New Directions in the History of Nursing: International Perspectives

By Barbara Mortimer; Susan McGann | Go to book overview

4

Puerperal fever as a source of conflict between midwives and medical men in eighteenth-and early nineteenth-century Britain

Christine E. Hallett

The idea that midwives and medical men fought for control of childbirth in the eighteenth century has long been viewed as a part of the history of midwifery. It is an idea that has been accepted implicitly by most writers on the subject, even those who have warned that it might be an over-simplification. 1 Originating from very different social backgrounds, the two groups operated from within radically different knowledge bases and drew on unique bodies of experience that overlapped less than might be supposed.


MIDWIFERY PRACTICE IN THE EIGHTEENTH AND EARLY NINETEENTH CENTURIES

Traditional midwifery had a long and established record of providing care and service to women in childbirth. Midwives were placed within a recognized and defined social role, which was sanctioned and controlled by local powers, both secular and religious; powers that recognized and accepted norms of apprenticeship-style training.

'Medical men', as I refer to them here, were an apparently inchoate group who shared certain important features that distinguished them from traditional midwives. All these men had some formal education and training. Physicians, who held the qualification MD, had been awarded a university degree, whereas surgeons' skills were recognized by guild or corporation membership. In addition to their status as members of recognized and formally educated groups, physicians and surgeons were usually drawn from gentry backgrounds, and were always men. The traditional midwives were women from lower social orders, with little or no formal education. In many ways the two groups could not have been more socially distinct. 2

The superior learning and education of medical men had evolved over time. Until the mid-eighteenth century, the practice of surgeons had been regulated by guilds and was closely associated with barbers. In London, the Barber-Surgeons Company (established by Act of Parliament in 1540) was the significant regulatory body for surgical practice until 1745, when the Company of Surgeons split from the barber-surgeons. During the second half of the eighteenth century, a

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