Midwives continued to deliver the overwhelming majority of babies throughout the eighteenth century. Trained initially by another woman practitioner — and regulated by a guild in many cities — the midwife primarily assisted in labor and delivering babies. She also treated female problems, such as irregular menstrual cycles, breast-feeding difficulties, infertility, and venereal disease, and ministered to small children.
The midwife orchestrated labor and birth in a woman’s world, where friends and relatives assisted the pregnant woman in the familiar surroundings of her own home. The male surgeon (and the husband) rarely entered this female world, because most births, then as now, were normal and spontaneous. After the invention of forceps became publicized in 1734, surgeon-physicians used their monopoly over this and other instruments to seek lucrative new business. Attacking midwives as ignorant and dangerous, they sought to undermine faith in midwives and persuaded growing numbers of wealthy women of the superiority of their services. As one male expert proclaimed:
A midwife is usually a creature of the lowest class of human beings, and of course utterly destitute of education, who from indigence, and that she is incapable of everything else, has been compelled to follow, as the last and sole resources a profession which people fondly imagine no very difficult one, never dreaming that the least glimpse of previous instruction is required for that purpose…. Midwives are universally ignorant. For where or how should she come by any thing deserving the name of knowledge.29
Research suggests that women practitioners successfully defended much but not all of their practice in the eighteenth century. One enterprising French midwife, Madame du Coudray, wrote a widely used textbook, Manual on the Art of Childbirth (1757), in order to address complaints about incompetent midwives. She then secured royal financing for her campaign to teach birthing techniques. Du Coudray traveled all over France using a life-size model of the female torso and fetus to help teach illiterate women. (See “Living in the Past: Improvements in Childbirth.”) Despite criticism, it appears that midwives generally lost no more babies than did male doctors, who were still summoned to treat non-elite women only when life-threatening situations required surgery.
Women also continued to perform almost all nursing. Female religious orders ran many hospitals, and at-home nursing was almost exclusively the province of women. Thus, although they were excluded from the growing ranks of formally trained and authorized practitioners, women continued to perform the bulk of informal medical care. Nursing as a secular profession did not emerge until the nineteenth century.