Midwifery from the Tudors to the 21st Century

History, Politics and Safe Practice in England

Julia Allison

• Publisher: Routledge
• Year: 2020
• ISBN:
  9781000090000
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

This book recounts the journey of English midwives over six centuries and their battle for survival as a discrete profession, caring safely for childbearing women.

With a particular focus on sixteenth and twentieth century midwifery practice, it includes new research which provides evidence of the identity, social status, lives, families and practice of contemporary midwives, and argues that the excellent care given by ecclesiastically licensed midwives in Tudor England was not bettered until the twentieth century. Relying on a wide variety of archived and personally collected material, this history illuminates the lives, words, professional experiences and outcomes of midwives. It explores the place of women in society, the development of midwifery education and regulation, the seventeenth century arrival of the accoucheurs and the continuing drive by obstetricians to medicalise birth.

A fascinating and compelling read, it highlights the politics and challenges that have shaped midwifery practice today and encourages readers to be confident in midwifery-led care and giving women choices in childbirth. It is an important read for all those interested in childbirth.

1
Late medieval and Tudor English midwives

Roles and responsibilities

The practice of 16th-century rural midwives was governed by prescriptive legislation. The 1511 Physicians and Surgeons Act followed later by the 1533 ‘Peter’s Pence Act’ had enforced ecclesiastical licensing of midwives. Evidence found in Archdeaconry Act Books, confirms not only that midwives were licensed but also that action, including excommunication, was taken against women who practised without a licence.¹

With the exception of royalty, 14th-century and 15th-century women of every social station, from the wife of a gentleman to the wife a labourer, used the services of a local midwife. In 1441, midwife Elizabeth Peverel, who was suffering from sciatica, sent a message to gentlewoman Margaret Paston, to reassure her that, if necessary, she ‘would come to her wheeled in a barrow’, when her labour began.² Birth among noble families was the occasion for lavish celebration. Ward writes that Edward II paid for minstrels to play at the celebration after the churching of Margaret, the wife of Piers Galveston.³ Margaret Cobbe was the fortunate midwife who attended Elizabeth Woodville, wife of Edward IV, at a successful birth, for which she received an annual pension of £10.⁴ Thirty years later, Alice Massy received the same annual payment for attending Elizabeth of York, wife of Henry VII. In early 17th century, when Henrietta Maria, wife of Charles 1, went into early labour while at Greenwich, the midwife who was to be in attendance ‘swooned’, and the ‘sage femme’, chosen by Henrietta’s mother, had been captured en route by a privateer. Another midwife, named Alice Dennis, was sent for urgently and, upon the safe birth, she was given £100.⁵ Charles I was known to have Catholic leanings, and at this time, there was a recusant midwife named Alice Dennis in practice in Essex, who may have been the same midwife.⁶

In the 16th century, midwives were still the primary caregivers to women of every social status, including noblewomen and gentlewomen. Local midwife Margaret Lynsey attended Lady Cromwell at her country home in North Elmham, Norfolk, and midwife Mistress Fiske of Binham attended Mistress Calthorpe, wife of the leader of Wabourne militia.⁷ While there is little written evidence by which to judge the place of women of every social station in 15th-century and 16th-century England, archive documents and parish registers give a strong indication of their place in the 16th century. The early Newport register is one of many which frequently omits the mother’s name at her child’s baptism, 30 November 1597, ‘Lucas son of William Colgate was baptised’; similarly in Clare burial register, ‘the wife and son of William Whatlock, was buried’.⁸ This did not apply solely to married women. Entries relating to servant women sometimes appear in the same manner: ‘Joan born of Finches maid was christened xth of January, 1568’.⁹

Conversely, among 200 16th-century parish registers, whereas men are seldom eulogised, the lives of some women were acknowledged with high praise, including midwives. This entry appears in Wells parish register: ‘Margaret Burwood widow, being about the age of 95 years, her whole life upright. She was a midwife gracious, for mercy detains any woman under her hand. She was devout, charitable, to her abilities, a good keeper of hospitality’.¹⁰

In terms of preparation for the infant, while importance was placed on proper clothing for the newborn, few families could attain the standard suggested by Thomas Deloney. Deloney, a silk weaver of Reading, in his book The Gentle Craft, lists the requirements for the newborn – including, among other things, tailclouts, swadlebands, bibs, diaper and bigginbonnet and a cricket-low stool for the midwife.¹¹ The tailclout was part of the clout or swaddling. Lined with a diaper, it was secured in place by the swaddling bands in a complex procedure, which to the wealthy 15th-century and 16th-century family was an important part of the whole birth process.¹² However, records of swaddling relate to the gentry and the wealthy; there is little evidence that this was practised among the rest of the population. Compare Deloney’s proposed requirements with those provided by Charles Haste, who in 1583 fathered a base child by widow Richmond. When pressed by the widow for support for the infant, he sent her one of his shirts ‘for clouts for the child’. Presumably, she was expected to convert the shirt into clothing for the infant. Later he gave her ‘a long silk gown which he took from about himself’.¹³

No evidence was found that swaddling, as we understand it to have been applied to the infants of the rich, was used for infants of ordinary or yeoman families. Among accounts and inventories of the House of Correction and Almshouse of Saffron Walden, where single mothers and infants were frequently admitted, no mention is made of swaddling for the infants of women convicted for giving birth to a base child.¹⁴ Given the high price of material and clothing in the 16th century, it is likely that the cost was prohibitive, to say nothing of the amount of laundry created by an infant, without the extra burden of swaddling, which would require changing at least every day.

By the 17th century, the belief that swaddling was essential to the health and proper development of the child, generally held to be true by the gentry, was already being criticised. However, an extant list of items that a post–World War II mother was required to assemble in preparation for a home birth, included a three-inch crepe bandage for cord binding. It could be argued that cord binding, which continued into the 1970s, was the last remnant of the practice of swaddling.

Midwives and baptism

There was a profound difference between 14th-century and 15th-century ecclesiastic expectations of a midwife and those that later emerged in the 16th-century midwives’ oath.¹⁵ Canon John Mirks’s 14-century/15th-century ‘Instructions for Parish Priests’ included a requirement that the midwife, in the case of a maternal death while the child was still in utero, cut the woman and perform a post-mortem caesarean section to baptise the child and secure its place in heaven:

And if the woman then should die

Teach the midwife that she hurry

For to undo her with a knife

In order to save the child’s life

And hurry that it christened be

For that is a deed of charity¹⁶

Duties of the late medieval priest, midwife, godparents and mother were laid out in Mirk’s long verse. Women ‘with child’ should go to confession (shriving) and receive holy communion. The priest must teach the midwife her duties, including to have ready some clean water. If the child is half born by the head and shoulders, the midwife must christen it and cast on some water. Should the mother die, the midwife should ‘undo her with a knife’, and rescue the infant. If the ‘midwife’s heart fail her, she is to call a man in to help her…. For if the infant is lost through her fault, she may weep for it evermore’. The vessel used for baptism should be burnt, and ‘if the infant survives, it may not be baptised twice’. By the 16th century, neither was a post-mortem caesarean section a requirement of a midwife’s oath, nor would such an action be forgiven by a bishop or county court. Leyser writes that in no early manuscript was the life of the unborn child to be put before the mother’s life.¹⁷

Baptism of infants by a midwife continued into the 16th century. Christine Walkley writes that midwives sometimes performed emergency baptisms before the infant was born, and the words ‘Creatura Christi’ would be used because the sex of the child was unknown.¹⁸ Duffy describes the birth of twins, in 1564 at Morebath, one baptised at home by the midwife.¹⁹ He suggests that because the child was certain not to survive, the midwife did not give it a human name but chose to baptise it Creature, which he describes as a bizarre custom of the parish.

The name Creature, Creatur, Creture or Creator was a baptismal name used for infants in several counties in this period, including a male christening in Suffolk.²⁰ The name Creature may simply have been an expression of Christian belief as in ‘a Creature of God’ or ‘God’s Creature’.²¹ Given that the purpose of baptism was to ensure the child’s place in heaven, it seems unlikely that the midwife would choose, or suggest, giving it a name which implied that it was not worthy of a human name or to name the child without consulting the mother. In a search of parish registers, it is clear that children baptised Creature were not simply destined to die as some appear in the registers later, when they marry. An example of a birth and later marriage of an infant named Creature occurs in Staplehurst, Kent. Creature Gibbons was born in 1572 and married on 11 January 1593 at Staplehurst parish church.²²

Creature was only one example of the fanciful nature of Christian ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Contents
• List of figures
• List of tables
• Foreword
• Preface
• Glossary of terms, definitions and conventions
• Acknowledgements
• Introduction
• 1 Late medieval and Tudor English midwives: roles and responsibilities
• 2 Tudor midwives: their lives and practice
• 3 Midwives and maternal death in Tudor England
• 4 Midwives and infant death in Tudor England
• 5 Challenge and change to midwifery practice
• 6 Midwives, accoucheurs and the bills of mortality
• 7 Midwives, institutions and civil registration
• 8 Certified and state-certified English midwives
• 9 Early years following the 1902 Midwives Act
• 10 English midwives in peace and war, 1936–1946
• 11 National Health Service and the domiciliary midwife
• 12 District midwives and general practitioners
• 13 The centralisation and medicalisation of midwifery care
• 14 Hospitalisation of birth
• 15 Statutory control, higher education and better birth?
• Conclusion: English midwives, 14th–21st centuries
• Appendices
• Index