Anything a Woman Can Do, A Man Can Do Better

Somewhere around the 17th century, a new class of obstetric practitioners developed, first in England and then spreading to the Continent. They called themselves man-midwives.

The theory was that those uneducated women who had been practicing midwifery for generations (millennia) were just too stupid to actually do a good job. It took a man.

We will carefully ignore the fact that women were excluded from any form of formal education at this time. Unless she was destined to be queen, a woman was lucky to get even a grammar school education, even in middle and upper class families. We will also carefully ignore the fact that secondary education in this age meant Latin and Greek and a thorough study of the classics, since that’s SO useful in midwifery.

Yes, with his razor sharp brain honed from parsing Homer, a man could do a much better job of coaxing those babies out.

The man-midwives replaced the loose, unregulated apprentice system that trained midwives with a loose, unregulated series of lectures by practitioners of dubious knowledge. Really. All you had to do to train man-midwives was put an ad in the paper and invent some sort of teaching device for them to practice on.

[This was one of the first common uses of the preserved corpse. The good schools had them. The not so good schools? Balloons and paper mache models.]

Modesty rules forbade a man to actually practice on a woman in actual labor. Only the actual attending midwife could actually be in the room when the good lady delivered, and he quite often worked with only his hands, under a sheet, eyes averted, to preserve her modesty. So the man-midwife delivered his first baby in actual practice with no attending to back him up.

Not surprisingly, they were often quite unprepared. But that did not stop the man-midwife movement.

[This woeful ignorance in training male physicians to deal with female anatomy was a continuing theme in the history of ob/gyn for another four hundred years. Some really funny stories come out of this genre--but you'll have to wait.]

What they were really, really good at was PR.

A MAN carried the cachet of education and authority.  A MAN was the only way to be certain that you had a trained professional at your bedside. A MAN midwife was the wave of the future.

Of course (and I’m sure that any OB who happens by will take offense, as will the trained midwives, but having done it more than a few times I stand by the argument) ANYBODY can catch a normal delivery. Taxi drivers apocryphally do it all the time. The real trick is knowing when you’re out of your league. I’m sure Pliny and Aristotle came in handy.

The loudest complaints against the man-midwife movement did not come from the woman-midwives. Oh, they complained, generally about the lack of knowledge that the men were required to obtain (especially since there WERE no requirements. At least a woman-midwife had to be licensed by the parish and had to bring testimony to her competency). But who cared what the women-folk thought, anyway?

The loudest complaining was done by the doctors. You see, man-midwives were not doctors. But they did siphon business from doctors, who would often take a fee to be basically “on-call” if the midwife had a problem. They had a few midwives they worked with routinely, and this fed into their more general practice–those babies had to be taken care of.

No, the doctors weren’t happy, at all. So they didn’t let them into their societies, where competency standards could have been enforced. The docs blocked any attempt by the man-midwives to form their own societies, where competency standards could have been enforced. They blocked the crown (in England, obviously) from enforcing any standards or regulations, since that would be an official nod to their existence.

It took a few hundred years for all this mess to resolve. And it took a few crises in maternal medicine.

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