Early modern midwifery: splitting the profession, connecting the history.
Abstract: "Early Modern Midwifery: Splitting the Profession, Connecting the History" examines the status of midwives in early modern England and makes two substantive claims. First, it argues that while historians have recognized that midwives came from across the social spectrum, they have failed to incorporate this knowledge into their analyses. Work as a midwife was (obviously) medical in nature, but midwives' medical authority depended on a range of other factors, including social and marital status, wealth, and neighborliness. Because midwives came from across the social spectrum, their experience as practitioners was similarly diverse: a wealthy midwife's practice would have been qualitatively different than a poor midwife's. Second, the article connects recent cultural histories of early modern midwifery to life in England's parishes. It. does this by analyzing the language in which ordinary men and women talked about midwifery, and argues that during the 1690s Enlightenment ideas about science, midwifery, and childbirth began to gain currency in provincial England. It was during this period that midwifery underwent a transition from a "mystery" to a "science," a change that facilitated the rise of male authority over childbirth.
Article Type: Essay
Subject: Midwives (Practice)
Midwives (Social aspects)
Childbirth (Management)
Childbirth (Social aspects)
Midwifery (History)
Midwifery (Social aspects)
Midwifery (Portrayals)
Author: Thomas, Samuel S.
Pub Date: 09/22/2009
Publication: Name: Journal of Social History Publisher: Journal of Social History Audience: Academic Format: Magazine/Journal Subject: History; Sociology and social work Copyright: COPYRIGHT 2009 Journal of Social History ISSN: 0022-4529
Issue: Date: Fall, 2009 Source Volume: 43 Source Issue: 1
Topic: Event Code: 200 Management dynamics; 290 Public affairs Computer Subject: Company business management
Product: Product Code: 8043500 Midwives NAICS Code: 621399 Offices of All Other Miscellaneous Health Practitioners SIC Code: 8049 Offices of health practitioners, not elsewhere classified
Geographic: Geographic Scope: United Kingdom Geographic Code: 4EUUK United Kingdom
Accession Number: 209577951
Full Text: It has been nearly twenty years since David Harley single-handedly demolished what he termed "The Myth of the Midwife-witch," and demanded a new history of early modern midwifery. (1) Responding to traditional medical historians and more recent 'herstorians,' who associated early modern midwives with witchcraft, Harley searched the archives and found no such connection. In short order Harley discredited much of what historians thought to be true about midwifery and asked the question: If midwives were not witches, then who were they? The first significant response to Harley's question came in a collection of essays edited by Hillary Marland, which confirmed Harley's argument and demonstrated that sustained research on midwives was possible and necessary. (2) In the years since scholars have approached midwifery from a variety of perspectives, but in the background of virtually every study is the question of how men came to dominate the field. If midwives were community experts in childbirth in the seventeenth century, how can we explain the rise of male authority in the eighteenth?

Adrian Wilson was first to attempt to answer this question. Building on the work of Harley and Marland, Wilson argued for midwives' social prominence and explored the social, religious and medical aspects of midwifery. Most significantly, he attributed the rise of male midwifery to choices made by mothers. (3) Historians such as Doreen Evenden have taken another approach, analyzing local and church archives rather than printed works. As social rather than medical historians, these scholars take as their starting point the identification of individual midwives, place them in their personal and professional networks, and explore both the nature of their work and their place in society. (4) Because they have not ventured into the eighteenth century, social historians have not played much of a role in the debate over the rise of male midwifery. Unlike Wilson and Evenden, who focused on the practice of midwifery and the midwives themselves, Mary Fissell and Lisa Cody have examined representations of midwifery and medical knowledge. Fissell argues that the religious and political crises of the early modern period drove men such as Nicholas Culpepper to re-imagine the female body, a project that undermined women's knowledge about their bodies and made the case for their subordination. (5) Cody focuses on a slightly later period and makes the case that the keys to the birthing chamber were Enlightenment epistemologies that allowed men to study reproduction. (6) While Fissell and Cody have produced valuable works, they leave open the question of the relationship between printed sources and the lived experience of mothers and midwives, particularly in the provinces. (7)

In the course of this article I will respond to this historiography on several fronts. First, it is my contention that while historians have acknowledged the social diversity of early modern midwives, they have not allowed it to shape their analyses, thus effectively lumping midwives together in an undifferentiated mass. I shall argue that a midwife's social status was central to her ability to carry out the tasks required by the office, both in the birthing chamber and in the community at large. Second, I will attempt to connect the cultural the narratives offered by Fissell and Cody with evidence from provincial archives. By examining the links between representations of midwifery in elite texts and descriptions of midwifery in the parishes, we can discover how changing conceptions of sex, childbirth, and medical authority affected the daily experience of mothers and midwives. Finally, this article will shift our focus from London to the provinces. One thing that most histories of midwifery have in common is their focus on the metropole, for it was there that men such as William Smellie rose to prominence and made it possible for men to claim the keys to the birthing chamber. But the fact that metropolitan elites came to believe new things about childbirth and midwifery begs the question of whether these beliefs had the power to alter experience in provincial England.

I

The main sources for my analysis are midwife testimonials from the Archdiocese of York spread unevenly over the period 1662-1751. (8) Over 330 of these testimonials are found in the Borthwick Institute. (9) In most cases, they included two parts: a declaration by churchwardens or a local clergyman that the nominee was of good character and conformable to the Church of England; and a statement by local women that she was skilled in midwifery. There was no relationship between when a woman began to practice midwifery and when she applied for a license, so, paradoxically, these documents tell us little about a midwife's training or experience. (10) Helen Taylor claimed seven years of experience, and according to Alice Constable's nomination, she was "a practiced and experienced Midwife, as not onley we whose handes are hereunto subscribed but hundreds more Good Women within this parish (to their benefit) can attest." (11) The fact that some women had extensive experience before applying for a license supports the argument that licenses usually ratified the choice that local women had already made, and there is no evidence that women saw licensed midwives as being more competent than their unlicensed counterparts. (12)

The cost of a license varied widely, but it could be significant in terms of money and time. In 1726, one John Elleray wrote to the Archdiocese, and included with his letter "a certificate for one Midwife's experience in the qualitys mentioned at the visitation & ... for fees nineteen shillings & four pence." (13) Elsewhere, fees ranged between [pounds sterling]1-2, though it is not clear how often they may have been waived or reduced. (14) In addition, a new midwife was required to travel to York to receive her license and take her oath, although this business could be carried out by mail. In 1726 when the vicar of Tuxford (Notts.) sent testimonials for Martha Charlesworth to the Registrar and noted, "she desires you will send her License as soon as you can conveniently by Post." (15) In light of the significant obstacles and insignificant benefits to taking a license, the question becomes why a woman would bother to get one. In short, a midwife applied for a license only when Church officials forced her to do so. The nominations of Anne Charlesworth and Sarah Butterworth of Almondbury coincided with the arrival of Thomas Tatham as the new vicar, so their nominations seem to have been driven more by his passion for bookkeeping than their desire to be licensed. (16) More insidious was the work of the above-mentioned John Elleray, who was in the business of harassing unlicensed midwives. In the same letter requesting a license for one woman, Elleray added, "I just now spoke the husband of the other [midwife] & he tells me he hath not seen her this two days & cannot tell whether she hath got a certificate or no. In the main I believe they are very short of money at present but. I shall call upon her frequently till she have got license." (17)

While the historical record may never offer a definitive answer to the question of how women became midwives, testimonials and records from visitations offer some suggestions. There is evidence of generational continuity, as women followed their mothers or mothers-in-law into the practice and even practiced at the same time. Nottinghamshire midwives Elizabeth and Mary Golstropp both failed to appear at a 1674 visitation, as did Margaret and Elizabeth Kilton of Leake in 1682. (18) Isabella Ellow of Birkby was presented for her failure to exhibit a license in 1662, and two decades later so was one Jane Ellow. (19) It is difficult to know the precise relationship between these women, but there is no such uncertainty in the 1695 testimonial on behalf of Elizabeth Green, which states that she "did accompany her mother Anne Yeoman ... to doe the office of a midwife as her mother Anne Yeomans assistant." (20) Training could also pass between mistress and maidservant, as in the case of Martha Stopford, who worked in the household of a wealthy York midwife, became her deputy, and eventually established her own practice. (21) Ironically, it is Sarah Stone, a vocal critic of traditional midwifery, who describes what was probably the most common way that women took up midwifery. In A Complete Practice of Midwifery, Stone complained that it was extremely difficult to distinguish the midwife from other women in the birthing chamber. (22) In the all-female arena of childbirth, women played a number of roles, from popping in briefly to offer encouragement, to staying for the entire labor and working as an assistant to the midwife. (23) While the fluidity of this atmosphere offended Stone and other Enlightened medical practitioners, the unregulated nature of childbirth allowed women to gain practical experience in midwifery by working in different capacities during the course of a labor. If a woman discovered an aptitude for the work, or simply wished to do more of it, she could establish a formal relationship with a local midwife and perhaps become her deputy. The transition from deputy to midwife would have been gradual, as a woman slowly assumed more responsibility under the senior midwife's supervision or even took the lead when labor seemed to be going smoothly. A woman became a midwife not through licensing, but through a process of self-identification and selection by the community. (24) She became a midwife when an expectant mother asked her to deliver her child.

While midwife testimonials leave many questions unanswered, they do provide evidence of the social status of many prospective midwives. Some came from the gentry and are referred to with the honorific "Mrs." or are married to men who are themselves "Mr." (25) While their testimonials do not survive, we know that the wife of the Lord Mayor of Chester practiced as well, and York midwife Bridget Hodgson was armigerous gentry and the daughter-in-law of the city's Lord Mayor. (26) Testimonials on behalf of Martha Baker describe her as "a Gentlewoman of great Judgement & skill in that Employ." (27) Below the gentry level, there are examples of midwives married to clergymen: Agnes Bowcocke's husband, John, held the living at Acomb; and Susan Topham, a midwife in Rilston, was probably married to the vicar John Topham. (28) Finally, there are women for whom work as a midwife was integral to their survival and who may have been encouraged to take the work in order to reduce their reliance on parish assistance. (29) Anne Doughty of Acaster Malbis is described as "very poore & hath very small employment," and Johanna Thompson "is very low and poore in the world ... " (30) The testimonial of Alice Crowther, a widow from Halifax, noted that "for and towards her and & Childrens subsistence [she] is desirous to follow the office of a midwife," and Church courts found that slander directed at Hannah Hall was "spoken with a designe to hinder her ... business and consequently take away her subsistence." (31) In early modern Bristol, parish funds dedicated to poor relief were sometimes paid to poor women who provided medical assistance to their neighbors, and it is possible that poor midwives received a similar benefit. (32) Evidence from Yorkshire is thus in keeping with patterns found elsewhere. Early modern midwives came from across the social spectrum: they were young and old, rich and poor, married, widowed, and even spinsters. (33)

II

Despite clear evidence of social distinctions among midwives, historians have approached them without due consideration of rank, allowing the practice of midwifery to trump all other aspects of a woman's identity. We can correct this by emphasizing what the practice of midwifery entailed both inside and outside the birthing chamber. Early modern midwifery blended the medical and the social with a significant emphasis on the latter, and when we focus on this side of midwifery, the importance of social status becomes clear. Midwifery was just one aspect of a practitioner's identity, and her authority as a midwife was inextricably linked to a range of social factors. People judged a midwife based on her skill in the birthing chamber of course, but also on her wealth, piety, and neighborliness. Also important was a woman's social connections, including who she married, who her friends were, and her ties to other medical practitioners. Medical practitioners deliberately constructed public personae that would enhance their medical authority and used their medical work to reinforce their social power.

The medical side of midwives' work in childbirth has been well documented. In keeping with its status as an art, there was much room for variation, but mid-wives might help prepare the mother for birth by stretching her labia, checking and palpating the cervix, and lubricating the birth canal. During labor the midwife might also administer various "clisters, purges, liniments, poultices, ointments and herbal infusions." (34) To the modern eye, such work might seem of marginal value, but in the early modern period a good midwife made labor less painful, moved it along more quickly, and could be the difference between life and death. In the midst of her labor, Susanna Watkin cried out, "Godsake either fetch Ellin Jackson (being a midwife) or else knock me on the head." (35) In a remarkable defamation case involving Cheshire midwife Anne Knutsford, one of Knutsford's clients testified that one woman "might have been delivered two houres sooner if she had had the said Anne's helpe when they desired it." In the course of the same case, Elizabeth Proudman claimed that she heard "Thomas Sherwin ... say that he could not prevale with the said Anne Knutsford to goe to his wife whoe was in labour at that time, [and] before he could get another midwife his wife miscarryed." (36) Once the midwife delivered the child, she or another birth attendant cut the umbilical cord, cleaned the newborn, and swaddled the baby. It was also the midwife who decided whether to deliver the placenta manually or naturally. At the risk of devaluing this side of a midwife's work, however, the fact remains that the "majority of births ... were uneventful whether attended by a physician, a midwife or a stork." (37) Because most births resulted in a live mother and child regardless of a midwife's medical knowledge or the degree of her intervention, the skill of the midwife lay elsewhere. A good midwife provided a positive experience for the mother, for in the early modern period " ... the healer's skill was still perceived as emanating from [the] ability to offer care and support as much as to cure." (38) A midwife's skill lay in her ability to manage the mother and the birthing chamber, and this was closely linked to her social identity.

Naturally enough, a midwife's social work focused on the mother. The midwife controlled the conditions in the birthing chamber, kept the mother calm and well-rested, and helped her through the pain and fear of childbirth. (39) This kind of work could have very real medical benefits, for through it, a midwife could speed or at least ease a difficult labor and make a knock on the head seem less attractive as a pain-management strategy. The midwife also encouraged the mother in the last stages of labor, as in 1739 when a midwife assured her patient that "in less than Two Minutes the Child would be in the World." (40) Another part of a midwife's social work was to manage any conflicts that might arise during the course of labor, whether between the mother and her birth attendants or among the gossips themselves. (41) It would also have fallen to the midwife to reassure anxious fathers during labor and to inform and console them in the event that the birth ended in the death of mother or child. In performing these tasks, from calming a panicky mother to controlling quarrelling gossips, a midwife relied on her social authority and thus would have established a persona to augment that authority.

Throughout Europe, the qualities of an ideal midwife, and thus the qualities that practitioners would deliberately cultivate, were not purely, or even primarily, medical. As a midwife built up her practice, she would "draw on those attributes offered by her background, connections and standing in the community to bolster her reputation as a skilful midwife." (42) The best evidence of the lengths to which midwives went to enhance their authority comes from cases in which they failed spectacularly. While there were childless midwives, there was a general sense that midwives should also be mothers; so in 1677, a London midwife faked her own pregnancy. She did so in part "to preserve her credit in her imploy which she thought somwhat prejudiced by the imputation of barrenness." Her ruse came to light when birth attendants discovered her efforts to smuggle a stillborn child into her own birthing chamber. (43) Further north, the women of Nantwich in Cheshire were in something of a bind because Anne Knutsford combined excellence in the birthing chamber with "very uncivill and base scandalous language." Elizabeth Cliffe described her as "a very good midwife ... one of the best in these parts," but she acted in a manner "unbecoming one of her sexe and profession to reveale the secrets of women in the time of their extremity." Another witness, Thomas Proudman, described Knutsford as "a ready handed woman in her profession," but added that she "is one much taken notice of to be given to vaine cursing and swearing." (44) Here, then, are two women who failed as midwives not due to incompetence in the birthing chamber, but because they did not uphold the social vision of what a midwife should be. The London midwife found herself on trial for infanticide (she was acquitted), and a church court banned Knutsford from further practice.

The significance of a midwife's social authority becomes even clearer when we consider her role in the legal system, particularly in the context of an infanticide investigation. (45) An investigation could succeed or fail depending on the power wielded by the woman who questioned female suspects and searched their bodies, and this woman was often a midwife. When a midwife interrogated a woman suspected of infanticide, she did so not by herself but as the head of the community's matrons. According to the testimony of Susan Topham, when the constable suspected a case of infanticide he "required this informt and other neighborhood wives ... to search Mary Broughton." (46) Upon the discovery of a dead child in the parish of Hawksweek, the constable was given a warrant "to summon and charge several grave matrons to enquier after and search all women ... that they should any way suspect to be guilty of the late privat bearing of a child." (47) The matrons in this case were not necessarily midwives, but midwives often led interrogations. While it would not have been impossible for a poor midwife to conduct this kind of investigation, it would have been far more natural for a village's women to follow a wealthy midwife than a poor one.

Questions of social status and authority become even more difficult when a midwife's investigation led her to the doorstep of an affluent neighbor and raise the issue of how effective a poor midwife could be in investigating men and women above her social status. The women charged with investigating a possible infanticide in Dalton, Cumberland ran into just this sort of resistance when they attempted to search the body of Anne Nicholson. The investigators were resisted not by Nicholson, but by her mistress, Mary Holme. Initially, Holme did her best to keep her servant's pregnancy a secret, and when word got out she attempted to prevent Nicholson's interrogation. When Nicholson's mother and another parish woman, who may have been a midwife, attempted to search Nicholson's body, Holme "replyed to them both saying--Let's se who dare be so bold as view her maids brests without her consent ... " (48) Holme did not resist because she viewed their efforts as an assault on Nicholson's body; rather, she saw their investigation as an assault on her authority as a mistress. (49) The resistance faced by poor midwives would exceed that faced by wealthy practitioners, for an investigation would be viewed by heads of household as far more threatening to their authority. Men and women of gentle or yeoman status could hardly be expected to suffer gladly the intrusive and embarrassing questions inherent in midwives' investigations. This is not to say that poor women could not exercise power, but that doing so would have been much more difficult than for women of higher rank.

In light of the disparities among midwives' social status and the social realities of the early modern hierarchies, it seems best to think about midwives not as a single group with a common experience, but as existing along a spectrum. At one end was the occasional midwife whose work was usually limited to delivering children and participating in the subsequent rituals. While these religious rituals were public, in the main her work focused on the mother rather than the community. At the other end of the spectrum was the midwife who had a more public presence. She was involved in the medical and ritual aspects of midwifery, but also was integral to the parish legal machinery both investigating crimes and enforcing communal sexual norms. The place of a woman along this spectrum was determined by a range of factors, including her social rank, marital status, religious piety, and reputation as both a woman and a midwife.

The occasional midwife practiced her art because she enjoyed it, or because she needed the money. She was not usually the first woman a mother would call, but she was competent; if the community's ranking midwife was unavailable, she filled in. Testimony in the case of Anne Knutsford makes clear that women wanted her as their midwife, and only after their entreaties failed did they resort to a second-rank midwife. The occasional midwife was more likely to be unlicensed if for no other reason than the nature of work made it less likely she would be presented at a visitation. Even if she were presented, she was unlikely to apply for a license because she was less able to afford the associated fees.(50) Because she only practiced from time to time, and probably came from the lower tier of midwives, she would not be anyone's first choice to lead an infanticide investigation. (51) Indeed, if she were among midwifery's poorer practitioners she might have been inclined to help women who were pregnant illegitimately. In both London and the provinces, there existed midwives who allowed unmarried women to give birth in their homes, and it is hard to imagine a wealthy midwife becoming involved in this kind of business. (52) All told, these occasional practitioners can be described as midwives, in that they were considered such by their neighbors, but midwifery was not their most significant social identity--it was a skill they had, not who they were.

The second kind of midwife has proved to be the most striking discovery of the new historiography. She was of higher social status and better educated than most of her neighbors and clients. She attended births, of course, but because her social authority supplemented her medical authority, she also led investigations of sexual offenses and was active in monitoring the female community. She enjoyed (in every sense of the word) the power and responsibility concomitant with the public work of midwifery. York midwife Bridget Hodgson exhibited notable self-confidence, giving the name Bridget to her own daughter and at least four goddaughters and announcing her status as a midwife in the opening of her will. (53) While her failings as a midwife render her a problematic figure, Anne Knutsford also was in this elite group. She was the wife of a prosperous grocer and much sought-after by Nantwich mothers. (54) She also exhibited something of an independent streak, for when she learned that the court had issued an inhibition against her practice, she publicly announced that "she would take it and wipe her arse with [it]." We do not know if she made good on her promise, but she later admitted to ignoring the order, and continued to practice in cases of necessity. (55) Adrian Wilson is probably right in thinking that these practitioners had a boldness and self-confidence not found in most women or even most midwives. (56) As we shall see, women could rise from the ranks of the occasional midwife to become a parish's ranking practitioner, but the case of Anne Knutsford is instructive, for in it we see that downward mobility was also possible.

While gaps in the historical record make it difficult to document this hierarchy with as much precision as we might like, there is evidence to support it. At a practical level, we know that all but the smallest of communities would have required more than one midwife. A parish of 1500 could expect to have two women in simultaneous labor at least once per year and by one estimate, communities of two hundred households usually had two (presumably underemployed) midwives. (57) Evidence from testimonials and visitations indicates that midwives may have worked in pairs, for it was not uncommon for two practitioners to be nominated or presented together. In the early 1660s, as church government was reestablished, Catherine Dixon and Elizabeth Nicholson were both nominated from the parish of Nafferton, as were Elizabeth Stancliffe and Jane Robinson of Fylingdales. (58) In 1662, Elizabeth Ness and Alice Theakston of Slingsby were cited for practicing without licenses, as were Ann Saville and Margaret Fisher of Kirbymoorside and Jane Gamble and Ann Anderson from a small chapelry in the same parish. (59) Such patterns continued into the Augustan period with the presentations of Ann Nicholson and Catherine Sterne in 1693 and the nominations of Martha Charlesworth and Jane Cocking in 1726. (60) While these midwives might have cooperated and divided their labor(s) equally, London midwives "probably comprised two layers: many hundreds who had low case-loads and correspondingly limited skills, and a small skillful elite ... who practiced at a high rate." (61) Obviously, the population density was much lower outside the metropolis, but there is evidence that some communities had a two-tiered system. In 1681, the residents of Upper Poppleton justified their nomination of Dorothy Smith by saying that the previous midwife, "in her life time resigne[ed] her office to [Smith] and al[l] her neighbours thinking how fit for it[,] some having made use of her ..." (62) While the transition is couched in less official language, Mary Gedney of Humbledon was similarly promoted in 1721. Gedney's neighbors wrote in their nomination, "And now that Jane Jonson of this town, midwife, being deceased we earnestly desire that Mary Gedney may be licensed as a midwife." (63) In cases such as these, where there was an orderly succession from old midwife to new, it is likely that the outgoing midwife trained and even designated her replacement. Prior to the transition these midwives also would have been the natural choice for parish women if they could not obtain the services of the primary midwife. The examples here emphasize that the practice of midwifery should be thought of as existing on a spectrum. An occasional midwife could, as in the case of Smith and Gedney, become the primary midwife. And as age undermined her ability to travel, the primary midwife, could scale back her practice, particularly in rural and upland parishes. In 1662, Prudence Harland was presented for practicing midwifery without a license, but the case was dismissed "because she hath not exercized the office of a midwife these 2 yeares last past & that she is of the age 85 yeares very poore & not able to put on her owne clothes." (64) A midwife's authority depended on a range of factors, including her wealth, reputation, social status and physical health, and all of these would change over a lifetime.

III

In addition to providing insight into the social diversity of midwifery, analysis of testimonials can give us a sense of how men and women viewed midwifery and its practitioners. Given the complicated social and legal space midwives occupied, we would expect to find people talking about the profession in different and sometimes contradictory ways. Indeed this is the case, but changes in the language of midwifery also offer tantalizing evidence of how perceptions of midwifery began to change at the end of the seventeenth century. The changes were uneven, but they can serve as something of a barometer for the rise of male authority over childbirth and perhaps the penetration of Enlightenment thought into provincial society.

The anomalous status of midwifery is illustrated by the fact that many of the terms used to describe the practice challenge the gendered hierarchies of early modern work, as contemporaries placed midwifery in the same conceptual category as work done by men. Many testimonials referred to midwifery as an "office," a term usually reserved for positions held by men. (65) Elizabeth Nicholson's 1662 nomination did this and simultaneously acknowledged the range of duties midwives were expected to perform: "Elizabeth Nicholson widow hath long practiced and would continue to practice the office of a Midwife (or grace wife) and will well and carefully performe the duty thereof, both private and publique ..." As noted above, one midwife formally resigned her office to her successor, and in 1702 Lydia Daniel was "approved among her neighbours for the good she hath done her neighbourhood whenever imployed in the office belonging to a midwife ..." (66) Added to this is the fact that midwives were the only women in England whose work required them to take a public oath. (67) Such language spoke to midwives' authority, but the use of masculine language to undergird women's claims to authority was something of a double-edged sword. This usage simultaneously put midwives' work on a par with that of men, and called into question the appropriateness of women conducting that work. (68)

At the same time testimonials used language coded as male to describe midwifery, midwives adopted a second strategy that emphasized the arcane nature of the work: midwifery was not just an office, but also an "art" and, significantly, a "mystery." The 1689 testimonial for the wife of James Phillips noted that she was "a Civill & discreet Matron & one well skilled & knowing in the Art & Mistery of Midwifery." A few years later, Elizabeth Arrandell was described as "well skild in the Mystery of Midwifery ..." (69) The use of the term "mystery" to describe midwifery is significant and requires exploration. It was common, of course, for men to use the language of mystery to establish the arcane nature of work ranging from carpentry to alchemy. So in a sense, midwives were simply using "mystery" the same way they used "office," in order to claim authority over childbirth and simultaneously exclude the uninitiated. But the use of "mystery" to describe midwifery had an additional layer that distinguished it from the mysteries of ironmongers or saddlers. Among the contemporary definitions of "mystery" was "A religious truth known or understood only by divine revelation; esp. a doctrine of faith involving difficulties which human reason is incapable of solving." (70) The religious truth to which midwives appealed was oriented on the birth of Jesus. (71) Prior to the Reformation, pregnancy and childbirth were associated with the Virgin Mary and imbued with a miraculous character. Midwifery was thus a "mystery" not just because midwives possessed knowledge denied to others (particularly men), but because their work had religious implications and linked them to the Nativity. By the late seventeenth century, the Reformation had robbed pregnancy of its miraculous connotations, but midwives continued to use this religiously-charged language in order to enhance their authority and to exclude "rational" men from the field. As we shall see, the ability of men to enter the birthing chamber required a new language of midwifery that permitted rational comprehension of pregnancy and childbirth. (72)

Given the opportunity to describe their work in court, midwives cast themselves as experts about childbirth and women's sexuality as a whole. Midwives often made these claims in the context of infanticide trials, and they criticized women who gave birth without benefit of a midwife. (73) At a trial in 1736, midwife Ann Winn noted that if the mother "had sought for help as she ought to have done the child might have been born alive ... " (74) The irony here is that this testimony, so critical of mothers, was also exculpatory--if the child were stillborn, there was no infanticide. In the wake of a mother's death in 1671, Katherine Firth sounded a similar note, saying that, "this informant doth believe that the said Anne Ellison [died] for want of helpe in bearing the sd child ... " (75) Philippa Bidall of Hull took a much broader perspective, and appropriated yet another masculine term for her work, by opening her testimony with the statement that "it is a hard thing to judge upon a woman ... " (76) Notwithstanding this difficulty, Bidall proceeded to judge the suspect without any apparent reservations. Infanticide investigations and trials were traumatic for all involved, probably more for the midwife than for any other parish official. But they presented midwives with the opportunity to state publicly, in the presence of powerful men, that they were capable medical practitioners and that their work could reduce the frequency of infanticide, maternal mortality, and neo-natal death. (77)

IV

Even as midwives asserted their authority over childbirth and sexual knowledge, scientific trends were in motion that ultimately undermined their claims. The literature examining the masculinization of science and medicine as a whole is far too rich for a detailed treatment here. (78) More relevant is recent work by Fissell and Cody, who have attempted to uncover the origins of male authority over midwifery. Fissell explores the depictions of childbirth and mothers in a broad cross-section of early modern literature. In her estimation, the key moment in the rise of male authority was the publication of Nicholas Culpepper's Directory for Midwives in 1651. In this work, Culpepper reacted to the social chaos of the civil wars by reconstituting orderly gendered relations in the body itself and "imagined the human body as a source of stability ... "In the course of imposing discipline on the disorderly female body, Culpepper "attacks the basis on which midwives and all women know things about female bodies." (79) Cody makes a similar case, arguing that during the eighteenth century men asserted their authority over reproduction, "in part by claiming to explain ... mysterious aspects of the natural world through their superior, masculine reason." (80) The question that these works leave unanswered is how and when these new ideas about the nature of childbirth and medical knowledge arrived in provincial England and their effect on the practice of midwifery and the experience of childbirth.

As we have seen, men and women alike understood midwifery in terms usually reserved for work done by men. Midwifery testimonials were gendered documents, with men confirming the applicant's religious and moral conformity and women attesting to her competence in the birthing room. In the 1690s, however, this dynamic began to change, both in the language used to describe midwifery and the role men played in the nominating process. This not to say that there is a sudden or complete transformation; history rarely breaks so cleanly. Rather, we see the early signs of a new medical regime informed by what we now call the Scientific Revolution and Enlightenment. It is in the 1690s that the cultural and intellectual changes described by Cody and Fissell began to shape popular perceptions of childbirth and of the practice of midwifery in the provinces.

One of the notable changes in testimonials was the emergence of a language of business to describe midwifery, a development that coincided with the growing importance of commerce in English society. In 1723, Sary Hebdin was nominated to practice midwifery, and her nomination included a letter of support from another midwife, Margaret Morrice. Morrice claims that "I have thurrayly instructed Sary Hebdin in Midwifery & she can perform her bissaness very well." The language of business also appears in the 1723 nomination of Sarah Moore, who, according to the women of Bretton in Sandal Magna, "hath done the business of a Midwife ... in a very decent & sufficient manner ... " (81) While the language of business is not inherently masculine, Fissell has argued that in the 1690s women's bodies were reimagined in mercantile language, as "pregnancy was compared to a merchant voyage. The women's body was like a ship, enclosing valuable cargo." More significantly for midwives and mothers alike, "No longer was pregnancy women's work ... women were just the containers, loaded and unloaded by men." (82) These changes naturally would have been felt first in mercantile centers such as London and, as we see here, came to Yorkshire rather later. This understanding of midwifery as a business reflects broad economic changes, reemphasizes the anomalous position of midwives, and further opens the profession to male intervention. Could the business of childbirth be left to women? The use of the language of business to describe midwifery was not, of course, sufficient for men to claim authority over childbirth. But the significance of this change is magnified when coupled with scientific understandings of childbirth and the female body.

In 1694 we find another notable change in the language of midwifery in a testimonial written on behalf of Preston midwife Isabel Grasscroft. According to the women of Preston, Grasscroft "is a woman well skilled & knowing in the art of Midwifery & duly qualified for her science & industry to take upon her the office of a midwife ... " (83) What is striking here, of course, is the use of the word "science," which, like "mystery," has a long history and is rich in meaning. As early as 1481, a complaint against a midwife described midwifery as science: "scienciam obstitricandi." (84) And in 1639, John Woodall's The Surgeon's Mate also paired it with mystery, referring to "that noble Science or Mystery of the healing mans body." (85) These early examples signal the need for caution before we leap to any conclusions about the significance of Grasscroft's testimonial. Nevertheless, there is a case to be made, for during the Restoration science and art began to take on an oppositional relationship, with science based on the theory underlying a particular practice and art governed by tradition and habit. (86) Male practitioners, with their formal training in anatomy, used precisely this distinction to attack the authority of women whose knowledge was based on experience and oral tradition. Moreover, in Grasscroft's nomination the word "science" is in English rather than Latin, is applied to midwifery rather than surgery, and is written not in London, Oxford, or Cambridge, but in eastern Yorkshire. Thus the coupling of science and art in Grasscroft's testimonial may seem odd, but it perfectly encapsulates the uncertain epistemological status of midwifery in the late seventeenth century and indicates that perceptions of midwifery were in flux. It is not that the ideas were necessarily new, but that they were new to provincial England.

The introduction of the language of commerce and science into midwifery testimonials paves the way for male authority over childbirth and helps us bridge the gap between the narratives of cultural historians and lived experience in provincial England. Taken on their own, these changes might only hint that the nature of medical authority was entering a period of transition. If this masculine vision of midwifery were purely rhetorical we would be supporting Fissell and Cody, but adding little of substance. However, the new language of midwifery was accompanied by a changing role of men in the nomination process. During the 1690s, Yorkshire medical professionals arrogated to themselves the authority to judge the medical rather than moral qualifications of prospective midwives. (87) While David Harley has argued that the appearance of male practitioners in midwives' testimonials indicates a close working relationship, his analysis misses a more significant point. (88) More important than any working relationship is that when male practitioners began to judge midwives, they were asserting their authority over them and the knowledge needed to practice midwifery. As we shall see, this claim had ramifications for England's midwives and mothers.

While the most common phrase used to describe the increasing presence of men in the birthing chamber is "the rise of the male-midwife," we must remember that for decades after the male-midwife had risen the vast majority of births still were attended by women. The change of the late-seventeenth and eighteenth centuries was epistemological, as knowledge about childbirth became something that men (and eventually only men) could claim. The rise of male authority was more subtle and pervasive than the presence of men in the birthing chamber, for male authority was felt even where men were nowhere to be found. This raises the question of how changes in medical authority, so central to Fissell's and Cody's accounts, came to the provinces. The most likely suspect, of course, is print. As we have seen, Fissell has argued for the influence of Culpepper's Directory for Midwives, which went through eleven editions between 1651 and 1700 and remained in print until 1777. But Culpepper was not alone: from 1670-1798 no fewer than two hundred obstetric texts were published in England. (89) This explosion in print no doubt made female claims that midwifery was a mystery rather more difficult to sustain and may have convinced provincial medical men that they had a role to play in evaluating local midwives.

The Royal Society of London also played a role in spreading knowledge about childbirth. The Society took an early interest in the science of reproduction, and published investigations of reproductive anatomy that "unveiled and made public the sorts of topics that had once been discussed in the oral, private culture of women's reproductive secrets." (90) Moreover, the Society's correspondence involved not just leading scientists, but "clergymen, amateur scientists, provincial doctors, and entirely ordinary businessmen," and its Transactions helped to spread natural philosophy to the provinces. (91) In 1667 or 1668, Adam Martindale, a Presbyterian minister from Cheshire, notes meeting with Dr. John Wallis during a visit to Oxford and making him privy to "some notions 1 had in my head ... concerning a dialing instrument." (92) Two years later, Martindale wrote to the Royal Society, "concerning the discovery of a rock of natural salt." (93) Even though they were not involved in delivering children, men such as Martindale helped to shape popular attitudes towards midwifery and childbirth and made a clear case for androcentric science.

The idea that men could be experts in childbirth found its first practical application in Yorkshire during the 1690s, as male medical practitioners began submitting testimonials on behalf of midwives. In 1695, the nomination of Alice Yales was signed by Leeds M.D., Daniel Roussel, and the nomination of Anne Booker was signed by two M.D.s, Charles Johnston and Thomas Boult. (94) The appearance of men evaluating midwives' medical skills is important, but it must be emphasized that the transition to male authority was a slow and uneven process. In each of these cases, the doctors' testimonials were accompanied by testimony from women whom the nominees had delivered. Given the limited knowledge and experience that male practitioners had with childbirth, this development begs a simple question: Upon what foundation did these men base their judgment? One answer to this question may be found in the 1697 nomination of Margaret Coakes. Coakes's nomination is signed by women she had delivered and includes a letter from John Coningham, a surgeon in Tadcaster. According to Coningham:

This testimonial, such as it is, is significant on a number of fronts. First, there is no indication that Coningham examined Coakes's medical knowledge. All he knows for sure is what other people think, and most of these people were women. On the surface Coningham seems to validate the role of mothers in evaluating their midwives, but by claiming the right to confirm this judgment, Coningham is implicitly undermining their authority. Indeed, the tentative language in the final sentence, "in my opinion I think," stands in contrast to the "certain knowledge" of the first sentence and betrays a degree of unease at basing his professional opinion on something so unreliable as female knowledge. As surely as the medicalization of pregnancy undermined the authority of midwives, it gradually took from mothers the ability to choose which of their neighbors was capable of serving as a midwife.

More remarkable than the appearance of men in some testimonials is the complete exclusion of women from others. In 1700, Grace Addison of Leeds was nominated and received testimonials only from men: John Killingbeck, the parish vicar, John Skelton, M.D., and a pharmacist named William Smith. (96) When Mary Bently applied for her license from the parish of Kirby Moorside, her license was signed by the vicar of Helmsley (from whence she had recently moved), the parish churchwardens, and art apothecary, Giles Montague. (97) Given that these women were perfectly aware that the men signing their testimonials had little or no practical experience in childbirth, one must wonder why they chose this route. There are a number of possible explanations, beginning with expedience. They may have believed, and may have been right in believing, that the signature of a male practitioner would hasten or assure approval of their nomination. (98) In addition, a request for a nomination may have created something of an alliance between midwife and medical man, which could help the midwife build and maintain her practice. Midwives sometimes competed for customers, and a male ally could be a valuable asset in such a situation. (99) While these developments are significant, it is important to emphasize that we have not entered an entirely new world. Well into the eighteenth century, most midwives received testimonials from women. But the point remains that in the early eighteenth century it became possible for men to dominate the nomination process in a way that would have been unthinkable a few decades earlier.

The subordination of maternal experience to medical opinion reached new heights with the 1730 nomination of Joyce Gale of Market Weighton. Some aspects of Gale's nomination were not unusual, in that it included a letter from several women stating that "We whose names are hereto undersigned have experimentally found that Joyce Gale ... is capable of executing the Office of a Midwife & that she has performed the same upon us with very good success." But on the same sheet as this standard testimony is a remarkable note from William Carr, the parish curate, stating, "We have no person in Town capable of examining into the abilities of the party mentioned, therefore you must take the matter as it is." (100) [Fig. 1] What is striking is that Carr wrote this immediately below the women's testimonial; clearly they believed that they were capable of judging Gale's abilities. Carr's note thus speaks to another remarkable effect of the rise of male medical authority: the declining significance of the mother in "medicalized" childbirth. Historians of English and continental midwifery have argued that male midwives approached parturient women from a radically different perspective than their female counterparts. The medicalization of pregnancy undermined the subjective and experiential knowledge of midwives, but equally important is that it challenged women's knowledge of their own bodies. (101) In the late eighteenth century "quickening" (sensed, of course, by the mother) lost its status as the marker of fetal life. Rather, male practitioners "dismissed quickening as a fundamentally arbitrary division between early and late foetal development, and actually used it to show instead the untrustworthiness, of maternal opinion." (102) This disregard for women's knowledge is also seen in Germany, where male practitioners resisted female knowledge about childbirth even when it appeared in print. (103) In essence, when it came to "science" the idea of female knowledge was a contradiction in terms. In a similar development peculiar to England, male midwives' accounts of childbirth highlighted their own heroics and either reduced the laboring mother to her relevant body parts or wrote her out of the birthing chamber altogether. (104) A similar trend can be seen in the etchings found in eighteenth-century obstetric texts, which focused entirely on the preternaturally mature child and portrayed the mother as dead flesh or absent entirely save her uterus. (105) This focus on the child at the expense of the mother became explicit in the nineteenth century when a member of the Obstetric Society overturned the traditional assumption that a fetus should he sacrificed to save the mother. Sir Charles Clark claimed before a Parliamentary Committee that there were cases in which the doctor might choose to sacrifice the mother in order to save the infant. (106)

[FIGURE 1 OMITTED]

In 1660 or even 1760 such a radical shift in perspective lay in the distance, but as we have seen here, the process was underway by 1730. In 1660, it would never have occurred to a parish vicar like William Carr to doubt the female community's ability to evaluate the local midwife. Because knowledge about childbirth was subjective and experiential, who better to make this kind of assessment? Within a generation, the foundations this epistemology had begun to crumble, and by 1730 it was possible (for men at least) to argue that women were incapable of judging a midwife's ability. The language of Carr's letter indicates that the means of judging midwives had shifted from experience to examination. Be-cause mothers lacked a formal medical education, they were incapable of judging a midwife's understanding of childbirth. The medicalization of pregnancy thus transformed midwifery, but also undermined the authority of mothers over their midwives and, by extension, over their pregnancies and their very bodies. If mothers could not competently form opinions regarding the most intimate of medical practitioners, their birth attendant, what was left for them?

In this examination of early modern midwifery, I have hoped to make two substantial points. First, I have argued that historians must approach early modern midwives with far more delicacy than we have to date and must recognize the significance of the social disparities among practitioners. Yes, all midwives delivered children, but beyond this their experiences diverged widely. Because early modern medical authority stemmed only in part from medical knowledge, wealthy and socially prominent midwives occupied a very different place from their poorer colleagues. This is not to say that poor practitioners did not establish themselves as experts, but that this process was more difficult and qualitatively different. Such differences would shape a midwife's role in legal proceedings, but they had much broader significance. Medical authority mattered at moments of crisis of course, but also in the day-to-day life of the midwife and her clients, and would have shaped every aspect. of a woman's practice.

My second point focused on the relationship between representations of midwifery and its practice at. the parish level. It is beyond the scope of this article, and perhaps beyond the grasp of historians, to connect the rise of male authority over childbirth to any particular cause. A change of this magnitude surely cannot have sprung from a single source. However, my analysis illustrates the timing and pace of these changes in provincial England, with the 1690s standing out as the decade when male authority over childbirth became thinkable. Locating this change is significant, but it raises as many questions as it answers. How widespread were the attitudes betrayed in Carr's note? How did changing attitudes towards medical authority in the realm of childbirth affect a mother's experience? Did they affect midwives' view of their own work? The answers to these questions lie in the connections between the social and cultural histories of midwifery and childbirth and will require research that bridges printed and archival sources, connecting the world of ideas to that of lived experience.

Department of History

Huntsville, AL 35899

ENDNOTES

The author is grateful to Lisa Cody, Mary Fissell, Angela Balla, and Sandra Mendiola for comments on early drafts of this article, and to Jennifer Staton for her assistance with the final draft. A portion of this article was presented at the 2008 meeting of the American Association for the History of Medicine.

(1.) David Harley, "Historians as Demonologists: The Myth of the Midwife-witch," Social History of Medicine 3, no. 1 (1990): 1-26.

(2.) Hilary Marland, ed., The Art of Midwifery: Early Modern Midwives in Europe (London, 1994).

(3.) Adrian Wilson, The Making of Man-Midwifery: Childbirth in England, 1660-1770 (London, 1995).

(4.) Doreen A. Evenden, The Midwives of Seventeenth-Century London (Cambridge, 2000); Samuel S. Thomas, "Midwifery and Society in Restoration York," Social History of Medicine 16, no. 1 (2003): 1-16. For a critique of this approach and of social history in general see Roger Cooter, "After Death/After-'Life': The Social History of Medicine in Post-Postmodernity," Social History of Medicine 20, no. 3 (2007): 441-464.

(5.) Mary E. Fissell, Vernacular Bodies: The Politics of Reproduction in Early Modern England (Oxford, 2004). See also Lianne McTavish, Childbirth and the Display Of Authority In Early Modern France (Burlington, 2005).

(6.) Lisa Forman Cody, Birthing the Nation: Sex, Science, and the Conception of Eighteenth-Century Britons (Oxford, 2005); Lisa Forman Cody, "The Politics of Reproduction: From Midwives' Alternative Public Sphere to the Public Spectacle of Man-Midwifery," Eighteenth-Century Studies 32, no. 4 (1999): 477-96.

(7.) James Sharpe asks just this question in his review of Fissell's work. James Sharpe, "Vernacular Bodies: The Politics of Reproduction in Early Modern England," English Historical Review 122, no. 495 (2007): 178-180.

(8.) Despite their shortcomings as a source, midwife nominations are central to any effort to identify this cadre of women. David Harley, "English Archives, Local History, and the Study of Early Modem Midwifery," Archives 21, no. 92 (1994): 145-54.

(9.) The temporal distribution of the testimonials is haphazard, ranging from zero in many years, to twenty in 1685 and twenty-two in 1726.

(10.) Adrian Wilson is currently at work on a much-needed book on the licensing process. For a detailed discussion of the licensing process, see Evenden, Midwives, chap. 1. It is unlikely that Evenden's belief that that women took out a license before beginning to practice is correct. See also Jean Donnison, Midwives and Medical Men: A History of Inter-Professional Rivalries and Women's Rights (New York, 1977), 6-7; David Harley, "Provincial Midwives in England," in The Art of Midwifery. Early Modern Midwives in Europe, ed. Hilary Marland (London, 1994), 30; Wilson, Making of Man-Midwifery, 32-3; J. R. Guy, "The Episcopal Licensing of Physicians, Surgeons and Midwives," Bulletin of the History of Medicine 56, no. 4 (1982): 528-42; J. G. Burnby, "A Study of the English Apothecary from 1660 to 1760," Medical History. Supplement no. 3 (1983): 1-128.

(11.) Borthwick Institute for Historical Research (BIHR), Norn. M. Undated (Helen Taylor); Norn. M. 1688/2 (Alice Constable).

(12.) Hilary Marland sees similar trends on the continent. Hilary Marland, "The 'burg-erlijke' Midwife: The Stadsvroedvrouw of Eighteenth-Century Holland," in The Art of Midwifery: Early Modern Midwives in Europe, ed. Marland, Hilary (London, 1994), 194-Wilson, Making of Man-Midwifery, 33.

(13.) BIHR, Norn. M. 1726/11.

(14.) Evenden claims incorrectly that this fee "helped ensure that only dependable and economically viable women were licensed." Thomas Forbes notes that some women paid under 4s. Evenden, Midwives, 38-41; T R Forbes, "The Regulation of English Midwives in the Eighteenth and Nineteenth Centuries," Medical History 15, no. 4 (1971): 238.

(15.) BIHR, Nom. M. 1726/3-5 (Martha Charlesworth).

(16.) Harley, "Provincial Midwives," 30. BIHR, Norn. M. 1706/3 (Anne Charlesworth); BIHR, Nom. M. 1706/5 (Sarah Butterworth).

(17.) Adrian Wilson intends a larger exploration of this phenomenon. BIHR, Norn. M. 1726/11.

(18.) BIHR, V. 1674 CB, fo. 174r; V. 1682, CB fo. 220r.

(19.) BIHR, V. 1662-3 CB1, fo. 452r; BIHR, V. 1682, CB, fo. 209r. See also the examples of Jane and Ann Gervas of Gedling, Nottinghamshire (BIHR, V. 1674, CB fo. 178v; BIHR, V. 1682, CB fo. 236v) and Ellen and Sarah Jackson (Public Record Office (PRO), ASSI 45/13/2/100; BIHR, Nom. M. 1700/1 [Sarah Jackson]).

(20.) BIHR, Nom. M. 1695/1 (Elizabeth Green). See also Wilson, Making of Man-Midwifery, 31-2.

(21.) Hodgson's remarkable will refers to Martha Stopford "my maidservant & my deputy." BIHR, Original Wills, 1685 (Bridget Hodgson). The men who inventoried Stopford's estate described her as a midwife. BIHR, Dean and Chapter Wills, 1702 (Martha Stoppard). See Thomas, "Midwifery and Society."

(22.) Isobel Grundy, "Sarah Stone: Enlightenment midwife," in Medicine in the Enlightenment, ed. Roy Porter (Amsterdam, 1995), 133.

(23.) For the history of childbirth, see: David Cressy, Birth, Marriage, and Death: Ritual, Religion, and the Life-Cycle in Tudor and .Stuart England (Oxford, 1997); Laura Gowing, Common Bodies: Women, Touch and Power in Seventeenth-Century England (New Haven, 2003); Linda A. Pollock, "Childbearing and Female Bonding in Early Modem England," Social History 22 (1997): 286-306; Adrian Wilson, "Participant or Patient? Seventeenth Century Childbirth from the Mother's Point of View," in Patients and Practitioners: Lay Perceptions of Medicine in Pre-industrial Society, ed. Roy Porter (Cambridge, 1985), 129-44; Adrian Wilson, "The Ceremony of Childbirth and its Interpretation," in Women as Mothers in Pre-industrial England, ed. Valerie Fildes (London, 1990), 68-107.

(24.) Gabrielle Robilliard notes that midwives in rural Germany were chosen by the community of women. Gabrielle Robilliard, "Accoucheur--City Council--Midwives--Mothers: Choosing midwives in early modern Leipzig" (presented at the Civil Society and Public Service: Early Modern Europe, Leiden, Netherlands, December 30, 2007), http://www.let.leidenuniv.nl/pdf/geschiedenis/civil/Robbillard.pdf. I am grateful to Carolyn Barske for her discussion of this point.

(25.) See for example, BIHR, Nom. M. 1683/2 (Margaret Conyers); BIHR, Nom. M. 1723/3 (Mary Smith); BIHR, Nom. M. 1726/7 (Ann Moore); a 1726 letter from the vicar of Tuxford in Nottinghamshire is quite revealing in his request for two licenses, one for "Jane Cocking" and the other for "Mrs. Charlesworth." BIHR, Nom. M. 1726/3-5 (Nominations of Jane Cocking and Martha Charlesworth). There is no evidence that work as a midwife would in itself result in a woman being referred to as "Mrs."

(26.) Thomas, "Midwifery and Society;" Harley, "Provincial Midwives," 32.

(27.) BIHR, Nom. M. 1684/3 (Martha Baker).

(28.) It is likely that further investigation will uncover more examples, for clergymen's wives were more than usually active as surgeons. BIHR, D/C, Nom. M. 1666/2 (Agnes Bowcocke); (PRO, ASSI 45/4/3/25-27; ASSI 45/7/2/117-19). Arthur Lewis Wyman, "The Surgeoness: The Female Practitioner of Surgery, 1400-1800," Medical History 28 (1984): 32.

(29.) For this practice in Germany, see Mary Lindemann, "Professionals? Sisters? Rivals? Midwives in Braunschweig, 1750-1800," in The Art of Midwifery: Early Modern Midwives in Europe, ed. Hilary Marland (London, 1994), 182; Robilliard, "Accoucheur."

(30.) Thompson's nomination added that, "formerly she lived in good estate." BIHR, Nom. M. 1663/1 (Ann Doughty); BIHR, Nom. M. 1662/2 (Johanna Thompson).

(31.) BIHR, NOM. M. 1707/3 (Alice Crowther); BIHR, CP. I. 227 (Hall c. Hall).

(32.) Mary E. Fissell, Patients, Power and the Poor in Eighteenth-Century Bristol (Cambridge, 1991), 67-8.

(33.) Wilson, Making of Man-Midwifery, 30.

(34.) Cressy, Birth, Marriage, and Death, 61-3. See also Wilson, Making of Man-Midwifery, 36-8; Mary Lindemann, Medicine and Society in Early Modern Europe (Cambridge, 1999), 222; Lynne Tatlock, "Speculum Feminarium: Gendered Perspectives on Obstetrics and Gynecology in Early Modern Germany," Signs 17, no. 4 (1992): 733.

(35.) PRO ASSI 45/13/2/100.

(36.) Cheshire and Chester Archives (CCA) EDC 5/1663/16.

(37.) Lindemann, Medicine and Society, 220-1. Adrian Wilson estimates that 96% of births were spontaneous and natural. Adrian Wilson, "William Hunter and the Varieties of Man-Midwifery," in William Hunter and the Eighteenth-Century Medical World, ed. W. F. Bynum and Roy Porter (Cambridge, 1985), 343-69.

(38.) Lindemann is referring to the experience of male physicians, but the lesson applies to midwives. Mary Lindemann, "The Enlightenment Encountered: The German Physicus and his World, 1750-1820," in Medicine in the Enlightenment, ed. Roy Porter (Amsterdam, 1995), 195.

(39.) The extent to which women feared childbirth is a subject of some debate. See Adrian Wilson, "The Perils of Early-Modern Procreation: Childbirth With or Without Fear.'," British Journal for Eighteenth-Century Studies 16: 1-19; Sharon Howard, "Imagining the Pain and Peril of Seventeenth-century Childbirth," Social History of Medicine 16, no. 3 (2003): 367-82; Cressy, Birth, Marriage, and Death, 28-31; Roger Schofield, "Did the Mothers Really Die? Three Centuries of Maternal Mortality in 'The World We Have Lost'," in The World We Have Gained: Histories of Population and Social Structure, ed. Lloyd Bonfield, Richard M. Smith, and Keith Wrightson (Oxford, 1986), 231-60.

(40.) William Bromfield, "Remark of the Case of a Poor Woman Who Had a Foetus in Her Abdomen for Nine Years, Opened May 6th 1739. by William Bromfield, Surgeon," Philosophical Transactions (1683-1775) 41 (1739): 697.

(41.) For conflicts in the birthing chamber, see Pollock, "Childbearing and Female Bonding;" Cowing, Common Bodies, chap. 5.

(42.) Hilary Marland, "'Stately, and dignified, kindly and God-fearing': Midwives, Age and Status in the Netherlands in The Eighteenth Century," in The Task of Healing: Medicine, Religion, and Gender in England and the Netherlands, 1450-1800, ed. Hilary Marland and Margaret Pelling (Rotterdam, 1996), 277; Tatlock, "Speculum," 742, 745; McTavish, Childbirth and the Display of Authority, 84-91. This is also true of male practitioners. Judith Schneid Lewis, In the Family Way: Childbearing in the British Aristocracy, 1760-1860 (New Brunswick, 1986), 103, 91-2. See also the example of the German Physicus. Lindemann, "Enlightenment Encountered," 183.

(43.) Old Bailey Proceedings Online (www.oldbaileyonline.org, 17 April 2008), June 1677, trial of a Midwife (t16770601-6).

(44.) CCA, EDC 5/1663/16.

(45.) They were central to the prosecution of crimes ranging from simple bastardy and prenuptial fornication to capital offenses such as rape, witchcraft, and infanticide. Clive Holmes, "Women: Witnesses and Witches," Past & Present 140 (1993): 45-78; Laura Gowing, "Secret Births and Infanticide in Seventeenth-Century England," Past & Present 156 (1997): 87-115; Harley, "Provincial Midwives;" Harley, "Historians as Demonologists;" Pollock, "Childbearing and Female Bonding;" Thomas, "Midwifery and Society," 11-15.

(46.) PRO, ASSI 45/4/3/27.

(47.) PRO, ASSI 45/12/4/88.

(48.) PRO, ASSI 45/8/1/81.

(49.) Gowing, Common Bodies, 72-3.

(50.) It was not uncommon for local officials to hire poor women to provide medical care for poorer residents of the parish. Diane Willen, "Women in the Public Sphere in Early Modern England: The Case of the Urban Working Poor," Sixteenth Century Journal 19 (1988): 559-73.

(51.) For unlicensed and even licensed midwives harboring single mothers, see Gowing, Common Bodies, 156; Robilliard, "Accoucheur," 13; Given she is arguing that licensed midwives harbored single women in violation of their oath, Cody is appropriately tentative. Cody, Birthing the Nation, 59.

(52.) Annabell Lewis, for whom there is no record of a license, assisted Isabel Craven and subsequently testified regarding the paternity of the child. BIHR, CP. I. 101. For London, see Old Bailey Proceedings Online (www.oldbaileyonline.org, 18 April 2008), May 1687, trial of M- S- (t16870512-18); and April 1691, trial of Elizabeth Deal (t16910422-22).

(53.) BIHR, OW, December 1685.

(54.) Testimony also indicates that she delivered many of her clients on more than one occasion.

(55.) CCA, EDC 5/1663/16.

(56.) Wilson, Making of Man-Midwifery, 30-1.

(57.) Wilson, "Participant or Patient?" 133; Wilson, Making of Man-Midwifery, 34, 43 (n. 80). Witnesses in Anne Knutsford's defamation case noted that the town, with a population of three thousand, was served by at least three midwives. CCA, EDC 5/1663/16. For Nantwich, John Howard Hodson, Cheshire, 1660-1780: Restoration to Industrial Revolution (Chester, 1978), 93, cited in Garthine Walker, Crime, Gender, and Social Order in Early Modern England (Cambridge, 2003), 18.

(58.) BIHR, Nom. M. 1662/1 (Catherine Dixon); Nom. M. 1662/2 (Elizabeth Nicholson); Nom. M. 1663/5 (Elizabeth Stancliffe and Jane Robinson).

(59.) See above BIHR, V. 1662-3, CB1, fos. 445r, 435r, 427r.

(60.) BIHR, V. 1693, CB 1, fo. 18v; Nom. M. 1726/3-5 (Jane Cocking and Martha Charlesworth).

(61.) Wilson, Making of Man-Midwifery, 35.

(62.) BIHR, NOM. M. 1681/1 (Dorothy Smith).

(63.) For the promotion of "plague midwives" in the Netherlands, see Marland, " 'Stately, and dignified,'" 277. On competition among birth attendants, see Lindemann, "Professionals?," 184. BIHR, NOM. M. 1721/1 (Mary Gedney). Johnson was nominated in 1715. BIHR, NOM. M. 1715/3 (Jane Johnson). The description of Elstronwick or Humbledon as a "town" is something of an overstatement. Humbledon, the larger of the two, was home to 79 families in 1743. Elstronwick had 34 houses in 1672, and in 1801 the population was 126. 'Middle division: Humbleton,' A History of the County of York East Riding: Volume 7: Holderness Wapentake, Middle and North Divisions (2002), 56-82. URL: http://www.british-history.ac.uk/report.aspx?compid=16129. Date accessed: 28 January 2008.

(64.) BIHR V. 1662-3, fo. 416v.

(65.) Margaret Pelling has argued that the public identity of midwives was "akin ... to that of men." Margaret Pelling, The Common Lot: Sickness, Medical Occupations and the Urban Poor in Early Modern England (London, 1998), 155.

(66.) BIHR, Nom. M. 1662/2, (Elizabeth Nicholson); Nom. M. 1702/3, (Lydia Daniel).

(67.) This requirement stemmed in part from religious concerns, as church officials worried that Catholic midwives might secretly baptize an infant using the popish rite, or Quaker midwives might prevent their baptism entirely. Also significant, particularly in the wake of the Civil Wars and the "Warming-Pan Scandal," were concerns about patrimony. Cody, Birthing the Nation, 71-83; Rachel Weil, Political Passions: Gender, the Family and Political Argument in England, 1680-1714 (Manchester, 2000).

(68.) Sarah Stone walked a similarly fine line in trying to use the language of Enlightenment to criticize untrained midwives without undercutting female midwifery entirely. Grundy, "Sarah Stone."

(69.) BIHR Nom. M. 1689/1 (Phillips); Nom. M. 1696/1 (Elizabeth Arrandell). See also Nom. M. 1689/3 (Anne Thompson) and Nom. M. 1696/2 (Mary Jervas).

(70.) "mystery, n. [.sup.l]"OED Online, March 2008, Oxford University Press, 13 March 2008,

(71.) Fissell, Vernacular Bodies. For the place of midwives in nativity plays, see Denise Ryan, "Playing the Midwife's Part in the English Nativity Plays," Review of English Studies 54, no. 216 (2003): 435-448.

(72.) Jonathan Sawday has argued that the creation of a new, masculine science entailed "the reform of the very language of science" along masculine lines. Jonathan Sawday, The Body Emblazoned: Dissection and the Human Body in Renaissance Culture (London, 1995), 231.

(73.) For the experience of these mothers, see Gowing, "Secret Births." Gowing, Common Bodies, chap. 1.

(74.) PRO, ASS1 45/21/1/112 (Information of Ann Winn).

(75.) PRO, ASS1 45/10/1/39 (Information of Katherine Firth).

(76.) PRO, ASS1 45/9/1/119 (Information of Philippa Bedill). Emphasis added.

(77.) German midwife Justine Siegemund, "displays a certain amount of irritation with the uncooperative patient and alludes to parturient women who went to their deaths when they would not allow themselves to he ruled by their midwives." Tatlock, "Speculum Feminarium," 751-2. For the increasing role of male practitioners in infanticide trials, see Cody, Birthing the Nation, 271-5.

(78.) Donnison, Midwives and Medical Men; Ruth Ginzberg, "Uncovering Gynocentric Science," in Feminism & Science, ed. Nancy Tuana (Bloomington, 1989), 69-84; Evelyn Fox Keller, Reflections on Gender and Science (New Haven, 1996); Genevieve Lloyd, The Man of Reason: "Male" and "Female" in Western Philosophy (Minneapolis, 1993); Robert L. Martensen, The Brain Takes Shape: An Early History (Oxford, 2004); Carolyn Merchant, The Death of Nature: Women, Ecology and the Scientific Revolution (San Marino, 1980); Julie Sanders, "Midwifery and the New Science in the Seventeenth Century: Language, Print, and the Theatre," in At the Borders of the Human: Beasts, Bodies and Natural Philosophy in the Early Modern Period, ed. Erica Fudge, Ruth Gilbert, Susan Wiseman (Basingstoke: 1999), 74-90; Londa L. Schiebinger, The Mind Has No Sex? Women in the Origins of Modern Science (Cambridge, MA, 1989); Sawday, The Body Emblazoned; Lynette Hunter and Sarah Hutton, eds., Women, Science and Medicine 1500-1700: Mothers and Sisters of the Royal Society (Stroud, 1997).

(79.) Fissell, Vernacular Bodies, 135,149.

(80.) Cody, Birthing the Nation, 8.

(81.) BIHR, Nom. M. 1723/2 (Sary Hebdin); Nom. M. 1735/3 (Sarah Moore). David Harley notes a male midwife using the language of business to describe midwifery in 1755. Harley, "Provincial Midwives," 40.

(82.) Fissell, Vernacular Bodies, 247-8.

(83.) BIHR, Nom. M. 1696/4 (Isabel Grasscroft).

(84.) Carole Rawcliffe, .Medicine and Society in Later Medieval England (Stroud, 1995), 199. I am grateful to Monica Green for this reference.

(85.) John Woodall, The Surgeon's Mate, 2nd ed. (London), Sig. A5.

(86.) "science" The Oxford English Dictionary, 2nd ed. 1989, OED Online, Oxford University Press. 6 May 2008,

(87.) During the civil wars and Interregnum, London midwives were regulated by the Company of Barber-Surgeons and examined by a team of six senior midwives and six surgeons. Guy, "Episcopal Licensing," 541.

(88.) Harley, "Provincial Midwives," 29. Doreen Evenden notes the presence of men in a small number of testimonials, but attaches little significance to this. Evenden, Midwives, 36 (n. 80).

(89.) Cody, "The Politics of Reproduction," 483.

(90.) Cody, Birthing the Nation, 16, 96-7.

(91.) Adrian Wilson suggests that most towns had one male surgeon, but as late as 1720 these men were only called in emergencies to deliver babies who had died in the womb. Wilson, Making of Man-Midwifery, 59; Cody, Birthing the Nation, 96; Andrea Rusnock, "Correspondence Networks and the Royal Society, 1700-1750," British Journal for the History of Science 32 (1999): 168; Rogers Blood Miles, Science, Religion, and Belief: The Clerical Virtuosi of the Royal Society of London, 1663-1687 (New York, 1992). For the influence of the Scientific Revolution on apothecaries, see Burnby, "English Apothecary."

(92.) One can only imagine Wallis's excitement. Adam Martindale, The Life of Adam Martindale: Written by Himself (Chester, 1845), 189.

(93.) Adam Martindale, "Extracts of Two Letters, Written by the Ingenious Mr. Adam Martindale to the Publisher from Rotherton in Cheshire," Philosophical Transactions 1665-1778) 5 (1670): 2015-2017.

(94.) While Booker's nomination is undated, it is almost certainly from the 1690s. Johnston also signed the 1698 nomination of Frances Chaddock. Booker's nomination was also signed by Anne Brooke, who was licensed in 1690. BIHR, Nom. M. 1695/2 (Alice Yales); Nom. M. 1698/2 (Frances Chaddock); BIHR, Norn. M. undated. (Anne Booker).

(95.) BIHR, Nom, M. 1697/4 (Margaret Coakes).

(96.) BIHR, Nom, M. 1700/2 (Grace Addison).

(97.) BIHR, Nom, M. 1726/22 (Mary Bentley).

(98.) That said, I have yet to find any evidence of a nomination being rejected by ecclesiastical officials.

(99.) In 1712, Em Hogley, a midwife in Harrington, appears to have conspired with one Hannah Hall to undermine the midwifery practice of Margaret Hall by spreading rumors that Margaret was a witch. I plan to return to this case in a future article. BIHR, CP. I. 227 (Margaret Hall c. Hannah Hall). For alliances between licensed midwives and surgeons against unlicensed practitioners, see Marland, "The 'burgerlijke' Midwife," 195.

(100.) BIHR, D/C Nom/M, 1730/1 (Joyce Gale).

(101.) Lisa Forman Cody, " 'The doctor's in labour; or a new whim wham from Guildford'," Gender & History 4 (1992): 175-96; Fissell, Vernacular Bodies, 152-3.

(102.) Cody, Birthing the Nation, 277-8.

(103.) Tatlock, "Speculum Feminarium," 734-5.

(104.) Eve Keller, "The Subject of Touch: Medical Authority in Early Modern Midwifery," in Sensible Flesh: On Touch in Early Modern Culture, ed. Elizabeth D. Harvey (Philadelphia, 2002), 76-7. Lynne Tatlock sees a similar trend in German midwifery texts, with those penned by Justine Siegemund focused on the mother, while Johann Christoph Ettner is far more interested in the fetus. Tatlock, "Speculum Feminarium," 753.

(105.) Cody, Birthing the Nation, 278-80. Lynne Massey, "Pregnancy and Pathology: Picturing Childbirth in Eighteenth-Century Obstetric Atlases," The Art Bulletin 87, no. 1 (2005): 73-91; Ludmilla J. Jordanova, "Gender, Generation and Science: William Hunter's Obstetrical Atlas," in William Hunter and the Eighteenth-Century Medical World, ed. W. F. Bynum and Roy Porter (Cambridge, 1985), 385-412.

(106.) Cody, Birthing the Nation, 280-1.

By Samuel S. Thomas

University of Alabama, Huntsville
Margaret Coakes of Abberford, is to my certain knowledge thought
  fittly Quallified (by her Nighbours in that Town and places adjacent)
  for to Under take the Office of a Midwife, haveing for a Longe time
  ben thought very Capable for the same. And in my opinion I thinke she
  very well deserves to be Licensed for that purpose. (95)
Gale Copyright: Copyright 2009 Gale, Cengage Learning. All rights reserved.