Midwiferie

Midwiferie is the area of medieval medicine that focuses on pregnancy, childbirth, postpartum mothers, and newborn care.

What we now know of medieval midwiferie comes from a variety of sources, spanning medical manuscripts to court records of accused witches.  For example, in the trial documentation for Margerate Bane, who was tried for witchcraft in Aberdeen, Scotland in 1597, her profession is recorded as midwife.  This provides documentation that a woman could be a professional midwife in period (at the very least, in late sixteenth century Scotland). The historian Monica H. Green believes it is doubtful that the male physicians of the middle ages who were writing about, diagnosing, and prescribing treatment for women’s health (gynecology and obstetrics alike) most likely never directly examined or treated their patients’ vaginas.  This limitation thus creating space for women to become medical practitioners.   It is also indicated repeatedly in various forms of documentation that midwifes were often of low socio economic class, just as Margerate Bane indeed was (also present in trial documentation).  Green writes in (2008) Making Women’s Medicine Masculine: The Rise of Male Authority in Pre Modern Gynaecology, that “if midwifes were literate, it seems to have been coincidental rather than a prerequisite of their work… [midwives] do not seem to be regularly married to men in the medical trades.

During the Middle Ages, very few texts were written for teaching midwiferie.  Women learned midwiferie from other women, from what can be surmised from the lean documentation that exists today.  Further supporting this theory, we know that men were likely banished from the birthing space, not allowed to view childbirth, maintaining a designated woman space.  Belgian historian Louis Theo Maes recorded a fifteen century fine for men who view childbirth: “One Henne Vanden Damme, for having hid behind a staircase to eavesdrop upon his wife, she being in labour of childbirth, which thing doth not befit a man, for the said eavesdropping was fined 15 livres.” (Greilsammer, The Journal of Medieval and Renaissance Studies, 21, pg. 285-329)

Returning to the unfortunate history of Margerate Bane, I would be remiss not to discuss the inherent risk in practicing midwiferie.  The question of associations between midwiferie and witchcraft began to clearly emerge around the time that witch persecutions gain momentum in the late middle ages.  It was around the time of midwiferie regulations by outside (male) authority that we also see a surge in witchcraft trials among the court records.  This is further supported in that such regulations on midwiferie included oaths of proper religious teachings and renouncing the use of witchcraft and unorthodox religious practices.


The Medical Manuscripts: 

Treatments for Women, the second of the three texts that comprise The Trotula, the most attributed to Trola herself, is the leading medieval source that I have found thus far on medieval gynecology.   This text also includes treatments in the area of gynecology, pediatrics, and cosmetic medicine.  This text poses some challenges for the the researcher.  There is an underlying anatomical and physiological basis, but that is assumed on the part of the author, and we are woefully left taken for granted and struggling in our modern interpretations.  It is here that we will begin to look at medieval obstetrics from Treatments for Women (Trotula).  The following is taken from Monica H. Green’s English translation.

For Difficulty Giving Birth:

[139] We should prepare a bath and we put [the woman] in it, and after she leaves [the bath] let there be a fumigation of spikenard and similar aromatic substances.  For strengthening and for opening [the birth canal], let there be sternutatives of white hellebore well ground into a powder. For just as Copho says, the organs are shaken and the cotyledons ruptured and thus the fetus is brought out and comes out.

On Extracting the Dead Fetus

[145] Those who labor excessively in giving birth to a dead fetus we assist thus.  Let us place the patient on a linen sheet and let us have it held by four strong men at the four corners, the head of the patient a little bit elevated.  We will make the sheet be pulled strongly in this way and that as the opposite corners, and immediately she will give birth.

On Retention of the Afterbirth (To Expel the Afterbirth): 

[146] There are some women to whom the afterbirth remains inside after birth, to whom we give aid for its explusion thus.  We extract the juice of a leek and mix it with pennyroyal oil or musk oil or juice of borage, and let us give it to drink, and immediately [the afterbirth] will be brought out perhaps because she will vomit and from the effort of vomiting it will come out. Nevertheless, the juice itself has such a power that it is sufficient for expulsion.

For Uterine Pain After Childbirth:

[140] The womb, as though it were a wild beast of the forest, because of the sudden evacuation, falls this way and that as if it were wandering.  Whence vehement pain is caused.  Therefore, take the tops of elder and grind them and, having extracted the juice, mix with barley flour and with the white of an egg, and then make little wafers with suet for eating.  And we give to these women warm wine to drink in which cumin has been boiled

On Prolapse of the Vagina of Women

[180] In prolapse of the vagina after birth we place a tampon, pressing it so that it does not come out except when she urinates. On the third day we make her bathe. Also we make the powders mentioned above in later [text] to be blown through the nostrils lest they become swollen.

On Pain of the Breasts

[200] For pain of the breasts caused by milk, we should mix clay with vinegar and make a plaster; this diminishes the pain and constricts the milk. But first we should foment the place with warm water.

On Cutting the Umbilical Cord

[217] When the umbilical cord of the child is cut, you should say as follows, holding the stump extended: “Jesus Christ is dead, he was pierced by the lance, and he took no thought of any ointment or of his pain or of any unguent.” But first tie the umbilical cord, and afterward, having said this charm, wrap it with a string of an instrument that is plucked or bowed or some other musical instrument. And if [the infant] feels pain, for nine days give it to drink trifera magna in the amount of a chickpea [mixed] with milk or wine or water.


Sources:

Green, Monica H.; (2002) The Trotula: An English Translation of the Medieval Compendium of Women’s Medicine.

Green, Monica H.; (2008) Making Women’s Medicine Masculine: The Rise of Male Authority in Pre Modern Gynaecology.

Greilsammer, The Journal of Medieval and Renaissance Studies, 21, pg. 285-329

Survey of Scottish Witchcraft Database, University of Edinburgh

Spalding Club Miscellany vol. I, pg. 141-2, pg. 156-62 and Vol. V. pg. 67

Further Reading:

Shatzmiller, Maya (1993) Labour in the Middle Islamic World (an extensive study of labour and midwifery in the social and economic life of Islamic communities around the Mediterranean in the 9th to 15th centuries)

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