Before hospital births, what was a mother-to-be to do?
Our heroine in The Baron and The Enchantress, Lilith Chambers, is a midwife in her parish of Allshire. A great deal of research has gone into understanding 18th century birthing procedures, routines and herbs for the enceinte woman, tools and equipment of the midwife, the role of the midwife, the procedures for birthing complications, the role of the physician in childbirth, the procedural differences between midwife and physician for pregnancy and childbirth, the role of the wet nurse, and much more. I researched far more than I ended up using in the book. Though I've not included the scholarly subscription sources I used (primarily from JSTOR), I did find some excellent and fun substitutes for your reading pleasure.
For this research segment, I'd like to offer a brief glimpse into the role of the midwife and where she stood in terms of the medical community.
In the early 18th century and before, birthing was a woman's business. Midwives had all to do with birthing no matter the status of the woman giving birth. Physicians, surgeons, and the like had naught to do with birth unless a midwife needed the physician's surgical tools or surgical knowledge in the event of death. Midwives trained from the passing of knowledge from a senior midwife, typically a community herbalist or healer, and were "licensed" through the church. These were, regardless of their own social and financial status, well-respected members of the community. This article gives a lovely overview.
When the mid 18th century rolled around, and science reached new heights (the good ol' Enlightenment era), physicians saw the power in defining medicine as science, which it had never been classified as before. Since women were not welcome in the science community, physicians saw it as a perfect opportunity to gain both power and profits. Instead of working with midwives (and other members of that community, such as apothecaries), they began a campaign against them, spreading untruths about their practices, calling them witches, and establishing themselves as the choice for high society. Though they knew little to nothing about the birthing process, it didn't take long for high society to turn this into a status war--commoners could have the midwives, and those of the upper crust could have physicians. This article is an interesting read.
The physicians' methods were a tad frightening, including such practices as having women "lying in," which meant being prone on a bed for a month before birth (and after) in a darkened (near to pitch black) and heavily heated (sauna) room while being bled regularly. The final result was the physician extracting the baby forcibly with the newly invented forceps, namely because the women were too weak at that point to help in the process. Soon, physicians created "lying in" hospitals to require mothers to go to them rather than them to the mothers, and to remove the family unit from the birthing process.
Midwives, meanwhile, used herbal mixtures and caudle while promoting walking to induce labor, the birth itself being helped by gravity through a kneeling position or a birthing chair. It was not uncommon for the midwife to recruit the help of the husband to hold the wife steady. The birth was in the comfort of the home with loved ones nearby, and the midwife always went to the mother rather than the other way around. This article talks a great deal about caudle, including a recipe. In a previous research post, we talk more about the herbs used, so be sure to check that out for more details. This is an informal overview article that might be of interest to learn about the transition from midwife to physician and more.
Midwives used a fascinating array of natural treatments and rituals to help the birthing process be comfortable and safe. Even complications were dealt with in natural ways without the use of invasive tools, surgeries, or blood-letting. Midwives were part of the process from start to finish, checking in throughout the pregnancy to ensure all was healthy with mother and child and progressing well. When reading about what all they did, how they worked through the check-ups, how they dealt with complications, and their status with the church and community, it is no wonder they were held in high esteem.