By Helen King (Regular Contributor)
Midwives Made to Order
‘Call the midwife’: yes, but call as you go into labour, or call well in advance of the due date? Today, when we talk about having something ‘bespoke’ we mean having it made to order – for example, a suit, or a pair of shoes. But a person too can be ‘bespoke’ if engaged – that is, ‘spoken for’, or booked specifically – in advance. And in the eighteenth century, when men were moving into normal childbirth as ‘men-midwives’, a key stage of their progress was when they came to be ‘bespoke’.
Books, Booking, and Training
We can get some idea of how this worked from Brudenell Exton’s 1751 book, A New and General System of Midwifery in four parts (London: W. Owen). He described his training under Edmund Chapman in 1737 and 1738, and said that although he admired Chapman’s practical skills he was not so convinced of his theoretical knowledge. After learning with Chapman, he took some more courses with Richard Manningham. While Chapman was a user of the still-new equipment, the obstetric forceps, Manningham rejected these and preferred the older method of the ‘fillet’, a more flexible looped structure by which the baby’s head could be grasped. Indeed, in the eighteenth century there was not always a neat line between forceps-fans and forceps-opponents; Chapman, although he used the forceps, preferred manually turning the baby in the womb, and if that failed, then he would use the fillet or the forceps.
In his book Exton gives details of 19 cases to which he was called. Some of these are emergency cases. In others, however, he was ‘bespoke’ – booked in advance. These cases show the sorts of reasons that, at this early stage of men-midwives, led to them being used, and also hint at why you would book one in advance.
Why Make the Call?
Sometimes, a man-midwife was called because there was an emergency, such as a very long labor, or the waters breaking too early. It is interesting to speculate about who decided that labor has gone on for too long, but in two of these cases the period of two days is mentioned, and in another the midwife had been in attendance for several days before calling Exton in. Exton says for one of his emergency calls that a midwife and ‘a Gentleman just set out in the Profession’ were there already. The baby’s head was ‘monstrously large’. In another, the woman is having twins but the second of these is not emerging normally. There is another multiple birth in his case list – this time, triplets, which are born alive without his intervention. It is not clear here why he was called, but a potential emergency seems most likely. He was also called after the baby had been delivered, if the placenta remained inside, or when the midwife suspected there was a ‘false conception’ still to come out.
What about the bespoke calls? In one, ‘A Person, who had a very hard labour of her first Child, spoke to me to attend her of the second. Accordingly I was sent for…’ In another, ‘I was sent for to a Woman in this Neighbourhood, who had some time before spoke to me to attend her in her Pains, having before had a difficult Delivery’. Here, ‘spoke to me’ indicates his status as ‘bespoke’. In another, ‘About three Years ago, a Person came, to desire that I would attend her in her Labour, for that she was in her 42nd Year, and the first Child. I promised her I would’. The fourth and final bespoke case opens as follows: ‘I was sent for, about Six months since, to a Woman who had before spoke to me to attend her in her Labour’.
So in two cases, the previous labor was so bad that a man-midwife seemed the way to go. In another, the woman was having her first baby in her 42nd year – what we now call an ‘elderly primagravida’. But in the fourth, there is no reason given. Perhaps this case represents the point at which the man-midwife becomes the attendant of choice even for those who have not had a previous bad experience, and who are not in an unusual category.
Lessons Learned
One lesson we can learn from this concerns how to use the wonderful online resources now available. Exton’s book is on Eighteenth Century Collections Online (ECCO). This site allows the user to search the text. But if you search ‘bespoke’, you won’t find it in Exton. ‘Spoke’ will find you three out of four of the bespoke cases. But the fourth one, ‘came to desire that I would attend’ is not going to show up with a search on either ‘bespoke’ or ‘spoke’. There is no substitute for reading the whole text!
Further reading:
Adrian Wilson, The Making of Man-Midwifery: Childbirth in England, 1660-1770 (1995)
Helen King, Midwifery, Obstetrics and the Rise of Gynaecology (2007)