Home1842 Edition

MIDWIFERY

Volume 15 · 899 words · 1842 Edition

the art of assisting women in parturition. In a more extended sense, it is understood to comprehend also the treatment of the diseases of women and children. It is obvious that the obstetrical art must have been almost coeval with mankind; but in Europe it continued in a very rude state till the seventeenth century; and even after physic and surgery had become distinct professions, it remained almost totally uncultivated.

It is a curious fact, that in China the very reverse of this has taken place. In that empire, both physic and surgery are still in a state of degradation; but for some hundreds of years, the art of midwifery has, it is said, been practised by a set of men destined to the purpose by order of government. These persons, who hold in society the same rank which lithotomists formerly did in this country, are called in whenever a woman has been above a specified number of hours in labour, and employ a mechanical contrivance for completing the delivery without injury to the infant. A proportional number of such individuals is allotted to each district containing a certain population. It is said, that the Chinese government was led to make this provision for alleviating the sufferings of women in childbirth, in consequence of a representation, that annually many women died undelivered; and that in the majority of cases the cause of obstruction might have been removed by very simple mechanical expedients.

Both Sir George Staunton and Mr Barrow were ignorant of this fact; and the latter in particular expressly mentions that there are no men-midwives in China; but we have learned the facts above stated from a gentleman who resided upwards of twenty years as surgeon to the British factory at Canton, and who had both the ability and the inclination to make himself acquainted, during the course of so long a residence, with all the customs and prejudices of the natives relating to the preservation of human life and health.

Towards the end of the seventeenth century, the same causes which had so long before led to the cultivation of midwifery in China produced the same effect in Europe. The dangers to which women are sometimes exposed during labour excited the compassion of the benevolent; and hence a considerable part of the first hospital which was established for the reception of the indigent sick, the Hôtel Dieu of Paris, was appropriated to lying-in women. The opportunities of practice which that hospital afforded, directed the attention of medical men to the numerous accidents which happen during labour, and to the various diseases which occur after delivery. Public teaching followed, and soon afterwards began the custom of employing men in the practice of midwifery. From this period the art rapidly improved; and it is now in many parts of Europe, particularly in Great Britain, in as great a state of perfection as physic or surgery. There can be no doubt that the improvement of the art of midwifery chiefly arose from medical men directing their attention to the subject; but the propriety of men being employed in such a profession has been much questioned by many individuals of considerable respectability. It appears, indeed, that this question may be brought within a very narrow compass. It may be assumed as a fact established beyond the reach of controversy, that sometimes dangers and difficulties occur during labour, which can be lessened or removed by those only who have an intimate knowledge of the structure of the human body and of the practice of physic. On such occasions, it must be admitted, that medical men alone may be useful. But as such labours occur only in the proportion of two or three in the hundred, the general practice might be confided to midwives, if they could be taught to manage ordinary cases, and to foresee and distinguish difficulties or dangers, so as to procure in sufficient time additional assistance. It is on this point that the decision of the question must depend, and there can be no doubt that women may be taught all this. But there are many who allege, that a little knowledge being a dangerous thing, midwives acquire a self-sufficiency which renders them averse to calling in superior assistance; and that, in consequence, they often occasion the most deplorable accidents both to the mother and the child. In England this is the popular opinion; and hence women are there almost entirely excluded from the practice of midwifery. A similar prejudice against midwives has, it is believed, begun in some parts of Scotland; but it is presumed this will gradually cease, when it is considered that, in general, the Scotch midwives are regularly instructed, and are at the same time both virtuous and industrious. If they attend strictly to their duty, and invariably prefer the safety of their patients to their own feelings or supposed interest, they will deservedly retain the public confidence. But if in cases of difficulty or danger they trust to their own exertions, or from interested motives decline the assistance of able practitioners, and if they interfere in the treatment of the diseases of women and children, they will in a few years be entirely excluded from practice. For details connected with the practice of midwifery, we refer to the professional works which treat of the subject, and which are too well known to require specification.