionally in the preliminaries of management of the lying-in; all this is right, salutary, and in due course: but that men should pretend to the manual operation in these cases, it certainly neither is nor can be their business. Nor is this negation of propriety a reproach to them. Will any man think it an indignity to be told, he cannot clear-starch, hem a ruffle, or make a bed as handily as a woman? The exceptions are the shame; and in this department of art it would be truer to say, that there are no exceptions than that there are only a few.

But can we wonder at the insufficiency of the lights thrown into the art of midwifery by that cloud of writers who have treated of it, when so few of them having had any other view than advertising themselves, and being incapable of saying any thing to the purpose, of the art of delivering the women, have filled up their books with insignificant digressions, or things intirely foreign from the point?

In some you see all distempers of women collateral to their pregnancy, which is certainly a very necessary and an infinitely extensive subject, while on the practical article of the deliverance they give you nothing but what is barren, jejune, or even false. Others, by way of filling up, run digressively into a discussion of the methods of treating infants. Others again have written only to recommend some pretended secrets, as powders, preparations, &c. Some have swelled their volumes with the more or less commodious structure of a couch, or the mechanism of a close-stool, or the make of different sorts of syringes for anodine injections. In others you meet with remedies for the deformities of the human body, for the contractions or stiffnesses of the muscles of the shoulders, arms, hands, legs, feet, thighs, haunches, &c. to straiten the crooked, and even, in a treatise on midwifery, to extirpate a polypus from the nose. Others, with all the parade of justly exclaiming against nostrum-mongers, the plausible writing against which serves at once to fill up, and give them an air of superiority to such trumpery, substitute however nothing better of their own than the recommendation of some instrument, which they give you for a master-piece of invention; and to establish which, they cry down every instrument of other practitioners, though not one jot inferior to it in any thing, but the not being the newest. Thus, after having perused such a multiplicity of authors, it is incredible to say how little true, or practically useful knowledge is to be picked out of the whole mass of them. You find almost every thing in them but what you are looking for.

In the mean time, the superficial examiner of things, who sees such a number of volumes, furnished by these pretenders to the art of midwifery, cannot conceive they contain matter so little essential as they do. The scientific air diffused over them, not a little embellished with pretty prints of machines, as of a windowed forceps, a stool, or of a gravid uterus, all these contribute to throw the dust of erudition into the eyes of those, who do not penetrate beyond the surface of things. And thus the aids and appendages of the art, or what is yet worse, even the abuses of it, pass for the art itself, the main of which, as it undoubtedly consists in the expertness or dexterity of the manual practice, can be so little and so imperfectly conveyed by description. I am however far from denying the benefit which may result to midwives, from consulting all that has been written on this subject. I am far from encouraging ignorance in the women of this profession. Their skill in the manual function cannot but be improved by the addition of a sound and competent theory. But it should always be remembered, that the very basis or capital point of the art is the manual dexterity; and in that point, the most learned of the men must yield to the most ignorant of the women. A point which the men surpassing the women in every thing else can never compensate: no not with all those dreadful “artificial hands”, of which they boast so much their invention, in the room of the infinitely preferably natural ones, of which the use, in this office, becomes the men as little, as their hands seem formed for it; and I might add, their heads, if they themselves can possibly think otherwise. In such an opinion the ignorance is theirs.

As to the treatise herein offered on the art of midwifery, as the object of it is principally to attack particular abuses and dangerous innovations in it, it will not be expected that the same should furnish a compleat general course of practice. But this I dare aver that if I should be induced to attempt such a work, it will not be the worse for my consulting more the experience I have of Nature in her operations in this one of her so capital concerns, than the authorities of men, who seem or pretend to know so little of her, as to think of assisting her with instruments, formed only for her destruction, or at least for doing her more damage by their violence, than any reason to hope good from them can justify.

Here I shall not offer any digressions on physic, anatomy, chemistry, or pharmacy; I shall confine myself entirely to the points of my business of the manual operation. Let the physician prescribe, the surgeon bleed, the chymist contribute medicines, the apothecary make them up; with none of these professions do I presume to interfere. But as to the man-midwife, who not only so often presumes in some measure to represent them all, but to join to them the exercise of an art so unnatural to his sex, I should think myself wanting to my duty in my profession, if I did not point out the mischief I apprehend to result from especially that method of practice, on which he grounds the pretence of necessity for his practising it at all; and this chiefly forms the object of this second part, in supplement to my first.

Of Deliveries.

We understand, by deliveries, in general, the issue of the fœtus out of the mother’s womb.

These are distinguished into two kinds, the one natural, the other preternatural.