Blame and Vindication in the Early Modern Birthing Chamber

Abstract

Who was to blame when a labouring woman or her unborn child died during the early modern period? How was responsibility assessed, and who was charged with assessing it? To answer such questions, this article draws on French obstetrical treatises produced by male surgeons and female midwives between 1550 and 1730, focusing on descriptions of difficult deliveries. Sometimes the poor outcome of a labour was blamed on the pregnant woman herself, but more often a particular medical practitioner was implicated. Authors of obstetrical treatises were careful to assign fault when injuries or deaths occurred in cases concerning them. Chirurgiens accoucheurs (surgeon men-midwives) regularly accused female midwives of incompetence, yet also attacked fellow surgeons as well as those male physicians officially superior to them in the medical hierarchy. Female midwives similarly condemned the actions of male practitioners, without hesitating to censure other women when their mismanagement of deliveries had tragic consequences. Part of authors' eagerness to blame others stemmed from the fear of being held accountable for mistakes preceding practitioners had made. Ascribing responsibility usually went hand-in-hand with defensive claims of innocence, or boastful declarations of having saved a suffering woman from the bungling attempts of less skilled birth attendants.

El Siglo de Oro de la comadre: testimonios de Inés de Ayala

“…12 Sostiene Lianne McTavish que el hecho de que las comadres recurrieran a los médicos también se debió al miedo de tener que cargar con la culpa y de ser responsabilizadas en caso de un desenlace funesto (McTavish, 2006). te, mujer del arquero Mateo de Reinalte.…”

Handywomen and Birthing in Rural Ireland, 1851–1955

“…58 Laurence M. Geary has shown how lying-in hospitals gradually increased in number throughout Ireland over the nineteenth century and, within these, teaching formed a core function. 60 In the late nineteenth century, as midwifery modernised and obstetrics emerged, Dublin midwifery was equivalent to, and at times ahead of, developments elsewhere. 60 In the late nineteenth century, as midwifery modernised and obstetrics emerged, Dublin midwifery was equivalent to, and at times ahead of, developments elsewhere.…”

“…59 Surgeons like McTavish's chirurgiens accoucheur (surgeon men-midwives) no doubt served Dublin's elite; indeed, Dr Bartholomew Mosse, founder of the Rotunda was a physician-accoucheur, but that tradition did not gain traction in rural Ireland. 60 In the late nineteenth century, as midwifery modernised and obstetrics emerged, Dublin midwifery was equivalent to, and at times ahead of, developments elsewhere. An array of hospitals provided maternity services both on-site and in domiciliary contexts but they were somewhat deficient.…”

Evidence-based medicine? Patient case studies in English surgical treatises, 1660–1700: Table 1

“…Obstetrical treatises, she stated, were full of case descriptions in which male surgeons and female midwives placed blame for a patient’s critical condition or death upon another practitioner 23. That phenomenon is not generally present in the English surgical treatises.…”