As families gathered linens, clothes and items for delivery, they also started to make practical arrangements for birth about where women would deliver, who would be there and who would be the midwife. These were decisions that, like other aspects of the experience of having babies, were driven by family interests and a desire to protect and enhance social standing. Midwives are dominant figures in histories of early modern childbirth, at least in part because of the dramatic rise in man-midwives that took place in the eighteenth century. Prior to this, it was highly unusual for men to be present in the room where women gave birth, and usually only when surgeons were called in when the mother or child had already died. From 1750 onwards, however, male practitioners, newly fashioned as ‘doctor midwives’ or ‘accoucheurs’, became the default practitioner to deliver babies for many elite families. By 1790, between a third and half of all deliveries in England had man-midwives in attendance.Footnote ¹

Historians have long speculated as to how and why this rapid shift in the sex of midwives changed in the period. For James Aveling, an obstetrician writing in the late nineteenth century, this shift was simply the direct result of medical, scientific and rational progress.Footnote ² Man-midwives were supposedly handed ‘the key to the lying-in room’ because they offered women forceps and other instruments that made birth quicker, less painful and safer.Footnote ³ Their incursion (in his opinion) constituted the timely emergence of the discipline of obstetrics. Generation was supposedly wrestled away from the inexpert and untrained hands of midwives and anchored within the male and institutionalised world of medicine and science. This is a teleology that Adrian Wilson has echoed in much milder terms more recently when he noted that before belonging to ‘medicine’, childbirth belonged to women.Footnote ⁴ When the majority of medicine took place at home in the period, including childbirth, it seems anachronistic to separate out these fields of knowledge and practice. Within these explanations there is an implicit assumption that before man-midwives, childbirth was more of a social affair and one that was confined to women. As early as 1919, Alice Clark noted that in many ways, this narrative mirrored a more general and longer story of women being shunted out of skilled and highly valued work.Footnote ⁵ Following in Clark’s footsteps, feminist scholars tackled the men-equal-progress narrative head on in the 1970s, and afterwards, claiming that it was precisely because midwives were highly trained that they were perceived as a threat by male authority figures. Barbara Ehrenreich and Deirdre English suggested that female midwives were often accused of being witches in order to limit and control their power, a theory that was later undermined by David Harley.Footnote ⁶ Man-midwives, in fact, supplanted expert, relatively well-educated women.Footnote ⁷ For historians in the 1970s, this shift was the result of young surgeons and physicians trying to create a new career path in an increasingly competitive medical marketplace. Female midwives were simply collateral damage. Wilson similarly sees competition for clients as key to this story of the rise of the man-midwife but sees women themselves as driving the shift from female to male practitioners as they sought to demarcate themselves socially by securing high-profile, quasi-celebrity man-midwives that accelerated this trend.Footnote ⁸ This chapter finds that man-midwives’ success was in a large part because making babies was already an affair that men were deeply involved in. This shift appears less dramatic when we find from family paperwork that the arrival of man-midwives did not change many aspects of birthing, especially when we consider that as we saw in previous chapters it was not the homosocial experience that other historians may have imagined it as. Indeed, female midwives often did much of the work at births, even when man-midwives were called on.

Like other aspects of childbearing, decisions about the practitioners that would be present at delivery was debated in family correspondence. Like the ways that male family members guided the purchase and acquisition of material things, they were also active in choosing ‘good’ midwives and nurses. Another theme of this book – that certain aspects of bearing children were highlighted and celebrated in family paperwork and other aspects minimised – is seen most clearly in the discussions that individuals had about practitioners. In particular, families became increasingly interested in the personal characteristics and identities of man-midwives in a way that they were not and had not previously been concerned with the biographical details of female practitioners. The exception was when female midwives and nurses were accused of malpractice. Instead, they were often designated ‘the midwife’ or ‘the nurse’ in account books, diaries and correspondence. Man-midwives, like the Chamberlens, a dynasty of man-midwives living in London of Huguenot descent who are most famous for having invented the forceps, represented themselves as having all-rounded expertise as family physicians rather than just experts in birth. These men became so-well known in certain elite circles that their eccentricities and mannerisms were celebrated. We know far less about individual female midwives. Even Jane Sharp and Sarah Stone, the only female midwives that are known to have published medical books in England, are difficult to identify in parish registers and family paperwork.Footnote ⁹

Historians of medicine have pointed to a gradual co-opting of women’s medical knowledge and skills in writing about generation from the medieval period to the eighteenth century.Footnote ¹⁰ From the late sixteenth century, as we have heard, men positioned themselves as having a superior knowledge of the secrets of generation and, as the seventeenth century progressed, importantly, they claimed to be better practitioners. Indeed, Mary E. Fissell suggests that man-midwifery was a logical development given the ways that generation was increasingly folded into technical, educational and institutional impulses of the Enlightenment project to improve infant and maternal welfare for the benefit of the State and its colonial power.Footnote ¹¹ The shift to seeing man-midwives as more authoritative than female ones in the eighteenth century then is simply the next tangible development in this trend.

The story of man-midwifery in England is the broader story of generation in this period writ large. When women took pains in procreation, it was expected as part of their domestic role and redounded to the family name more broadly. When men did generative work, it was either obscured in family paperwork (when it appeared too similar to what women might be expected to do within households) or celebrated as being directly related to their own individual characteristics. Men entering the birthing room therefore was simply a more obvious and tangible reflection of a broader trend of men knowing about, directing and controlling childbearing. Whilst Wilson has claimed that the arrival of man-midwives in birthing chambers ‘undermined an underlying pattern of gendered space’ in which women deliberately excluded men and the family during birth,Footnote ¹² looking at where and how women gave birth shows that men were active in shaping this ‘space’ long before the eighteenth century. Family correspondence reveals that women often went to their natal home to give birth, and that they insisted on their husbands being in the house when they delivered. The seventeenth-century birthing chamber may have been mostly female but the rooms below were filled with male family members, meaning that the incursion of man-midwives might not have been the dramatic cultural shift that other historians have claimed it was.

Good and Bad Midwives

From the 1630s onwards, the authors of childbearing guides began increasingly to write about the importance of selecting a ‘good’ midwife. Before the seventeenth century, childbearing guides were notably more neutral and often focused on procedures of care rather than the relative virtues of practitioners. The Byrth of Mankynd (1540), for example, told midwives that they should ‘dilligently observe and wayte’ during delivery and not to force the child out, but did not expand on what would happen if a midwife were to apply force.Footnote ¹³ John Jones’ 1579 Arte and Science encouraged the practice of washing babies in warm water after birth, without spending too much time detailing the harm that might come from cold water or not washing newborns.Footnote ¹⁴ Other texts were directed towards women themselves that helped prepare them for what midwives would do during delivery. The 1636 Sick Womans Looking Glass noted that pregnant women should ‘let’ the midwife administer ‘oyle of lillies, marjerom, and bayes’ to her privities. The midwife ‘putting up her finger, shall feele the mouth of it [the womb] retracted and closed up’.Footnote ¹⁵ From the mid-seventeenth century, however, midwifery guides became very vocal about the dangers and perils of childbirth, and the threat of poor care.Footnote ¹⁶ Whereas earlier guides advertised themselves as being useful to birthing women, now guides explicitly sought to instruct midwives in their craft.

The 1636 English translation of Jacob Rüff’s De Conceptu et Generatione Hominis was retitled The Expert Midwife. For those selecting a midwife or training to become one, the emphasis on expertise in midwifery served to simultaneously conjure up images of an anti-midwife who was ignorant, careless and/or mercenary.Footnote ¹⁷ The guide worried that poor practice had already ‘cost the lives of many’. Childbirth was ‘so dangerous, and so full of perill’ that the skills of a midwife could determine the outcome. In his chapter on ‘the Office of Midwives’, Rüff imagined a skilful midwife who knew ‘the time’, observed the pains, was able to ‘comfort and cheare up the labouring woman’ and direct prayers.Footnote ¹⁸ In Edward Poeton’s manuscript dialogue between two midwives from the 1630s, he offered to help women who were ‘not well furnished w[i]th knowldg concerning the misteries of yt profession’.Footnote ¹⁹ His insight, he claimed, came from male-authored childbearing guides – ‘the matter is other mens’.Footnote ²⁰ This was despite the fact that his own wife was a midwife. Whilst Poeton’s characters were literate, skilled, accomplished midwives, they were merely literary devices to position himself as an obstetrical authority, even at the expense of his wife and assumed that there would be a great many midwives who were in dire need of his instruction.

The idea that many midwives were poorly skilled was often referenced in texts about the licensing and organisation of midwives from 1616 onwards too. Ecclesiastical licensing of midwives was the norm until the eighteenth century (apart from during the interregnum).Footnote ²¹ Dr Peter Chamberlen the elder furthered himself as the ‘Governor’ of a new ‘Society’ of midwives in a ‘humble petition of the midwives in and about the city of London’ that was presented to the king. They shared this prevailing fear that ‘manny women labouring with child and their children do perish’ as a result of poor practice.Footnote ²² The petition was unsuccessful. Peter’s nephew, also called Peter, would petition the King again in 1634, calling again for a midwives’ society. This time there was rather more opposition from midwives themselves, published in An Answer (1649).Footnote ²³ A new development signed a complaint led by Mrs Shaw and Mrs Whipp in which they accused Chamberlen of refusing to attend poor women and seeking excessive rewards. A short tract represented him as trying to ‘get himself created vicar generall of the Midwifes in city & suburbs’.Footnote ²⁴ The appropriation of women’s medical skills and knowledge into a male and learned corpus was not new to the mid-seventeenth century, however, we see clearly that the intensified interest in midwives was.

Nicholas Culpeper took on the task of directing midwives in their art even further in his 1651 Directory for Midwives. The preface was dedicated to ‘The Midwives of England’ who he ‘wisheth success in their Office’. The Directory marked a major shift in the ways obstetrical knowledge was authored. As Fissell notes, Culpeper did away with the normal meek apologies for ‘intruding’ into women’s business, and he was strident in his descriptions of all the things that could cause havoc in women’s bodies originating from the womb.Footnote ²⁵ Whereas Eucharius Roeslin, Rüff and Jones had simply described good practice, Culpeper set out ‘Rules’ for midwives to follow. They were not ‘so many that they will burden your Brain, nor so few that they will be in-sufficient for your Necessity’. Importantly, following them would mean midwives did not have to send for a ‘Man-Midwife’, which was a ‘disparagement not only to your selves, but also to your Profession’.Footnote ²⁶ Culpeper’s text was laden with suggestions that it was the norm for midwives to do a bad job, foreshadowing the ways in which man-midwives constructed claims about their own superior knowledge and practice in the eighteenth century.

Over the seventeenth century, owing to authors like Culpeper, medical texts progressively devalued the skill and knowledge of midwives. So much so that from the 1650s, authors’ definition of a good midwife narrowed and was eventually defined by their subservience to male practitioners, the family, the Church and community more broadly. The 1656 Compleat Midwifes Practice outlined how women ought to choose midwives who were neither too young nor old, were ‘in good habite of body’, free from disease or disability and had small hands with short nails. They ought to be ‘Courteous, ‘sober’, ‘chast[e]’, ‘prudent’, ‘wary’ and ‘cunning’. Perhaps most crucially though, they should not be arrogant, complaining or covetous.Footnote ²⁷ Families should want to hire a midwife that was a social manager and obsequious rather than authoritative and firm. Indeed, it was dangerous for a female practitioner to be too confident in her expertise. Aristotle’s Master-piece idealised midwives who never imagined themselves to be perfect and constantly added to their ‘Knowledge by study and experience’.Footnote ²⁸ By this, he meant that he expected them to defer to physicians regularly and thought this was the cause of ‘so many Women and Children’ dying.Footnote ²⁹

Percivall Willughby, a man-midwife, also used the amorphous threat of the death of ‘poor innocent infants [and mothers]’, which he perceived as at epidemic levels due to the poor industry of midwives, in particular the practice of tying labouring women to chairs, which he said caused injuries that prevented future conception.Footnote ³⁰ Midwives should be ‘Wise and Silent not apt to talk foolishly of what she sees in the Houses where she hath to do’, yet another insight into the ways in which birthing practitioners were meant to uphold the narratives that families wanted to be told about them.Footnote ³¹ His Observations would ‘inform common midwives with such ways as I have used with good success’, although his text remained unpublished until the Victorian period.Footnote ³² Midwives also had to be outwardly and obviously pious. She should ‘know, that God hath given to all things their beginnings, their Increasings, their Estate of perfection, and declination’.Footnote ³³ A key part of the midwives’ role was increasingly represented as subservience – to God, to higher-trained male medical professionals and to the family. These delicate and pedantic boundaries mirrored the ways wives and mothers were expected to be knowledgeable about fertility, bodies and medicine but not too knowledgeable; skilled but not too skilled; and that they would tirelessly labour to procure positive procreative outcomes, without obvious credit. Midwives were also caught in this cultural bind. The fact that midwives occupied a socially laudable position in communities and households as well as a medical one has been prominent in histories of midwifery as evidence of their power in early modern society. This does not fully take account of the complexity of medical encounters in the period that rarely involved merely a patient and practitioner but always took place in a complex web of social, familial and community interactions and pressures. Social obligation or expectation did not necessarily bring authority or even influence.

This idea that good midwives would be discreet, adept social managers and administer care only so far as their (quite limited) capabilities allowed is a prominent theme in the oaths that midwives were asked to swear in order to obtain licences in the early modern period. The parallels between the expectations that midwives would be highly skilled as well as meekly work to perpetuate the family and enhance its social reputations, and the ways families imagined ideal mothers would also toil tirelessly and without much fuss, is by no means accidental. It spoke to male fantasies of domestic harmony and the discomfort with acknowledging the pain, peril and work that women had to do to obtain these ideals. Margaret Parrey was granted a licence in 1588 by the Bishop of London after she swore she would be ‘dilligente faithfull and redye to helpe everye woman traveling of Childe’ regardless of wealth; ensure women named the correct father of their child; ensure that women did not claim ‘anye other womans childe for her owne’; prevent any babies from being harmed; request additional assistance from midwives when necessary; rely on prayer rather than sorcery; not provide advice or assistance to women wishing to end pregnancies; not try and extort too high of a payment from families; never allow women to give birth without at least ‘two or three honest women’ present; ensure men were not allowed into the birthing chamber ‘unlesse necessarye or grete urgent causes shall constreyne you soe to doe’; if the child died, bury it in a ‘secrett place’ safe from disturbance; make sure other midwives were practicing appropriately and report them to authorities if they were not; be ‘honeste’; report those midwives that did not have licences to the authorities; and finally, check that anyone serving under her was also ‘righte honeste and discrete’.Footnote ³⁴

In this way, female midwives shouldered the weight of regulating and representing their whole profession, and the oaths they took often insisted on accepting being policed by families, the Church and state, and, in turn, policing other midwives. Another oath from 1649 consisted of fifteen promises that repeated many of the same hallmarks of practice.Footnote ³⁵ She had to be ‘diligent and faithfull, and readie to helpe every Woman labouring of Childe, as well as the poore as the riche’. Four items concerned preventing and managing bastardy: the midwife was asked to extract the name of the father; insist on having two or three witnesses to any woman seeking to give birth secretly; not advise or knowingly allow a woman to take measures to abort her child; and the midwife had to prevent the death or injury of the child. Others were religious – she should use ‘honest behaviour unto the woman being lawfully admitted to the roome’ and facilitate the baptising of the child into the Church of England. Four promises concerned what might be termed ‘policing’ the profession. Item 11 asked midwives to report other midwives who did not abide by the oath to the bishop or chancellor, and item 13 asked them to notify if they knew any midwives who were practicing without a licence. Item 9 asked them to keep their ‘Office’ secret from men unless ‘urgent cause’ necessitated it, presumably more about not divulging the details of birth rather than disguising their profession, and item 14 demanded they not appoint any apprentices ‘but such as you shall perfectly know to be of right honest and discreet behaviour, as also apt, able, & having sufficient knowledge and experience’.Footnote ³⁶ Midwives oaths show that despite the veneration of subservience, it was also hoped that midwives would minister in ways that continually adapted to the social and bodily needs of women and their families before, during and after delivery, which demanded skill and considerable knowledge.

It was not just male medical authors and oaths that sponsored fears about the dangers of unskilful practitioners. Female medical authors also added to this discourse. Sharp’s 1671 Midwives Book reflected on the many ‘Miseries Women endure in the Hands of unskilful Midwives; many professing the Art (without any skill in Anatomy, which is the Principal part effectually necessary for a Midwife)’.Footnote ³⁷ And Stone’s 1741 Observations repeated Culpeper’s warning from 1651 that without proper training and instruction, country midwives would be forced to call male practitioners in uncomplicated deliveries.Footnote ³⁸ But for her, these ‘boyish Pretender[s]’ were an even greater threat than inadequate female midwives. She feared that they were likely to cause the death of healthy infants, expose the modesty of the pregnant woman and damage the midwife’s reputation. She relayed in visceral and persuasive terms how babies had been born ‘with their Brains working out of their Heads’, butchered by hooks and knives.Footnote ³⁹

Both male and female midwives were represented as potentially murderous and dangerous in cheap print too. A 1699 ballad, A Hue and Cry After A Man-Midwife, Who has Lately Deliver’d the Land Bank of Their Money, described the new figure as a ‘Doctor, Projector, Man-Midwife and C-----’ who ‘Cunningly manag’d a subtle Device’. Through his deception, he ‘strangles more Necks, than the Rope and the Gallows’.Footnote ⁴⁰ In A New Ballad of the Midwives Ghost, the midwife in question murdered ‘Bastard-Children’ and buried them around a London house that was subsequently haunted.Footnote ⁴¹ Another midwife, Mary Hobry, supposedly murdered her own husband.Footnote ⁴² Elsewhere, midwives were represented as guilty of collusion and manipulation, particularly when it came to paternity. In the 1680–1690s ballad Lass of Lynns New Joy, the midwife colludes with a newly delivered woman and her mother to persuade a new husband that the baby is actually his rather than the result of a previous dalliance.Footnote ⁴³ Advice to Young Gentlemen warned men not to be taken in by the ‘Oration’ that midwives made after the birth of a child that ‘the poor Infant is so like the Dad’ when really it was the product of pre- or extra-marital affairs.Footnote ⁴⁴ The prevalence of inept, mercenary, and sometimes murderous, midwives – male and female – as characters in print culture in the latter part of the seventeenth century speaks to the perceived significance of practitioner choice as well as their role in managing the emotional and practical demands of the households they served. But the questions that this literature asked about agency, control, power, knowledge and skill in managing generation were not new ones, but the ones that families had asked for decades.

The worry that female practitioners would do a bad job in managing childbirth and the consequences, not just for the health of mothers and babies, found its way into lots of different kinds of printed texts across the seventeenth century, and was backgrounded by the loud competition for clients and reputation that many healers were partaking in to stake out their claim within the marketplace. These discussions in early modern English midwifery guides reflect a wider intellectual trend in the period to subsume female procreative work – both by mothers and midwives (and as we shall later see by nurses and servants) – within expectations of basic female comportment.Footnote ⁴⁵

Selecting a Midwife

One wonders how in this cacophony of advice about what made a midwife ‘good’ and the possibilities of selecting a bad one how families ever landed on a practitioner they were happy with. Surprisingly, it was not a very common topic in family correspondence until the eighteenth century. Firstly, this was because it was hard to secure the services of midwives reliably in advance of birth because as specific (or accurate) as women were in calculating when their ‘reckoning’ was, they might deliver well before or after this date. Secondly, the visibility of these discussions about the expertise of birthing practitioners in medical and popular print appears to have led to more anxiety about the ramifications of bad midwives in the eighteenth century. In this period, the added possibility of hiring a man-midwife meant elite families were faced with new choices to make.

In some circumstances, elite families sought to select and retain a midwife in advance of birth to secure a particular practitioner. Wealthier families tended to pay a midwife to travel sometimes considerable distances and lodge with them for the weeks when the pregnant woman expected to give birth. Joan Thynne wrote to her husband in 1590, asking him and her sister to find a ‘good midwife’ for Easter ‘or ten or twelve days after’ because the midwife that had previously served her in Longleat, ‘goody Barber’, had died.Footnote ⁴⁶ That they found a midwife living in London, a hundred miles away, points to the considerable distances that medical practitioners could travel to serve clients. Elite families relied on recommendations from other family members or similarly wealthy and ascendant friends. In 1698, John Mordaunt reported to his wife that ‘Mrs North’ had been ‘very well [deli]ver’d of another Daughter’ by a midwife from Lynn ‘who, they commend very much’.Footnote ⁴⁷ Midwives were often hired based on recommendation in much the same way as families recommended pregnant women eat certain things or alter things about their routine. Lower down the socio-economic scale, Rebecca Harley of Clapham, thirty-two, asked Richard Napier in 1617 whether she should ‘leave her old midwife’ who was a ‘paynfull & a laborious woman’ because all three of her previous babies had died in or shortly after delivery. She hoped a change might shift her ‘ill lucke’.Footnote ⁴⁸ In smaller communities, there would most often have only been one or two midwives who delivered the majority of babies. Not everyone might have the choice practically and financially that Rebecca did to simply change midwives.

When a midwife proved inept, violent or negligent, families typically sought the advice of other practitioners or even, at times, courts. These records of dispute reveal much about the contours of medical decision-making in the period and how individuals trusted particular medical practitioners. Mistress Newton of Bidnam consulted Napier in 1600 with her uncle, complaining that an ‘unskilfull midwife’ had ‘rent’ [ripped] her womb beyond repair. Goody Parker of Weston also asked for Napier’s assistance when her bladder was ‘perished by the mydwiffes negligenc’.Footnote ⁴⁹ Similarly, when Anne Knutsford, a midwife, was accused of ‘lying, swearing and cursing’ in Nantwich, one witness, Elizabeth Cliffe, described her as a ‘very good midwife’ and indeed ‘one of the best in these parts’ but she behaved in a way that was ‘unbecoming of her sexe and profession to reveale the secrets of women in the time of their extremity’. Thomas Proudman relayed how she was a ‘ready handed woman in her profession’ but ‘given to vaine cursing and swearing’.Footnote ⁵⁰ Such conflicts reveal that some individuals distinguished between the embodied skills of a midwife in facilitating delivery and their bedside manner. Both of these things made someone a ‘good’ practitioner and lacking one could render them undesirable and untrustworthy. A midwife could be good at delivering infants, but not good at managing the social relationships that made birthing a positive experience for families.

Men tended to be particularly taciturn in their diaries or account books about the details of the midwives that they hired. Whereas physicians were often named fully, midwives were often simply ‘the midwife’ in these records. Robert Woodford recorded early in the morning on 29 August 1638 that his wife Hannah ‘began to fall in travell’ [labour] and ‘so the midwife was sent for, and came’.Footnote ⁵¹ The Thynne family book of receipts from 1599 to 1560 listed a reward ‘to the Midwife bringing my Lady abed’ of a son.Footnote ⁵² It was not just parents that paid the midwife or gave her gifts, but grandfathers too. William Jessop wrote to his daughter, Ann Hulton of Hulton Park in 1668, asking if she would ‘give something as from me to y[ou]r Midwife & Nurses employed when litle Jess was borne I think it might doe well and I should take it well giuen’, without bothering to find out or list their individual names.Footnote ⁵³ A Gloucestershire man, John Clifford, recorded giving a sugarloaf to the midwife at his grandson’s christening in February 1676.Footnote ⁵⁴ When Sir Daniel Fleming of Westmoreland’s daughter, Barbara Tathum, gave birth in March 1691, he recorded that his unmarried daughter, Alice, gave the midwife (called ‘Grace-Wife’) two shillings and six pence, and the baby, her god-daughter, one pound. Daniel himself gave the midwife and nurse five shillings.Footnote ⁵⁵ The midwife returned to her home fifty-five miles from Kendal in Wigan shortly after. Fleming recorded the name of the midwife of each of the births of his children, including in 1673 when his wife died ten days after giving birth to a little boy. Mistress Scott delivered eight of the Fleming’s children, Ann Rigg delivered two, Ann Array delivered one and ‘Huff-wife [th]e midwife’ also delivered one. Although Mistress Scot appears to have been the family’s favourite, there was surprisingly little handwringing about getting a different midwife.Footnote ⁵⁶

These glimpses indicate that elite families had considerable buying power in selecting whoever they wanted to deliver their babies and in a style that fitted them. The perceived close and emotional relationship between these practitioners and the family mattered until it was inconvenient for the family in question. Added to this, although midwives were important members of the household for the time they were employed, men were not particularly interested in the details of their work. Although they were often largely uninterested in the individual and personal characteristics of the midwives they hired, they did find these women through recommendation. We see when considering the fuss that surrounded man-midwives that female ones had quite a different experience. Women’s good work did not necessarily follow them in the same way.

The casebooks of three early modern midwives reveal that many families did tend to visit the same midwife habitually. An anonymous London midwife recorded the deliveries she attended between 1694 and 1716. She delivered a number of her own family members. On 17 March 1711, she ‘Laid’ her daughter ‘of a son’.Footnote ⁵⁷ She also delivered her daughter-in-law and her cousins of their children.Footnote ⁵⁸ The frequent mention of the links between patients – in 1713, for example, she ‘Laid in Ms Daingrfilds sister’ – suggests she got business through recommendation.Footnote ⁵⁹ A Cumbrian midwife practicing in Kendal between 1669 and 1675, Elizabeth Thompson, also kept a book recording births. She carefully recorded the profession of the father, whether a shoemaker, shopkeeper, apothecary or vicar. Her clients came from a wide range of professions and social statuses, including three children of Christopher Phillipson of Crooke, a prominent Westmorland gentleman.Footnote ⁶⁰ This reinforces Doreen Evenden’s finding from London midwives’ testimonies that patients were often connected by the professions of their husbands, and midwives had substantial repeat business.Footnote ⁶¹ Katherine Manley, a Whitby midwife, similarly kept a casebook, containing 3,316 deliveries between 1720 and 1764, suggesting that women did often use the same midwife for a succession of deliveries.Footnote ⁶²

These casebooks suggest that when man-midwives fashioned themselves as offering wholistic care during childbearing, they were not really departing from tradition, but they borrowed the model of work that female midwives had been enacting for years before. Man-midwives, for the most part, had university degrees and stressed this as being crucial to being a good and well-rounded practitioner. Female midwives had and continued to provide women assistance in managing maternal health after birth and cooperated with other practitioners to provide the best care. Elizabeth Thompson and Katherine Manley used their books to record several medicinal recipes that were not always directly related to childbearing, suggesting that midwives might minister to multiple members of the family and in more wholistic ways than we might have previously imagined. Thompson kept a recipe for a plaster in the back of her records, now fragmented.Footnote ⁶³ Manley included a receipts ‘to hinder miscarriage’, ‘for a sore breast’, an ‘oyntment for a sweld brest’, one for ‘twisting of the guts’ and a ‘wound water’ in the back of her book.Footnote ⁶⁴ An anonymously penned book of Catholic prayers attributed to a nurse or midwife similarly contains a number of remedies directed towards parturient women and babies, including a receipt ‘for hasting delivery’ and ‘for after Paines in women newly Delivered’.Footnote ⁶⁵ Midwives sometimes visited Forman and Napier on behalf of their own patients when they were unable to travel – another indication that they took on a myriad of medical tasks for women rather than just delivering babies. In 1602, ‘the midwife of newport’ visited Napier on behalf of Mistress Garner. Elisabeth Colman’s midwife, Goody Bird, came to Napier in 1609 for assistance immediately after the birth.Footnote ⁶⁶ It should not be surprising that midwives did more than just deliver babies. Firstly because of the pluralism and fluidity of early modern medical practice, and secondly because of the ways (as we shall see) man-midwives sold themselves as practitioners. Man-midwives represented themselves as departing from tradition, even as they borrowed the model of work from their female counterparts and co-opted for their own gain.

Families wrote much more about their medical decision-making when they were considering hiring a male midwife rather than a female one. Elizabeth Freke recalled in her meditations how the man-midwife that had been employed during her first pregnancy with Ralph in 1675 had judged that the baby was ‘long dead in me’ and started to put on his ‘butchers habit’ to extract the unborn infant in pieces. Just before the man-midwife began the operation, God ‘raised me up a good woman midwife who came in att this juncture of time and for aboutt two or three howrs in her shift worked till by my Gods mercy and providence to me I was saffly delivered’.Footnote ⁶⁷ Mary, Marchioness of Worcester, worried that the midwife her daughter, Elizabeth Lady Bruce, had employed previously was ‘quaking’, or fearful, and that Dr Chamberlen would be more appropriate.Footnote ⁶⁸ Like other decisions about the material preparation for childbirth, men as heads of household were often responsible for adjudicating this choice. In the eighteenth century, Sir John Gordon requested that the Duke of Newcastle allow his wife to be attended by a ‘man midwife’, either Doctor Bamber, Doctor Middleton or Doctor Nesbit. This was to be in addition to a female midwife, Mrs Cannons.Footnote ⁶⁹ Gordon did not clarify the respective role of these practitioners, although as we shall see, it appears not to have been an uncommon practice to hire a female midwife as well as a male one.

Isabella Wentworth entered into lengthy and fraught negotiations with her son, Thomas, to pay for the hefty fees of ‘Dr Chamberlin’, Hugh Chamberlen, the last of five generations of man-midwives, to deliver his wife, Anne, of their first child in 1713. Although Anne was most likely in favour of this option, the enthusiasm and persistence suggests that it was more Isabella’s request than anyone else’s. Tellingly, she asked Thomas not to share her letter or hopes with his wife.Footnote ⁷⁰ Three days later, she wrote again, this time more urgently, stressing that ‘the time drags draws now very near’ and Chamberlen would make Anne, who lost her own mother in childbirth, ‘very esy’. Isabella paints him as a superior and self-important man who ‘is very proud’ and used to being ‘very much Coarted’. He supposedly loved ‘a glass, of good wyne’ and was a ‘very great man’, although it was unclear in this latter observation whether she was referring to his stature or reputation.Footnote ⁷¹ Her following letters employed a number of persuasive tactics to get Thomas to agree to Chamberlen. She described how Anne had shed tears over his resistance. She supplied plentiful testimonies of other aristocratic women who had used his services with great success. Lady Roysten ‘sayde that most had him in the house for it kept the wemen Midwifse in Awe’.Footnote ⁷² Isabella’s own niece had already had ‘five Lovly boys’ by Chamberlen.Footnote ⁷³ Lady Lansdell had been brought to bed ‘of bothe her children’ and Lady Massom consulted him for a number of health issues.Footnote ⁷⁴ To justify his exorbitant fee (a figure she revealed rather late in these exchanges), Isabella stressed that Chamberlen was not merely a midwife but a ‘Dockter to the family’ and had as much ‘pracktiss for Physick as for the other’, and in this role he not only managed delivery but the care of the newborn (a job that we have already seen midwives had always done). He was not, she was at pains to say, as the stereotype suggested, overly interventionist. Isabella described how he had refrained from using any instruments because there might be ‘harm’.Footnote ⁷⁵ As yet another tool of persuasion, Isabella frequently mentioned that Anne’s own mother had died in childbirth, and that selecting a man-midwife would help prevent history repeating itself. She told her son that the cost of Chamberlen was worth securing an heir. She said if the baby was a boy, ‘consider thear is twoe Livse depending upon him [Chamberlen]’, not just his wife’s.Footnote ⁷⁶ What she failed to say in these letters was that they would also hire a female midwife for the birth and that Chamberlen would cost ten times more than her whilst she did most of the work.

Chamberlen’s payment structure was two-tiered. It was possible that man-midwives also borrowed this structure from some female midwives, and particularly the practitioners that elite families employed to live in for weeks surrounding delivery. If parents wished to wait and see whether he was available, he charged thirty guinneys (£31.50).Footnote ⁷⁷ If, however, they wanted to ensure he would be there when the woman went into labour, they could secure his services with a hundred guinneys (£105.00).Footnote ⁷⁸ Isabella pushed for the latter, with a female midwife for ten guinneys. At last, Thomas wrote to Chamberlen formally contracting his services and Isabella was overjoyed. Isabella said they could only ‘imagin how much better it is having him then a woman’, and a recent happy client, Lady Lansdell, had proclaimed that she would pay 500 Guinness ‘rether then not have him’. The Duchess of Buckingham ‘& many moar that he Lays [delivers]’ also attested to his skill.Footnote ⁷⁹ From Isabella’s letters, one might assume that Dr Chamberlen would be the only practitioner serving the family during the birth. Certainly, he was the only one she wrote about. In fact, they also employed a female midwife who did the majority of the work. The ‘woman Midwife’ arrived at 10 pm, shortly after labour began, and assisted until 4 am, when Anne was close to delivery. This was when Chamberlen made his big appearance. As soon as she saw the doctor, ‘she found a great alteration for the better’ and, although it was ‘the strongest part of her Labour’, she did not ‘indure soe much as with the woman’, and was shortly delivered. The narrative is strikingly similar to the one Stone painted of rural midwives that called in men ‘when the Work is near finish’d; and then the Midwife, who has taken all the pains, is accounted of little value, and the young men command all the praise’.Footnote ⁸⁰

The exchanges about Chamberlen in the Wentworth family letters would at first glance wholeheartedly confirm Wilson’s argument that the shift to man-midwives in eighteenth-century Britain was driven by a particular brand of female elite sociability. Isabella reeled off the list of other ladies that had used his services to aide her case. Isabella’s insistence on Chamberlen, however, was much about complying with family expectations and standing than it was about homosocial conviviality. That Isabella perceived Chamberlen to be a better and more qualified practitioner is hardly surprising given the rhetoric man-midwives fostered, and the longstanding attempts of male authors to position themselves as authorities on childbirth. Certainly, the fact that Chamberlen could offer forceps (something Wilson notes often appealed) did not feature prominently in Isabella’s letter. Indeed, the ‘Dockter to the family’ did not seem to offer anything inherently different from a female midwife. Although it is often noted in correspondence that man-midwives were also doctors and therefore more dextrous and adaptable in their practice, they were simply following in the footsteps of female midwives who were intimately involved in the families and communities they served. Male practitioners, however, were seen as offering double the expertise, albeit for sometimes ten times the price. They supposedly combined the superior medical knowledge associated with university-trained physicians with the experience of more irregular practitioners, making them the superior choice. Nancy Tulley, for example, visited a ‘Dr midwife’ in 1701 after being told by a physician she was pregnant and taking medicines to ‘bring the child to maturity’. The man-midwife, using his specialist knowledge, told her she was not pregnant, and got her to stop taking the medication that had made her ‘soe monstrous fatt that shee would have dyed of fatt’. Then she said she was in ‘such good order’ that the ‘Dr midwife’ was sure she would go on to have children.Footnote ⁸¹

Female midwives were never celebrated in the way their later male counterparts were like Chamberlen. This was not because they were any less qualified or because they necessarily came from a more lowly social group than man-midwives, although men like Chamberlen were careful to represent themselves as particularly befitting for elite families. Female midwives were the daughters, wives and widows of parish ministers, barber surgeons, clothworkers, shoemakers, innkeepers and yeomen.Footnote ⁸² They were often literate, and sometimes licenced. They performed important legal, religious, social and medical functions within their communities, and yet by the early eighteenth century, female midwives were increasingly represented as unlearned and incompetent in managing the grave task of birth. The spectre of the bad midwife was dominant in medical writing from the 1650s onwards, and mirrors the ways in which women’s efforts in procreation were similarly embedded within a web of social, emotional and financial imperatives set by the family. It was these same values and priorities that dictated where women would give birth too.

Going ‘Home’ to Give Birth

The retreat of women into a chamber to give birth has been prominent in accounts that argue childbearing took women away from the family and that birth was a moment where the ties of femininity were stronger than those of family, community or even faith. Accounts have envisioned this as a moment where a woman and her friends (gossips) took over domestic space and excluded men. Many women, however, chose to give birth not in their marital homes but in their own or their husband’s family home, and although male family members were not usually permitted in the birthing chamber, they were often downstairs. We have heard how items like linen and clothes for birth helped to cement the social and emotional boundaries of family, as well as how male and female family members were invested in imagining and predicting the character and appearance of unborn babies. Women, by travelling to give birth in their own or their husband’s family home, made their infants literally and symbolically part of the family and its perpetuation. In more practical terms, it also allowed them to take advantage of the emotional and practical support of kin. Anne Clifford recorded that Lady Margaret Coventry ‘deliver’d of a Daughter in her fathers house’, the earl of Thannet in Hothfield.Footnote ⁸³ Elizabeth Freke gave birth at ‘my fathers att Hanington’ along with her aunt and Sir George Norton.Footnote ⁸⁴ Katherine Danby travelled to be with her mother and father to give birth in 1633.Footnote ⁸⁵ The Staffordshire gentleman and landowner Thomas Congreve, who kept a detailed account of business and family affairs, also recorded that his daughters, Isobel and Elizabeth, often returned to their parental or their uncle’s home to give birth.Footnote ⁸⁶ In 1608, Isobel stayed with her father for the ten weeks before she gave birth and for two months afterwards while she recovered.Footnote ⁸⁷ Althea Talbot gave birth to her second child in 1608 while residing with her mother, Anne, countess of Arundel.Footnote ⁸⁸ This was not just an elite practice. Thomas Congreve recorded that his wife’s butler, Jane Pattricke née Blackemore, went to ‘her fathers howse to lye in’.Footnote ⁸⁹ Anne Dey, the servant of Elizabeth Congreve, went to her brother Edward’s house to give birth.Footnote ⁹⁰ Thomas (as their master) was deeply involved in the personal affairs of his servants. His daughter was a gossip at Jane’s birth, and after Anne’s birth, he hosted all the ‘wieves’ at his estate, Stretton Hall.

Family members often moved across the country to be with women when they gave birth. In 1607, Congreve and his wife, Margaret, travelled to Powick in Worcestershire to be with their eldest son, Frances, and his wife, Dorothy, when she gave birth.Footnote ⁹¹ Margaret also travelled to Elizabeth’s home for her second birth.Footnote ⁹² Mary, countess of Warwick, was requested at the deliveries of her niece, Lady Ann Barrington. She reported, ‘I went directly theithar’ when Ann’s pains began and ‘stayed with her all night, she having a most terable sharpe labour. I was exsidingly afraide of her and with much earnestness and many teares begde a safe delivery for her.’Footnote ⁹³ Jane Joselin was present for the births of all her daughters’ first babies, and she offered assistance after birth.Footnote ⁹⁴ The Scottish woman Margaret Cunningham described how her husband’s neglect forced her to beg the vicar and his wife for a ‘birthe chamber’ and care when he threw her and her servant out of the house for sleeping naked together in the same bed in 1604. This was part of her account of her miserable marriage to Sir John Hamilton between 1598 and 1607, written either to justify her legal separation from him or her subsequent remarriage to Sir James Maxell in 1610.Footnote ⁹⁵ For Margaret, the lack of provision of a place within the household to give birth in and support from her husband was key evidence in warranting a separation.

Families did not always discuss which friends or family members would be at births in detail in correspondence and diaries. However, like the choice of practitioner, when someone who was expected to be at the bedside was snubbed or conflict arose, this was worthy of note. Henry Newcome recorded in his diary on 1 March 1662 that his wife had not been called to Mrs Houlbrooke’s labour, which was ‘a pretty vanity of my spirit to be concerned as I felt myself to be this day’.Footnote ⁹⁶ A defamation case from the Durham Consistory Court between Barbara Errington and Alice Coleman in June 1621 suggests that declining to invite certain individuals could be a real insult. In a witness statement, Alice Lambton, claimed that Coleman had arrived late at the childbirth of another woman. When there, she ‘began to find fault’ with the women already present for not inviting her sooner. Errington reportedly told Coleman that if she ‘had been a good neighbour her neighbours would have called her’.Footnote ⁹⁷ There were clear social expectations around birth but families rarely agonised over non-related people who would be present at births, suggesting that the primary importance of such rituals was in cementing familial bonds.

Pregnant women often expressed their fervent desire for their husbands to be in the same house when they gave birth, indicating again a desire to be physically close to family when birthing. Peregrina Chaytor, for example, was deeply worried that she would be separated from her husband when she was pregnant in 1697. She was staying in London and worried that the journey to her home in Croft, Yorkshire, would be a ‘great hassard’ whilst so heavily pregnant, although the company of her husband would make the delivery ‘e[a]sy’.Footnote ⁹⁸ She desperately tried to seek another appropriate place to give birth, although was concerned that it was too expensive to find temporary lodgings and that the cold air rising from the Thames would damage her health. She could not give birth where she was staying because the lack of closet made it unsuitable. Someone called ‘Mrs Brown’ offered her Sir Richard Temple’s apartment for twenty shillings a week, but this was thought to be too noisy. Another option was ‘Mr Grey’s’ apartment, as he was due to depart for Barbados imminently, but his dates were unfixed and his resolve shaky. The instability of arrangements, lack of home comforts and loneliness of being away from her husband and their children made Peregrina uneasy. She complained to her husband that ‘we se[e] littell company soe am lonely anuff for I am not well able to walk’.Footnote ⁹⁹ Eventually, she decided to take Brown’s apartment, but in her next letter complained that the noise was ‘so ill for my head that I think I must ether lyin [lie in] in the room above or have my bed removed in to another part of the room tho they must go away when I am brought to bed for we must have boeth rooms above for that time’. Her lodger was unknown to her and rumoured to be in legal trouble, something she found worrying.Footnote ¹⁰⁰ All of this was exacerbated by her husband’s absence, and at times his infrequent correspondence. In one letter, she expressed that his letters were ‘more pleasing to me then any deversion hear’. Given being cheerful was so important in healthy pregnancy and birth, this was not a flippant remark. Another expressed that if he were there, his presence would quite literally be medicine or ‘the best cordiell’.Footnote ¹⁰¹ It seems that Peregrina did secure her husband’s presence at her delivery. There is a fragment of a draft letter to a male correspondent from William Chaytor in which he excused himself from business because ‘my wife sent for me up shee being soe near her time and she came before her time and the child is since dead’. Another draft to an unknown ‘Madam’ reveals the infant ‘took the gripes’ four days after birth and died when it was eleven days old.Footnote ¹⁰²

Anne, countess of Leven, similarly pined for her husband while pregnant in November 1695, and was worried that he would be unable to be there for the birth. Her mother, Margaret, the countess of Wemyss, sought over several letters to calm her and told her to be ‘wise and kinde to the childe in y[ou]r belly as not to grieve as much as you did last’. The emotional distress brought about by separation could threaten maternal and infant health. Anne’s husband’s ‘presence’ at her birth would be ‘pretious’.Footnote ¹⁰³ When Catherine Danby gave birth in 1632, her mother wrote to her son-in-law congratulating him on the birth of a second son, noting that her ‘paines and weaknes’ prior and during the birth were ‘a[u]gmented by your absence’.Footnote ¹⁰⁴ She fretted that if the child became unwell, they would have to baptise it in his absence, which would be all the more troubling. In these reflections, one senses that male presence and involvement in birth was perceived as essential in anchoring delivery and newborn babies in their proper context: in the family.

Husbands were also central actors in the ceremony of christening. Gossips, or ‘godsiblings’, were not always female (despite later cultural associations). Isabella Twysden listed her brothers as gossips at her delivery.Footnote ¹⁰⁵ Simon Forman was entreated to be a gossip for a man called ‘Fardell’ in 1598.Footnote ¹⁰⁶ This term could occasionally also mean family confidants – Henry, earl of Bath, and his wife Rachel called their respective friends gossips.Footnote ¹⁰⁷ A three-tiered woodcut representing the experience of delivery that was printed in the frontispiece of the 1724 edition of Sharp’s Midwives Book, retitled The Compleat Midwife’s Companion, clearly shows the birthing room as female only (first tier), the baptism/churching ceremonies as male and female (second tier), and the celebrations accompanying delivery and the baptism and churching ceremonies also as a mixed gender affair (third tier) (Figure 4.1). The seemingly private and solely female nature of the birthing chamber has been central in other accounts of childbirth in early modern England, and particularly the ways in which space was temporarily rearranged in women’s favour. As this chapter has shown, however, not only were families and, in particular men, central in driving the choice of birthing practitioner, women often travelled to their natal or husband’s natal homes to deliver. Giving birth, like other medical encounters in early modern Europe, provoked individuals to travel to receive the care they thought would be most beneficial.Footnote ¹⁰⁸ By insisting on the presence of their husbands and fathers, women of different social levels often prioritised family connections over homosocial ones.

Figure 4.1

Jane Sharp, The Compleat Midwife’s Companion: or, The Art of Midwifry Improv’d (London: 1724), frontispiece.

Figure 4.1 Long description

Top Scene. A domestic setting where a woman, possibly a midwife or servant, is tending to a cradle near a fireplace. Another woman, likely the mother, is lying in bed resting, possibly after childbirth. The room is furnished with a chair and a bed, emphasizing a warm and intimate household environment. Middle Scene. A group of well-dressed men and women walking in a procession. The women wear elaborate dresses and hold fans, while the men wear wigs and coats, indicative of aristocratic or upper-class fashion. Bottom Scene. A lively gathering around a table, where elegantly dressed individuals are engaged in conversation and drinking. The table is set with food and drink, indicating a feast or banquet. The participants’ elaborate wigs and clothing suggest a high-society setting.

Wellcome Collection.

Conclusion

As women approached their reckoning day, they had to shoulder the domestic and social expectations of the family, including the possibility that the pregnancy that families had been investing in for many months would end not in the birth of a large, lusty baby but in their own or their child’s death. It is perhaps in the genre of manuscript and printed maternal legacies that women most visibly displayed the ways that birthing served their husband’s family and name.Footnote ¹⁰⁹ When Peregrina Chaytor got closer to birth, she urgently wrote to her husband, setting out her desires and hopes for what might happen if she died. Even in these final difficult weeks and months before birth, women took pains to record parts of their experience that confirmed the ideas that families had about themselves and their identity. Peregrina hoped that her husband would ‘take a true care of and be a verry kind father to’ their children, particularly Tom, who she indicated had been treated too severely in the past. She hoped if at all possible that they should each have ‘som[e] provesion and be put to imployments’. They ought to be led to understand their duty in God. She set out the ways in which she hoped her children, one alive and another not yet born, would be provided for, including the gifting of a locket if the baby was a girl. More instructions followed about how and when the estate should be sold. She hoped he would ‘not take amis[s]’ her directions, an apology which echoed the expectations of conduct writers that women would be ever submissive, even as to give up her body and soul for the furthering of her family. Peregrina’s letter is a far cry from the convivial and profligate spending sprees and lying-ins that reformers worried women might engage in. Peregrina places her delivery within the context of her family, rather than within a female sociable world, even as she faced giving birth outside its confines. As the choice of practitioner and the decisions families made about where women would give birth indicate, bearing children was often aggressively familial and exclusionary. Like the material goods that families gathered, these aspects of preparing for birth were often represented as being ‘given’ to women as a sweetener for the pain and peril to come, but this idea concealed the ways in which gifting, borrowing and negotiating served a greater purpose: it cemented and delineated the family and provided tangible records of duty and approval.