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Blame and Vindication in the Early Modern Birthing Chamber

Published online by Cambridge University Press:  16 November 2012

Lianne McTavish
Lianne McTavish
Affiliation:
Department of History, University of New Brunswick, PO Box 4400, Fredericton, NB, Canada E3B 5A3
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Who was to blame when a labouring woman or her unborn child died during the early modern period? How was responsibility assessed, and who was charged with assessing it? To answer such questions, this article draws on French obstetrical treatises produced by male surgeons and female midwives between 1550 and 1730, focusing on descriptions of difficult deliveries. Sometimes the poor outcome of a labour was blamed on the pregnant woman herself, but more often a particular medical practitioner was implicated. Authors of obstetrical treatises were careful to assign fault when injuries or deaths occurred in cases concerning them. Chirurgiens accoucheurs (surgeon men-midwives) regularly accused female midwives of incompetence, yet also attacked fellow surgeons as well as those male physicians officially superior to them in the medical hierarchy. Female midwives similarly condemned the actions of male practitioners, without hesitating to censure other women when their mismanagement of deliveries had tragic consequences. Part of authors' eagerness to blame others stemmed from the fear of being held accountable for mistakes preceding practitioners had made. Ascribing responsibility usually went hand-in-hand with defensive claims of innocence, or boastful declarations of having saved a suffering woman from the bungling attempts of less skilled birth attendants.

Type
Articles
Information
Medical History , Volume 50 , Issue 4 , 01 October 2006 , pp. 447 - 464
Copyright
Copyright © The Author(s) 2006. Published by Cambridge University Press

References

1 Jacques Gélis, La sage-femme ou le médecin: une nouvelle conception de la vie, Paris, Fayard, 1988, pp. 305, 325, contends that despite expanding their practices, men-midwives exclusively devoted to childbirth remained an exception in France until the nineteenth century, especially in the southern parts of the country. Mireille Laget, Naissances: l'accouchement avant l'âge de la clinique, Paris, Seuil, 1982, p. 211, notes the practice of female midwives declined primarily in large, urban centres.

2 See, for example, Edwin A Jameson, Gynecology and obstetrics, New York, Hoeber, 1936; James V Ricci, The genealogy of gynaecology: history of the development of gynaecology throughout the ages, 2000 B.C.–1800 A.D., Philadelphia, Blakiston, 1943; Theodore Cianfrani, A short history of obstetrics and gynecology, Springfield, IL, Thomas, 1960; Irving S Cutter and Henry R Viets, A short history of midwifery, Philadelphia, Saunders, 1964; and Walter Radcliffe, Milestones in midwifery, Bristol, Wright, 1967.

3 See, for example, the essays in Hilary Marland (ed.), The art of midwifery: early modern midwives in Europe, London, Routledge, 1993.

4 Adrian Wilson, The making of man-midwifery: childbirth in England, 1660–1770, London, UCL Press, 1995, p. 2.

5 Ibid., pp. 185–95.

6Statuts et reiglemens ordonnez pour toutes les matronnes, ou saiges femmes de la ville, faulxbourgs, prevosté, et vicomté de Paris, Paris, n.d. See also Wendy Perkins, Midwifery and medicine in early modern France: Louise Bourgeois, University of Exeter Press, 1996, p. 102.

7 See, for example, Jacques Duval, Traité des hermaphrodits, parties génitales, accouchemens des femmes, Rouen, 1612, p. 196; François Mauriceau, Des maladies des femmes grosses et accouchées, Paris, 1668, pp. 350–1; Philippe Peu, La pratique des accouchemens, Paris, 1694, p. 261; and Pierre Dionis, Traité général des accouchemens, Paris, 1718, p. 228.

8 Wilson, op. cit., note 4 above, p. 97.

9 Peter M Dunn, ‘The Chamberlen family (1560–1728) and obstetric forceps’, Archives of Disease in Childhood, 1999, 81 (3): 232–5; Martial Dumont, ‘Histoire et petite histoire du forceps’, Journal de Gynécologie, Obstétrique, et Biologie, 1984, 13 (7): 743–57; and Laurence Brockliss and Colin Jones, The medical world of early modern France, Oxford, Clarendon, 1997, p. 615.

10 Eduard Kaspar Jakob von Siebold, Essai d'une histoire de l'obstétricie, Paris, Steinheil, 1891–1892, vol. 2, p. 84, argues that the sixteenth-century surgeon Pierre Franco used his speculum as a kind of forceps. See Pierre Franco, Chirurgie, Geneva, Slatkine Reprints, 1972 (orig. 1561), p. 238. G Panel, Jacques Mesnard, chirurgien et accoucheur (1685–1746) et ses oeuvres, Rouen, Lestringant, 1889, p. 25, argues that an instrument used by Mesnard, the tenettes, was in fact a true forceps.

11 I both list and discuss these treatises in my book Childbirth and the display of authority in early modern France, Aldershot, Ashgate, 2005.

12 Ibid., pp. 27–30; and Robert A Erickson, ‘“The books of generation”: some observations on the style of the British midwife books, 1671–1764’, in Paul-Gabriel Boucé (ed.), Sexuality in eighteenth-century Britain, Manchester University Press, 1982, pp. 74–94.

13 Isobel Grundy, ‘Sarah Stone: Enlightenment midwife’, in Roy Porter (ed.), Medicine in the Enlightenment, Amsterdam, Rodopi, 1995, Clio Medica 29, pp. 128–44, and Nina Rattner Gelbart, The king's midwife: a history and mystery of Madame du Coudray, Berkeley, University of California Press, 1998, discuss treatises in terms of reputation. McTavish, op. cit., note 11 above, argues that obstetrical treatises made authors visible (see esp. ch. 2, pp. 57–79).

14 François Mauriceau, Observations sur la grossesse et l'accouchement des femmes, Paris, 1695, pp. 82–3: “La verité de ce triste recit me fut aussi-tost confirmée par un de mes confreres, qui me dit avoir esté mandé à l'heure mesme par ce second Chirurgien, pour faire la reduction des intestins de cette femme qui estoit agonisante, lesquels il trouva tout-à-fait hors de son ventre, tout meurtris, & le mézentere tout déchiré en lambeaux, m'assurant qu'il n'avoit jamais vû un spectacle plus horrible, & en mesme temps plus pitoyable; parce que cette pauvre femme avoit pour lors sept autres petits enfans vivans.” For Mauriceau's biography, see D Ficheux, ‘François Mauriceau, accoucheur sous le Roi Soleil’, Thèse pour le doctorat en médecine, Université d'Amiens, 1985.

15 Mauriceau, Des maladies des femmes grosses et accouchées appeared in four editions during the surgeon man-midwife's lifetime (1668, 1675, 1681, 1694), numerous reprints after his death in 1709, and translations into German, Dutch, Italian, Latin, Flemish, and English.

16 See, for example, Mauriceau, Observations sur la grossesse, op. cit., note 14 above, pp. 15, 35, 153.

17 Peu, op. cit., note 7 above, 347–8: “En presence de Monsieur l'Evêque mon confrére, de Monsieur son gendre, & de Madame Ardon sage-femme, que eurent la charité de me servir d'aide, j'acouchai & délivrai de son premier enfant la femme d'un Marchand fripier nommé Bérnard demeurant ruë de la grande Friperie. Elle étoit depuis vingt-quatre heures dans les convulsions quand j'y allai. Son enfant se trouva mort & à demi corrompu. Je le tirai avec l'instrument. Elle recouvra bien-tôt une santé parfaite & prit mieux ses mesures pour l'avenir. Dirai-je qu'elle avoit été abandonnée d'un homme dont le nom a fait grand bruit & de plusieurs de ses disciples, qui emploiérent beaucoup de spécieux prétextes pour gagner l'esprit de la mére & m'empêcher de sauver la vie à sa fille, se récriant contre ma métode, & s'éforçant par leurs vains discours de sauver leur réputation aux dépens de la mienne.”

18 M. Simon, Factum ou lettre écrite par Mr. Simon à Mr. Peu sur la falsification d'un fait qui se trouve à la fin du premier livre de sa pratique des accouchemens, n.l., n.d. For the section of Peu's treatise attacking Simon see La pratique des accouchemens, op. cit., note 7 above, pp. 252–6.

19 See Mauriceau, op. cit., note 14 above, unpaginated Avertissement, for the most detailed attack on Peu's method.

20 Philippe Peu, Réponse de M. Peu aux observations particulières de M. Mauriceau sur la grossesse et l'accouchement des femmes, n.l., n.d. For Peu's initial critique of Mauriceau's instrument, see ‘Du tire-tête’, La pratique des accouchemens, op. cit., note 7 above, pp. 357–76.

21 I thank Nathalie Comeau for assisting me with this translation and suggesting this interpretation to me.

22 Peu, op. cit., note 7 above, pp. 261, 273.

23 Pierre Amand, Nouvelles observations sur la pratique des accouchements, Paris, 1715, pp. 182–5.

24 Guillaume Mauquest de La Motte, A general treatise of midwifry, trans. Thomas Tomkyns, London, 1746 (orig. French, 1721), pp. 336–7. For a similar story, see Paul Portal, La pratique des accouchemens, Paris, 1685, pp. 49–50.

25 For a discussion of the continuing “diatribe” against traditional midwives in the French literature, see Madeleine Lazard, ‘Médecins contre matrones au 16e siècle: la difficile naissance de l'obstétrique’, in Marc Bertrand (ed.), Popular traditions and learned culture in France, Saratoga, CA, Anma Libri, 1985, pp. 25–41, and Evelyne Berriot-Salvadore, Les femmes dans la société française de la renaissance, Geneva, Droz, 1990, pp. 267–75.

26 For recent publications on Bourgeois, see Philip A Kalisch, Margaret Scobey, and Beatrice J Kalisch, ‘Louyse Bourgeois and the emergence of modern midwifery’, Journal of Nurse Midwifery, 1981, 26 (4): 3–17; Berriot-Salvadore, op. cit., note 25 above, pp. 257–66; Perkins, op. cit., note 6 above; Colette H Winn, ‘De sage (-) femme à sage (-) fille: Louise Boursier, Instructions à ma fille (1626)’, Papers on French Seventeenth-Century Literature, 1997, 24 (46): 61–83; François Rouget, ‘De la sage-femme à la femme sage: réflexion et réflexivité dans les Observations de Louise Boursier’, Papers on French Seventeenth-Century Literature, 1998, 25 (49): 483–96; and Bridgette Sheridan, ‘At birth: the modern state, modern medicine, and the royal midwife Louise Bourgeois in seventeenth-century France’, Dynamis, 1999, 19: 145–66.

27 Louise Bourgeois, Observations diverses sur la stérilité, perte de fruict, foecondité, accouchements et maladies des femmes et enfants nouveaux naiz, ed. Françoise Olive, Paris, Côté-Femmes, 1992 (orig. 1652), pp. 104, 110.

28 Ibid., pp. 204–6.

29 Ibid., p. 206.

30 Many treatises make this distinction. See, for example, Bourgeois, Observations diverses, op. cit., note 27 above, p. 78, and Peu, op. cit., note 7 above, p. 34.

31 Joseph Lévy-Valensi, La médecine et les médecins français au XVIIe siècle, Paris, Baillière, 1933; François Millepierres, La vie quotidienne des médecins au temps de Molière, Paris, Hachette, 1964, pp. 169–87; Jeanne Rigal, ‘Démêlés avec la Faculté de Médecine, 1600–1655’, in idem, La communauté des maîtres-chirurgiens jurés de Paris au XVIIe et au XVIIIe siècle, Paris, Vigot Frères, 1936, pp. 25–42; and Toby Gelfand, Professionalizing modern medicine: Paris surgeons and medical science institutions in the 18th century, Westport, Greenwood, 1980, pp. 21–57.

32 See clause 11 of Statuts et reiglemens ordonnez pour toutes les matronnes, ou saiges femmes de la ville, faulxbourgs, prevosté, et vicomté de Paris.

33 Mauriceau, Des maladies des femmes grosses, op. cit., note 7 above, unpaginated preface, and Dionis, op. cit., note 7 above, p. 291.

34 Mauriceau, Observations sur la grossesse, op. cit., note 14 above, pp. 6–7.

35 Ibid., p. 49.

36 Jean Liébault, Trois livres appartenant aux infirmitez et maladies des femmes, Paris, 1582, a French translation of Liébault's Latin version of Giovanni Marinelli, Le medicine partenenti alle infermità delle donne, Venice, 1574, and Charles de Saint-Germain, Traitté des fausses couches, Paris, 1655. Saint-Germain also wrote L'eschole méthodique et parfaite des sages-femmes, Paris, 1650.

37 Nancy G Siraisi, Medieval and early Renaissance medicine: an introduction to knowledge and practice, University of Chicago Press, 1990, pp. 170–2. Though early obstetrical treatises included relatively few accounts of personal experience in the lying-in chamber, the books gradually included more and by 1695 Mauriceau's text was entirely composed of such stories.

38 For an account of this case, see Ambroise Paré, Des monstres et prodiges, ed. Jean Céard, Geneva, Droz, 1971, pp. xiv–xvi.

39 Louise Bourgeois, Récit véritable de la naissance de Messeigneurs et Dames les enfans de France, ed. François Rouget and Colette H Winn, Geneva, Droz, 2000, pp. 58–9, describes the royal physicians supporting her for the position of royal midwife. For an account of Bourgeois' shifting relationship with male practitioners, see Perkins, op. cit., note 6 above, pp. 99–120.

40 Portal, op. cit., note 24 above, pp. 74, 117, 277.

41 Bourgeois, Observations diverses, op. cit., note 27 above, pp. 64–6. The surgeon Jacques Duval, op. cit., note 7 above, p. 110, claimed midwives frequently caused premature labours in this fashion, killing the child.

42 Bourgeois, Observations diverses, op. cit., note 27 above, p. 188.

43 Ibid., p. 143.

44 Mauriceau, Des maladies des femmes grosses, op. cit., note 7 above, pp. 270, 350. In his preface to the English translation of Mauriceau's treatise, The accomplisht midwife, treating of the diseases of women with child, and in child-bed, London, 1673, Hugh Chamberlen reported that men's use of hooks led to the belief “that where a man comes, one or both must necessarily dye”.

45 Portal, op. cit., note 24 above, p. 275: “Je ne conseilleray jamais à Chirurgien, de travailler aprés un autre, s'il n'est assuré d'un bon succés, parce que l'on blasme toûjours celuy qui travaille le dernier, & qu'on l'accuse de la mort de la Malade.”

46 Mauquest de La Motte, op. cit., note 24 above, p. 338.

47 Peu, op. cit., note 7 above, pp. 426–7.

48 Ibid., p. 155.

49 Mauriceau, Observations sur la grossesse, op. cit., note 14 above, p. 25.

50 For the most detailed account of this pamphlet war, see Wendy Perkins, ‘Midwives versus doctors: the case of Louise Bourgeois’, Seventeenth Century, 1988, 3: 135–57. For the original documents, see François Rouget and Colette H Winn (eds), Récit véritable de la naissance de Messeigneurs et Dames les enfans de France, Geneva, Droz, 2000, in which are reprinted: Rapport de l'ouverture du corps de feu Madame, pp. 108–9, as well as Louise Bourgeois, Fidelle relation de l'accouchement, maladie et ouverture du corps de feu Madame, pp. 99–109, and Charles Guillemeau (attr.), Remonstrance à Madame Bourcier, touchant son apologie, pp. 111–20.

51 Portal, op. cit., note 24 above, p. 349: “Si cette Femme avoit esté une grande Dame, on l'auroit laissée mourir, parce qu'on auroit eu peur d'en avoir du blasme, si elle fust morte.”

52 Mauriceau, Des maladies des femmes grosses, op. cit., note 7 above, p. 350.

53 Ambroise Paré, ‘La manière de extraire les enfans tant mors que vivans hors le ventre de la mère’, Briefve collection de l'administration anatomique, Paris, 1550, pp. 93–4.

54 Dionis, op. cit., note 7 above, pp. 294, 305.

55 Peu, op. cit., note 7, pp. 404–5.

56 Mauriceau, Des maladies des femmes grosses, op. cit., note 7 above, p. 351.

57 Dionis, op. cit., note 7 above, p. 228.

58 Peu, op. cit., note 7 above, p. 496, and Bourgeois, Observations diverses, op. cit., note 27 above, p. 80.

59 Mauquest de La Motte, op. cit., note 24 above, p. 467.

60 Dionis, op. cit., note 7 above, p. 317: “toutes ces femmes ne lui pardonneroient jamais.”

61 Though Renate Blumenfeld-Kosinski, Not of woman born: representations of caesarean birth in medieval and renaissance culture, Ithaca, Cornell University Press, 1990, argues that the post-mortem caesarean operation enabled men to enter the lying-in chamber, historians claim men were usually called too late to perform it (see esp. pp. 74–90). See Mireille Laget, ‘La césarienne ou la tentation de l'impossible: XVIIe et XVIIIe siècle’, Annales de Bretagne et des Pays de l'Ouest, 1979, 86: 177–89.

62 Dionis, op. cit., note 7 above, p. 315.

63 Peu, op. cit., note 7 above, pp. 136–44.

64 Jacques Guillemeau, De l'heureux accouchement des femmes, Paris, 1609, pp. 196–7.

65 Mauquest de La Motte, op. cit., note 24 above, pp. 533–4. Dionis, op. cit., note 7 above, p. 244, advised using surgical instruments only in the presence of another practitioner.

66 Portal, op. cit., note 7 above, pp. 23, 39–40, 98–9.

67 Ibid., p. 163: “de me faire justice, & de ne point me blâmer”.

68 Marguerite de La Marche (du Tertre), Instruction familière et utile aux sages-femmes pour bien pratiquer les accouchemens, Paris, 1710; (orig. 1677). For her biography, see A Delacoux, Biographie des sages-femmes célèbres, anciennes, modernes, contemporaines, Paris, Trinquart, 1833, p. 107. For the training of female midwives in France, see Henriette Carrier, Origines de la Maternité de Paris. Les maîtresses sages-femmes et l'office des accouchées de l'ancien Hôtel-Dieu (1378–1796), Paris, Steinheil, 1888; Marcel Fosseyeux, ‘Sages-femmes et nourrices à Paris au XVIIIe siècle,’ Revue de Paris, October 1921, 19: 535–54; and Berriot-Salvadore, op. cit., note 25 above, pp. 251–3.

69 De La Marche, op. cit., note 68 above, p. 75.

70 Ibid., pp. 79–80.

71 Ibid., unpaginated preface.

72 Cosme Viardel, Observations sur la practique des accouchemens naturels, contre nature & monstrueux, Paris, 1671, p. 221.

73 Mauriceau, Des maladies des femmes grosses, op. cit., note 7 above, p. 350.

74 Bourgeois, Observations diverses, op. cit., note 27 above, p. 55.

75 Ibid., p. 63. In a different situation, the midwife Catharina Schrader wanted to have a surgeon with her “to avoid all scandal” because she was still a relatively inexperienced practitioner. See Hilary Marland (trans. and ed.), “Mother and child were saved”: the memoirs (1693–1740) of the Frisian midwife Catharina Schrader, Amsterdam, Rodopi, 1987, p. 50.

76 Mauquest de La Motte, op. cit., note 24 above, pp. 317–18. Bourgeois, Observations diverses, op. cit., note 27 above, pp. 150–1, described a case in which a surgeon took credit for a delivery managed by two established female midwives. When acting as the exclusive birth assistant at the female client's next delivery, however, the surgeon bungled the job, killing the woman, and providing an apt punishment for her husband, who had failed to recognize the original midwives. Yet Bourgeois (ibid., pp. 70–1) also urged female midwives to summon surgeons rather than to let women die, noting that relying on men was not a sign of dishonour.

77 Portal, op. cit., note 7 above, p. 191.

78 Ibid., p. 88.

79 Baudoin's ‘Lettre sur les accouchements’ is reproduced in Paul-Émile Le Maguet, Le monde médical parisien sous le grand roi, suivi du “portefeuille” de Vallant, Paris, Maloine, 1899, pp. 314–40. Baudoin addressed her letter to Monsieur Vallant, the doctor of Mademoiselle de Guise and Madame de Sablé, indicating she did so at his request, in the hope that he would publish what she wrote to him. The quotation is on page 328: “il est quelquefois impossible de tout detacher et je souhaiterois que messieurs les médecins eussent la charité de ne pas blasmer une sage femme”.

80 When royal physicians performed an autopsy on the body of Madame de Bourbon-Montpensier in 1627, they claimed portions of the placenta remained in the womb, and Bourgeois considered herself blamed for the death of her client. Though modern authors have argued that Bourgeois was not directly accused, it is indeed likely that mentioning the retained afterbirth was meant to accuse her, in keeping with the conventional method of implicating rather than directly naming the guilty party.