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(supervisors: Hilary Marland and Claudia Stein)
MIDWIFERY EDUCATION in 18th century London Anna Bosanquet (supervisors: Hilary Marland and Claudia Stein)
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BACKGROUND Century of great social, economic, political changes, affecting daily lives of women, including their experience of childbirth working lives of midwives and doctors, including their training, knowledge and practice
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PROFESSIONAL RIVALRIES
New species: a man-midwife Old tradition: a female midwife
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TRADITIONAL HISTORY negative view of a female midwife
‘Very little is known of the early history of the English Mid-wif’... It is certain, however, that she was a woman of inferior education’. Superstitious, elderly, drunk and dirty women: ‘Ignorant of anatomy, and obviously unreliable in emergencies, they contributed considerably to the maternal and neo-natal death-rates; yet they flourished for lack of alternative facilities.’ J. Aveling ENGLISH MIDWIVES: THEIR HISTORY AND PROSPECTS , reprinted 1967
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THE ENGLISH MIDWIFE?
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Challenges to triumphalist medical history since 1980s
Donnison Marland Versluysen Evendeen Croxson Cody Wilson Harley Grundy Tew Schofield
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MIDWIFE TRAINING BEFORE THE 18TH CENTURY
Traditional apprenticeship Long period of training – majority 5-10 years; (3-30!) High literacy levels Testimonials and witnesses England different to the Continent and Scotland No structured / national training Various failed proposals Always political: humanitarian efforts but also vested interests and hidden agendas
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RESEARCH QUESTIONS What types of midwifery courses and training were available for men and women in 18th century London? What was their content, structure, and what teaching methods were used? Who were the midwifery pupils and what was their experience? What were the consequences of new training methods for the professional standing of a female midwife?
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SOURCES 1 Midwifery textbooks, manuals and course syllabi published by man-midwives and female midwives
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SOURCES 2 Hospital archives, including minutes of Board meetings and published reports
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SOURCES 3 Hand-written lecture notes taken by midwifery pupils
Personal letters describing training
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SOURCES 4 17th-18th century Burney Collection newspapers
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SOURCES 5 Year accepted Last Name First Name Husband's Name Age Husband's Occupation Cross References Address/Town Region/County Widow spinster 1753 Fiddes Elizabeth George 36 Fletcher 1754 Hall Margaret John 28 Nettlefold Mary 30 Russell Anna Maria 26 Preest Richard 38 Apothecary Kingston-upon Thomes (late of) Surrey x Butler Jane Pierce Surgeon and Apothecary Appointed Matron of the British Lying-in Hospital Chancery Lane, London London 1755 Emerton Sarah Mariner Hamlet of Ratcliff in the Parish of Stepney Stepney Evans Ursula Charles Farmer Wellington in the County of Hereford Hereford 1756 Brightwell Agnes 27 Superviser of the Excise Basingstoke in the County of Hants Hants Boadger Catherine William Former patient 1757 Gyfford Edward Barking Essex 1758 Blackstock sister of Matron, Mrs. Oakes Case 44 Surgeon Lynn Norfolk Prick Abigail 40 Bricklayer Queenborough Kent Tuffin 25 Cornet in the Regiment of Horse called the Oxford Blues 1759 Vacry Maria Margaretta Nicholas John Albemarle Row, London 1760 Wright Susanna Yeoman Feniton Devon Webb 29 Carpenter St. Dunstan in the West, London Fearnall Martha 34 Tallow Chandler Oakingham Berks Randall Chawton Southampton Maynard Hair Merchant Gloucester Haynes 1761 Turner James 32 Silver-Smith late of St. Martin's Lane; but now of Jamaica Jamaica Powell Henry c 42 Coach Keeper Old Bethlehem, London Middleton Thos. 43 Cabinet Maker Gosport Hampshire Ring Mason Basinstoke 1762 Coates Anne Theal Higgs St. Mary le Bone Boxall Ann 35 Plestow Sussex Williamson Esther 41 York Cartwright Jeremiah 31 of the Hay County Brecknock 1763 Allen Joyner Egham Ross Merchant Aberdeen Scotland Garlick Maltster Stelmet Court, in the Strand, London Yewd Secretary to this Charity Wife of the Secretary of the British Lying-in Hospital Officer of excise Bevan Neith County Glamorgan, South Wales 1764 Seyliard Thomas Attorney Serves as deputy matron through March 1766 Peckham Jones Wheelwright Old Brentford Guerrier Tidesman Dockhead Southwark 1765 Racketta Alexander Chester Featherstone Frances upwards of 30 Whitby Langcake about 35 Taylor Windmill Street, London Goff about 28 From the late 1760s onwards, Mr. and Mrs. Goff advertised in the London press their lying-in hospital. Pall Mall, London Secondary analysis of original data provided by other scholars and re-analysis of published data Lisa Cody: private communication Susan Lawrence: 1996
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Newspapers items relating to midwifery
YEARS Midwife or midwives or midwifery Midwifery and lectures Midwifery and course Midwifery and pupils Midwifery and students 99 - 144 1 771 15 8 2 1092 19 13 25 834 5 7 1152 152 80 102 21 2541 56 29 36 9 2715 50 47 2944 181 170 167 53 2377 362 365 69 51 436 178 211 101 70 401 165 203 164
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Classified ads . World (1787) (London, England), Friday, March 12, 1790; Issue 996
Dr. Osborn and Mr Clarke’s last Winter courses in Midwifery and the Diseases of Women and Children will begin as follows: The MORNING COURSE at No. 10, Queen Street, Golden-square, on Tuesday next, March 16, at half past Ten o’Clock. The EVENING COURSE, at No. 12, Chancery-lane, Fleet –street , (for the concenience of Gentlemen living near the City, or who cannot attend in the morning) on the folllowing Monday, March 22, at half past Five. Proposals may be had, and farther particulars known, by applying to Dr Osborn, Hanover-square; Mr.Clarke, Queen-street, Golden-square, or at the Lecture-room, in Chancery-lane.
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MEDICAL EDUCATION IN 18th CENTURY LONDON
No university, no centralised training Private medical courses Advertising in newspapers Increasing opportunities for pupils to gain practical experience in hospitals at least 234 men lecturing on various medical subjects (Lawrence 1996) 1 in 5 taught midwifery 33 midwifery teachers between
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MALE MIDWIFERY TEACHERS in 18th century London
Graph prepared using adapted and re-processed data relating to general medical training in London, published by Lawrence 1996 in ‘Charitable Knowledge’ .
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MALE MIDWIFERY TEACHERS in 18th century London
Never more than 6 Most specialised 14 linked to hospitals Others: Homebirths From 1 to over 30 years From 9 to 24 lectures Similar content (but two camps!) Very different teaching styles Using ‘machines’ for demonstrations Different costs guineas Smellie – 900 men, 1150 mothers in 10 years Many publications
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MAN MIDWIVES: PUBLICATIONS
John Maubray 1730 Richard Manningham 1744 William Smellie 1752 Brundell Exton 1766 John Leake 1767 William Hunter 1774 Thomas Denman 1782 Colin MacKenzie 1789 William Lowder 1789 William Osborn 1792 John Haighton 1799
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RULES AND REGULATIONS Clear rules about costs and privileges
Attending women at home or hospital Strong etiquette ‘… all conversation tending to excite apprehension in the patient be avoided, such as descriptions of bad labours, anatomical dissections, the state of their experience in obstetrical subjects, &c.’ (Haighton 1799)
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MALE STUDENT EXPERIENCE letters of Thomas Bishopp of Leister
25 /5/1793 Mr Cruikshank lectures have finished. He has now ‘entered with Dr Clarke - the surgeon to study midwifery, as well as Dr Pearson’s lectures on physic, chemistry and materia medica from eight till half past ten in Leicester Square’. There are no other lecturers on midwifery so nearer and anyway, Thomas 'should not be so well satisfied with any other'. 17/9/94 'I am sorry to say that I have failed in every attempt I have made to get any private patients in midwifery’…
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COMPLETION OF TRAINING letters of Thomas Bishopp
Anatomy Dr Baillie and Mr Cruikshank 4 courses Mr Cline 1 course - dissected 14 subjects , 2 for Dr Bailleys lectures Physiology Dr Heighton 2 courses Surgery Mr Hunter’s lectures by Home, 1 course The practice of St Thomas’ , Guy’s, St Bartholomew’s and St George's hospitals successively for 4and a half years Midwifery Dr Clarke and Dr Osborne 6 courses Chemistry Dr Babington 2 courses Botany Dr Smith 1 course Physic Dr Fordyce lectures 1 course Dr Crichton lectures 1 course Fordyce’s and the practice of the other physicians at St Thomas’ hospital 2 years. During attendance at the above hospitals took down about 1500 medical and surgical cases. Natural philosophy Mr walker 1 course Rev Mr Roberts 1 course Took out a diploma at Surgeons Hall in 1795 COMPLETION OF TRAINING letters of Thomas Bishopp 7/11/1794 'I shall be sufficiently acquainted with practical dissection and anatomy to undertake all the common operations in surgery with good confidence in my qualification and I am not at all doubtful but that I understand the theory and practical department of midwifery as well as the majority of those who settle in the country.
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FEMALE MIDWIVES Jane Sharp 1671, 1724&5 Sarah Stone 1737
Knew Greek and Latin Sarah Stone 1737 Three generations, trained in dissections Elizabeth Nihell 1760 Two years training in Hotel Dieu in Paris Margaret Stephen 1795 Trained by man midwife, pupil of Smellie Martha Mears 1797 ‘Spent some years under the most eminent professors of midwifery’ Jane Wright 1798 Pupil at the British Lying in Hospital
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EDUCATING FEMALE MIDWIVES in 18th c LONDON
Some of the male teachers offered courses to women Different costs and conditions Women expressing dissatisfaction about unfair treatment of female pupils When successful: proud to be trained by men Evidence of only one private midwifery school run by a woman to train female midwives: Margaret Stephen
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Margaret Stephen: MIDWIFERY TEACHER
‘I teach my own pupils the anatomy of the pelvis… and of the foetal skull, on preparations which I keep by me, with everything else relative to practice in nature, at labours; also turning, and the use of the forceps, and other obstetric instruments, on a machine which I believe few teachers can equal… and I make them write whatever of my lectures may prove useful to them in their future practice, for which they are as well qualified as men.’ (p 4) ‘I intend to continue my lectures as usual to women entering upon the practice of midwifery, until the men who teach that profession render them unnecessary, by giving their female pupils as extensive instructions as they give the males’ (p 6)
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Lying-in hospitals in 18th century London
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Female pupils 1739 Female pupils 1758 Female pupils 1753
First Lying in Facility: Manningham’s private rooms [?Marylebone Road] Female pupils 1758 Female pupils 1753 Exton, Denman, Khron, Heineken W.Hunter, Sandys, Layard, Kelly Female pupils 1758 Heineken, Ball, Grundy Information entered on and added to an original map presented by Wilson 1995 in The Making of Man-Midwifery p 147 Female pupils ?1809 Female pupils 1769 MacDonough, Walsh New Westminster Lying-in Hospital 1765 [Westminster Bridge Road] Leake, Brickenden, Harris
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MIDWIFERY PUPILS AT THE BRITISH LYING IN HOSPITAL
Admitted from 1753 No more than 4-6 pupils at one time 3-6 months training Resident in the hospital High cost at 35 guineas Taught by ‘Gentlemen of the Faculty’ Delivering under the matron’s and man-midwives’ supervision Certificate on completion
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MIDWIFERY PUPILS AT THE BRITISH LYING IN HOSPITAL 1753-1819
1753- 1763 1764- 1773 1774- 1783 1784- 1793 1794- 1803 1804- 1813 1814- 1819 Total Number of new pupils 38 25 19 30 28 7 185 Range of admissions per year 1-6 2-6 0-6 0-8 2-5 1-2 Original analysis presented here is based on unpublished data collected and kindly given access to by Lisa Cody, personal communication 2011
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MIDWIFERY PUPILS AT THE BRITISH LYING IN HOSPITAL
Mean age 37, most in their 30s, range 20-60 2/3 married, 1/3 widows, few spinsters from 1780s 1/3 from London, 1/3 close to London, 1/3 far away – North, Ireland, Scotland, Jamaica Economically stable social backgrounds
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British Hospital MIDWIFERY PUPILS 1753-1819: HUSBAND’S OCCUPATION
TOTAL 1:10 wives of medical men 42% artisans/ craftsmen 29% tradesmen /skilled workers 7% Gentlemen/professionals
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Jane Wright Wife of a wine merchant In London for 6 years
Has practised much among poor gratis on the continent and at home Enrols as pupil at the British LI Hospital in 1797, aged 32 Publishes pamphlet 1798 Later serves as Matron at the Westminster Lying-in Hospital
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Jane Wright 1798 Jane had ‘taken much satisfaction, for years, to acquire knowledge in female diseases under able instructors both at home and abroad’. Intends ‘to practise midwifery, being entitled to it by my liberal certificates, from the physicians and surgeons of the British Lying in hospital in Brownlow Street’. She feels ‘sincerest obligations to them for their 'goodness and able instructions', as well as to the 'intelligent matrons of that useful charity' to whom she also offers her honest acknowledgements. (p 34)
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THE LYING IN CHARITY FOR DELIVERING WOMEN AT THEIR OWN HABITATIONS
1757 What was its role in training male and female midwives? Further research is required
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CONSEQUENCES? FROM PRIDE TO HUMILTY
Enormous impact Overly progressive Intrinsically regressive Increasing control of training by men Removal from community to hierarchical institutions: embedding values of obedience and conformity Sub-servant role: less attractive to well-off women FROM PRIDE TO HUMILTY
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18th century
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Before the 18th century
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Before the 18th century
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End of 18th century
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End of 18th century
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Post-18th century
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Post-18th century
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Post-18th century
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