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

May the women then, for their own sakes, for the sake of their children, cease to be the dupes, sure as they are to be in some measure the victims of that scientific jargon, employed to throw its learned dust in their eyes, and to blind them to their danger or perdition! may they, in short, see through that cloud of hard words used by pedants, whose interest it is to impose themselves upon them: a cloud, which is oftener the cover-shame of ignorance, than the vehicle of true knowledge, and perhaps oftener yet the mask of mercenary quackery, than a proof of medical ability!

As to the writings of the men-midwives especially, I dare aver, that, though there may be here and there some very just theoretic notions, borrowed from able physicians and surgeons, nothing is more contemptible than most of their practical rules; what is tolerable in them being most probably got from midwives, but so disfigured with their own absurd sophistications, that I should heartily pity any woman, subjected to have her labor governed by such, as should have no better guidance than their ridiculous instructions.

Then it is that a sensible woman would, in defence of her own life, or of any life that she holds dear to her, in the case of needing the aid of midwifery, view with equal disdain, with equal horror, either the rough manly[^[45]] he-midwife, that in the midst of his boisterous operation, in a mistimed barbarous attempt at waggery or wit, will ask a woman, in a hoarse voice, “if she has a mind to be rid of her burthen,” or the pretty lady-like gentleman-midwife, that with a quaint formal air, and a gratious smirk, primming up his mouth, in a soft fluted tone, assures her, and lies all the while like a tooth-drawer, that his instruments will neither hurt nor mark herself nor child but a little, or perhaps not at all. (See p. 448.)

This last character, if less brutal than the other, is not perhaps the least dangerous, since the practice being at bottom the same, pregnant consequently with the same mischief, the gentleness of the insinuation gives the less warning, and paves the way for the admission of a handling not the less rough for the smoothness of the address. But is there any such thing as polite murder? is mischief the less mischief for being perpetrated with an air of kindness? well considered it is but the more provoking. The male-practitioners then are not quite in the wrong, to presume as they do upon the weakness of the women’s understanding, since they can so grossly pass upon them their needless cruelties, under so inconsistent and false a color as that of a tender compassion. Thus to all the rest of the shame to which they put them, they add that of so palpable an imposition in that flimsy cover of the mean interest, which is so probably the real motive at bottom of their taking up a function, to which they were never called by Nature, nor by any necessity, unless, perhaps, of their own.

In the mean time, the truth is, that, in vain, would the men, by way of sparing the women the terror of their masculine figure, upon those delicate occasions of officiating, and to appear the more natural in the business, aim at an occasional effemination of their dress, manner and air. They can never in essentials atone for their interested intrusion into an office, so clearly a female one, that, if but only as to the manual discharge of it, not even the qualifying them for the opera, would, perhaps, sufficiently emasculate them.

Conclusion of the Second and Last Part.

Here, confessing my just apprehensions of not having fulfilled the promise of my title-page; there will not, I hope, to that reproach of my deficient powers in the performance, be added the undeserved ones of vanity or injustice in the design or conduct of my feeble essay.

For as to vanity, or any presumption, on my part, of any thing so weak, so unauthoritative as my representation, having any chance to remove the abuses, not however the less existent for that incapacity of mine to remove them, my knowledge of the world would alone defend me from so ridiculously wild a thought. I am but too well aware of the tenaciousness of especially false prejudice in most minds, where it has once gained entrance, and with whom prepossession is ever eleven points of the right. I have then purely had in view the discharge of that duty, incumbent on every member of human society, to oppose such errors as appear to be pernicious to the good of it. In that light I have beheld the growing practice of the instrumentarians, and in that sincere belief I have hazarded the publication of my sentiments, without surely pretending to any authority over the opinion of others. That I chearfully leave to every one’s reason, who is capable of reason. And to write for others than the rational, would be only labor deservedly lost.

As to injustice, I am, at least, clear of that of partiality to my own sex. I grant and lament as much as any one the incompetency of but too many of the midwives. The number of such cannot be too little. But then would the banishing them out of the practice be preferable to the having them better taught, especially since there is nothing but what is so much worse to put in their room, men and instruments? What occasion too for such a dangerous extremity? For as the deficiency is evident, so are the causes: which are not only the want of sufficient care in the training and education of women to this profession, but the actual discouragement, which must grow every day greater and greater, by the encroachments of the instrumentarians, whose plea for supplanting them will be consequently strengthened by that alarming scarcity of capable midwives, which themselves will have so much contributed to create. These being then the principal causes, and well known to be so, the remedies are not obscure, nor hard to attain.

A good education especially is of great importance, to accomplish what Nature has already gone so great a way in, by her giving in many respects to the women such a superior aptitude for the business. Capable midwives would much help to form good female pupils; and the lying-in hospitals especially might be made highly useful to so desirable an end. But surely as to the practical part of midwifery in these hospitals, it ought not to be under the direction of men, whose interest it should be, only to form the women so deficiently, as that themselves might be the less unnecessary; to form them, in short, more for their own service, than for that of the public. That temptation being removed, the female-practitioners could not receive too respectfully from the surgeons lectures or instructions, any lights in anatomy relative to their theoretic proficiency. But to nothing should they be more constantly and effectually excited, than to perfect themselves in the manual operation; and indeed, in general, so to capacitate themselves for their function, as to prove and establish the perfect inutility of all instruments whatever. Nor will it be a difficult task for a woman to acquire a superiority in her hands to the most boasted of those unnatural substitutes. This is the true way of laudably disarming the instrumentarians, and of thereby depriving them of the only shadow of a pretence they have for supplanting the women, and invading the female province, of which invasion it is so probable, that not the cause they plead, but the pay they squint at, is the real motive.