A Treatise on the Art of Midwifery / Setting Forth Various Abuses Therein, Especially as to the Practice With Instruments: the Whole Serving to Put All Rational Inquirers in a Fair Way of Very Safely Forming Their Own Judgement Upon the Question; Which It Is Best to Employ, in Cases of Pregnancy and Lying-in, a Man-midwife; Or, a Midwife

Say what you will, the fashion will predominate. It is now the fashion to prefer men-practitioners of midwifery to midwives. You will oppose the torrent in vain.

ANSWER.

The conclusion against me that I shall oppose the torrent in vain, is a very just one. As to myself, I ought to expect that I should oppose it in vain, if the decision of the public was to turn upon any thing of so little authority as my private opinion, especially in a point where it is so justly liable to the suspicion of its being byassed, both by private interest, and partiality to my own sex. I readily then grant that my own opinion should go for nothing. But what ought to go for a great deal is my reader’s own judgment, formed upon his own reason and knowledge. But that is not all. I have some dependence on Nature and common sense recovering their rights, from this preference of the men-midwives which shocks both, being, in truth, nothing more than a fashion, not even of the growth of this country, but transplanted from a neighbouring one, whose follies are unhappily so contagious, though for the most part so despicable. How a few interested men, for want of business in their own professions, transplanted this baneful exotic here, where it has met with such undue cherishment has already been touched upon.

But then as this unnatural preference has all the folly and whim of fashion in it, it may be hoped, that it will also have all the instability and transitoriness of one. Time that confirms the dictates of Nature destroys the fictions of opinion. But in points where Nature is herself attacked or injured, inconveniencies and damages never fail of following thereon, enough to oppose the duration of them. The numbers of lying-in women (thanks to beneficent Nature) rather not destroyed than duly assisted by the men-operators, can neither atone for those who perish, sometimes the mother, sometimes the child, sometimes both, while none of them are but sufferers in some degree; nor long blind a public, that has so much interest not to be imposed upon in a matter so essential to it, by false pretences, or by an injurious and interested degradation of the midwives, who at the worst can hardly be so bad as the very best of the men, in the capital point of their business, the manual function. The oftenest greater danger, and always the greater pain, under men-operators than under the midwives hands will, sooner or later, determine the parties concerned to open their eyes on their greatest interest, in a point of such infinite importance to them.

Granting then to Fashion all the power it really has, and a greater one it is, than for the honor of human kind, can well be imagined, still, it not only has its limits of extension, but duration. It is only for the truth of Nature to be universal and eternal.

Fashion, it is true, may not only govern people in indifferent matters, such as dress, furniture, equipage, or so forth, but even in essential, even in capital ones, such, for example, as is this point of option between the men-operators and the midwives: it may, in short, exert its tyranny in many things, one would rather think left better to the determination of Reason. But then this tyranny cannot well be long-lived. The evils which such a fashion begets destroy at length their own parent. No opinion then, as I have before observed, can be permanent that is not founded on the truth of Nature: but where the consequences of such an opinion are detrimental to the good of society, which is the darling object of Nature; that spirit of self-preservation which she has so manifestly diffused thro’ human kind, will hardly suffer errors pernicious to it long to subsist. There is no fashion can, under such objections, long hold out against victorious Nature, who is sure to revenge the violences offered her.

And here I even officiously seize on an occasion that rises to me out of the very bowels, I may say, of my subject, of selecting for one proof of the danger of adopting innovations offensive to Nature, a point of such near analogy to midwifery, as that of nursing children, the care of whom, next to that of the mothers, is the true midwife’s tender province.

I wish then that those, who too readily admit that this so recent a fashion of employing men-midwives preferable to female ones, is an improvement receivable on the foot of its supposed advantage to human kind, would consider a little the actual consequences of having flown in the face of Nature with respect to the bringing up young children, in a way scarce more foreign from her dictates, than that of men delivering women. That women are by Nature herself formed for the office of aiding women in their lying-in; that they are also formed to bring up children by the breast, are two parts of their destination by Nature, which in all ages, and in all countries seem to have born little or no controversy. Interest has lately invaded both these provinces. With this difference, that as to the first, that of women supplanted in their business of delivering women, an active interest has prevailed; as in that of denying the female breast to children, it is a purely passive one^[19]; and we shall soon see what a dreadful effect this sacrifice of Nature to interest has produced.

As to the mischief produced by the other, of the implicitly excluding the women from midwifery, by the power of prejudice and fashion, it is not, as yet, of a Nature for obvious reasons quite so susceptible of proof, though most certainly not the less therefore existent. And that mischief is palpably owing to the gain which the men-midwives find or presume in the exercise of that profession. This is the active interest: that end to which the means give so justly the construction of base and sordid. The rich are the object of this wretched imposition, which will probably last so much the longer, for the interest to be found in imposing upon them.

But for the denying the female breast to children; it has not indeed passed hitherto into a tenet, that children may as well be reared by the spoon as by the breast, because there is not that prospect of the place of a dry-nurse being as lucrative as that of a man-midwife. If it was so, I should not dispair of seeing a great he-fellow florishing a pap-spoon as well as a forceps, or of the public being enlightened by learned tracts and disputations, stuffed full of Greek and Latin technical terms, to prove, that water-gruel or scotch-porridge was a much more healthy aliment for new-born infants than the milk of the female breast, and that is was safer for a man to dandle a baby than for an insignificant woman.

As this unnatural treatment then of children is almost entirely as yet confined to the very poor, that is to say, to new-born babes thrown upon the public CHARITY for their SUSTENANCE, the rearing by the spoon is not yet regularly established as a general doctrine, it is only admitted in Practice! As proper wet-nurses, from the difficulty in procuring them, might be dearer than dry ones; the cheapest method is preferred, and forms a kind of passive interest or saving œconomy.

But what are the consequences of this violation of Nature, in the grudging her peculiarly appointed aliment to these poor little candidates for life? What follows the substituting, for cheapness-sake, such food as is meant to be afforded them, and is perhaps sometimes even not given them? Death. Death with all that cruelty of torture that attends atrophy or inanition. Thus perish these miserable victims to the false opinion, that the course of Nature can be changed with impunity. I have said here false opinion only, because, with all the obduracy of heart that the spirit of interest so notoriously creates, with all the crimes it so often produces, I cannot think, that such an horror, as the murder of so many innocents, can be entirely imputed to interest without ignorance coming in for its share, though interest has doubtless contributed to the so long continuance of it.

If that maxim is not a false one, that he who knowingly suffers an innocent person to perish, and can help it, is actually guilty of murder: and I prefer here the term of guilty to that of accessary; because I am told, that where there is guilt of murder, all are in the eye of equity and law, principals. Ignorance then, of the sure murder of these innocents by their method of treatment, can be the only plea for those to whom the national charity had committed the care of them. I should think too, that even I myself sinned against charity, if I did not believe, that there is none of those trustees of the poor children, that would not shudder at the thought, of himself taking an infant up by the leg and dashing its brains out against the wall. And yet that would be balmy mercy, the dispatch considered, compared to the lingering tortures, in which those poor little creatures must expire, in the common way of parish-nursing. What is certain however is, that Death would scarce more assuredly be the consequence of the child’s brains being at once beat out, than of that impropriety of aliment, which in the mildest construction is owing to an error in opinion or belief, that any aliment could be salutarily substituted to the one dictated by Nature.

I have here mentioned barely impropriety, or sometimes negation of aliment, without allowance for other causes of destruction to those infants, such as cold, bad air, uncleanliness, neglect of due attendence, or deficiency, in short, of requisites, which are not to be expected from the very poorer sort of the people, to whom the rearing of those infants is generally committed. But that omission of mine is neither undesigned nor unfair. I presume I shall have the greatest physicians on my side, in averring, that even new-born babes are endowed with a surprizing hardiness. Their little seemingly so delicate bodies bear cold to a degree scarcely credible, but from the commonness of both observation and practice, that they only thrive the better for immersions in cold water. Cleanliness, a good air, and attendence, have doubtless indeed some share in the well-doing of children of that age: but all together are in no degree of comparison to the importance of bestowing on children their appropriate aliment. The physical disquisitions into the reason of this do not belong to me here: nor are a few instances of infants reared by the spoon any valid justification for breaking the general rule of Nature, assigning to the female breast the nutrition of children: of which too there is this salutary consequence, that in the very act of lactation there is, by Nature, generated such an indearment of the suckled child to the nurse^[20], as that she who began it perhaps only for hire, finds herself engaged by a growing affection to supply in some measure the place of the mother to the orphan or deserted babe. The rearing by the spoon is so far from inspiring any such dearness, that the innocent infant is considered only as an embarrassment, of which the quicker the riddance, in the death of the brat, so much the better.

The opinion, however, that this one of the greatest institutes of Nature for the preservation of the species, for which she has so admirably organized the female breast, could be dispensed with in favor of a most sordid savingness, has alone caused more human sacrifices, to that black Demon of Interest, than probably were ever made to the “grim idol of” Moloch in the valley of Hinnom, while the cries of the poor children could not be heard by ears closely stopped up in honor of that infernal spirit.

But if any reader should imagine that I here invent any thing, or that, in favor of my inference of danger from the case of revolting against the unalterable institutes of Nature, I have exagerated matters, nothing will be more easy, nor probably at the same more shocking, than the procuring himself a proof of the scarce not actual murders I have mentioned.

The parish-registers of this great metropolis are, I presume, open for inspection. There needs but to examine them, to discover the red-letter catalogue of the armies of innocents that have been put to death under the management of the charity destined to preserve their life. There will be found not one but many, even of the most populous parishes, where for fourteen, twenty, or more years, not one poor babe of the thousands taken in have escaped the general destruction, and sacrifice to that inhuman fiend of Hell, Interest. Here with what propriety might Nature borrow from one of her most dutiful children and darling, the following exclamation,

This is so rigidly true of some parishes, that if I am not misinformed, the verification was not long ago made, as to one of them before a court of justice, of not a single infant having been brought up in the term of fourteen years. And I could name another, in which, during the course of above twenty years, ALL, ALL the new-born children that fell under the administration of the Parish-Charity, perished, except one boy, of whom it is recorded as a prodigy, that he lived till he was five years of age, when he filled up the number, and died like the rest. Will any one here say, that this TOTAL mortality was purely accidental?

But this can be no wonder to those who know there is such an expression, even proverbially in use, as that of children being a BURTHEN to the parish. An expression of which it is hard to pronounce whether it is more execrable or more silly. But what is so inconsequential as the spirit, or rather the no-spirit of interest? Children may indeed be a burthen to private families; and yet for the sweetness of it, how chearfully is it oftenest born, or with very few extraordinary exceptions to the general rule? But to a nation, or what is the same thing, to the lawful representative of the nation, a parish, what can be on earth a falser light to view children in, than that of a burthen? What could be so intolerable in the sum to be added to that actually paid for their being worse than murdered out of hand, to save their little lives, and bring them up to that age, in which the national wisdom should have established for them, at once, the means of earning their likelihood, and of earning it with such beneficial retribution to their truly mother-country, as should amply reward her for her not having neglected the duties of humanity towards them? All the good, all the sensible part of mankind allow, that the true riches of a state, are in the numerousness of it subjects. Trade, arts, the navy, the militia, our colonies all open inexhaustible channels of employment and maintenance. And yet there are who can call children, those children too of the public, not in a ludicrous, but in the dearest tenderest sense, since in the public they ought to find that office of a parent, of which the guilt, the inability, the want of nature in their natural relations, or their death may have defrauded them; there are, I say, who can call such children a burthen! We complain of the defect of population, and yet have seen interest creative of obduracy, and perpetuating ignorance and error, manifestly thinning the species, by nipping those tender blossoms of human kind.

Here, if this notice of the treatment of children should even appear a digression, I should, in favor of the intention, hope forgiveness from a humane reader. He would scarce impute it to me as matter for criticism, the having sacrificed propriety to the introduction of a point so important to humanity. But the truth is, that neither as a digression, nor as a false or over-strained argument, nor as a misapplication, can the same well be considered, by any who will withal consider its strict affinity in so many points to the subject of which I am treating.

It will readily appear, that both these violences offered to Nature in the substituting the men-midwives to the females, and dry-nurses to wet-ones, acknowledge exactly the same common parent, interest, and have exactly the same common effect, the destruction of infants. Is it then possible to be too much on one’s guard against those so flagrant impositions, which are the offspring of that proof-hardened passion? Is any thing sacred from it, since the lives of innocents palpably have not been so, in one branch of practice, nor very presumably are one jot more respected in the other? It is true indeed, that the practice of employing dry-nurses has not yet ascended much among the great and rich; first, because fashions rarely do ascend from the lower classes of life, and next, because there is no such temptation of actual lucre to defend or spread it: but as to that of preferring men-midwives, nothing is so likely as its descending, as it is so much the nature of fashion to descend, and none are more readily adopted by the lower ranks of people from the higher ones, than those fashions which are the most foolish and the most pernicious. And certainly this is not the one that the least deserves those epithets.

Was it not for this influence of the fashion, in making the most unreasonable as well as the most dangerous things pass into practice from the highest down to the lowest life, many an honest man might escape the bad consequences of his following the example of those, than whom none are so liable to be imposed on in such matters, the great and the opulent. These make it worth the while of interested persons to deceive them, and thus often for being cheated, pay with their money, their health, and even with their lives. In the mean time, many who are seduced by the vogue in which they see the men-midwives, employ them on a principle which cannot be enough commended, their natural affection to their wives and children. The reasoning which occurs to a husband in middling or low life on this occasion is probably as follows. “My wife and child are full as dear to me as those of the greatest man in the kingdom are to him, and shall I grudge a little more expence in the provision for their greater safety?” So far he reasons right: all his mistake lies in taking too readily for granted, that same greater safety, to be on the side of the men-practitioners in preference to the midwives, because the former are employed by the great, who, by the by, consult Nature the least of any class of life, even in points of their own health. And certainly in many respects to that sine-quo-non of human happiness, the great had better follow the example even of the poor, than the poor theirs. Make the most then of your reasoning from the prevalence of fashion, the gout and the men-midwives, well considered, are no very enviable appendixes of high-life.

If in some that laudable tenderness for mother and child, is the determining consideration for employing a man-midwife by whom Nature, if consulted, would assure all concerned, that the safety of both was more likely to be endangered than not, there are others again, in whom calling in the aid of a man-midwife is rather matter of luxury, of parade or ostentation, than of opinion of superior safety. These are of that imitative kind of beings, with whom the preference of a man-practitioner for the conducting of his wife’s lying-in, turns upon no other motive, than what would equally make them bestow a silk gown of a new fashion, or a laced-head upon her; from a spirit of emulation of some neighbour or superior.

But what is more surprizing yet, is that notwithstanding the kind of loathing and repugnance with which Nature inspires the women to receive such an office from a man, as that of delivering them, a repugnance to which they had so much better listen, since it has all the characters of a salutary instinct; there are women so weak, as not only not to represent to their husbands the expedience of examining, at least, the propriety of such a fashion, before they blindly adopt it on the faith either of others liable to be deceived, or of those interested in the deceiving them; but who even, in a ridiculous complaisance to that fashion, of which themselves and children are not unlikely to be the victims, will make a point of being attended by a man-midwife, by way of a piece of state.

I have myself known women so infected by this silly vanity, that on receiving visits from their friends after lying-in, and being delivered by a woman, with the utmost safety and satisfaction to them, have been ashamed of having had the better sense and regard for themselves, to employ a midwife in defiance of the fashion, and have told their friends, that it is true Mrs. —— had lain them, but that there was a Doctor at hand in the next room. This by the by was false, for such a Led-Doctor is neither needed nor employed, where a midwife that knows her business is called. If any occasion for medical or even chirurgical skill arises from the complication of a case, there is always time to have the advice of a regular physician, or a regular surgeon, because that complication can never escape timely notice. It can only then be, for the sake of his iron and steel instruments, that a man-midwife has so much as the pretext of being necessary, and I hope to prove, that all the needful can be much better done without them. Yes, I repeat it, better done without them.

For here and throughout the reader will please to observe, that it is on the superiority of safety in employing midwives that I impugn the growing fashion of a recourse to men-practitioners. It is the side of Nature I take against a set of mean mercenaries, who commit the cruellest outrages upon her, under the falsest of all pretences in them, that of assisting her. I would not be so criminal as to wish the benefit of a false argument, in a point of life and death to those mothers and children, my tender care, even could I be silly enough to imagine, that I could pass such an one upon my reader. I wave therefore all plea of the novelty of this upstart profession of men-midwives. Such a plea I readily confess is not receivable. Were It so, how many valuable discoveries or improvements must have been stifled in their birth, if the objection to their being novelties was a valid one? All that I would contend for is, that an innovation should not be admitted only because it is an innovation; and that the decision of a matter of such capital importance, is better left to Reason, always herself submissive to Nature, than abandoned to Fashion, which so often acknowledges no other jurisdiction than that of whim or humor.

There is no prescription for error, no sanction in custom against improvements. But certainly in such a capital point as the life of so many human creatures, in short, in one of the most sacred objects of government, that of population, such a novelty as that of bringing men-midwives into general practice, requires rather a greater authority than that of Fashion, while there is such a standard of essay as Reason.

Inoculation was not long since a novelty in this nation. The lady who introduced it, for any thing I know to the contrary, still lives to enjoy the honor of having procured so great a benefit to mankind. But then this benefit would bear the fairest of all trials, that of calculation: for what is reason itself but another word for calculation? The procuring then the small-pox by inoculation, in a body duly prepared, and especially at an eligible age, affords, according to the doctrine of chances, so much a fairer prospect of safety, than in the case of a spontaneous or accidental infection, that nothing scarcely could be imagined more friendly to Nature than such a rational prevention of her danger, from a distemper too rarely escaped, for the possibility of that escape to be employed as an argument against such a method of prevention. Here then the seeming violence offered to Nature, appeals for its justification to Nature, Reason and Experience.

Consult Nature as to this innovation in the employing men-practitioners preferably to the midwives, who have been for ages, and so universally considered as the properest for that function. Nature will tell you, that it is injuring her to suspect her of being so cruel a mother-in-law, as to deny her tenderest production the female sex sufficient succors within herself, or leave women under a necessity of recurring to men for aid in their greatest need of it, during those sufferings, to which it has pleased the great master of Nature to subject peculiarly the women. If Nature then is but another name for his Fiat through all his works, never was his will more plainly signified than by her voice in this point: a repugnance in both sexes to that office being administered by a man. A repugnance which is not even one of Nature’s least remarkable signs of abhorrence from this innovation, and is only to be surmounted in the men by interest, and in the women by their false fear, or what is weaker yet, by their rage in following that bell-weather Fashion, though it should lead them like sheep to the slaughter. The uncouthness and inaptitude of the men, so ill compensated by their miserable inventions of iron and steel instruments, form another loud protest of Nature against this important function being committed to men-operators.

But while it is to the tribunal of Nature, of Reason, and of Experience, that I presume to wish that this same Fashion might be brought; I readily acknowledge its force though not its justice. I feel the power of it, with pain, for the sake of humanity^[21]! My opposition then to this fashion is rather founded in duty than in hope. The weakness of it will probably furnish fashion only a new matter of triumph, not indeed over me who am too low for it, but over the welfare of mankind, which it has often, in more points than this, the pleasure to see sacrificed to it, though in not one perhaps more palpably than in this one.

In the mean time it might be worth the while of even those who not being themselves men-midwives, nor having any personal interest in patronizing them, owe their favorable notion of them to their own fair judgment; it would, I say, even be worth their while to consider that there may possibly be a time, when they may themselves see reason to change that judgment of theirs. They may possibly discover the illusions of interest, under the old stale mask of service to the public. They may find out the folly of fashion. But will not it be too late, when that fury of fashion shall, like a pestilence, have either swept away the good midwives, or at least have so thinned their numbers, as not to leave enough for the demand of the service? They must in time become, to all intents and purposes, like an old obsolete law, as effectually abolished by disuse, as if abrogated by a formal repeal. “The matter would not be much if they were,” an instrumentarian will probably say, but I doubt much, whatever he might gain by it, whether mankind or population would profit much by that extermination, even though the men-midwives with their tire-têtes, crotchets, and forceps, were to succeed to their business.

And that such an extermination is far from improbable, will appear no strained inference to those who consider the power of Fashion, which establishes its tyranny, much as the first Roman emperors did theirs over that commonwealth, by leaving a semblance of liberty without the substance; whence the baneful effects do not the less follow, or rather the more surely follow. Thus there is indeed as yet no act of parliament for the preference of men-practitioners or the extinction of the midwives, but the statutes of fashion are not only more forcible than any act of a human legislature, but, in this matter even than the laws of Nature herself tho’ inculcating their observance, under pain of death, or at the least of severe corporal punishment; such as being torn with cold pinchers, or cut or punctured with instruments, or put to more pain than necessary.

Already has fashion driven numbers of women out of their livelihood to make way for the encroachments of the men on the female provinces of industry, though there never was a time, in which it was not a just complaint that there were rather much too few means of employment for women. Fashion has determined it otherwise, and many callings formerly appropriated to females are now exercised by men.

But as to this profession of midwifery, even the total extinction of the real midwives, would not be perhaps so bad as giving that name to those poor creatures in training under the men-practitioners, who independently of their own incapacity of practice, consequently of forming good practitioners, have a palpable interest not to suffer their women-pupils to gain any eminence in the profession that might give umbrage to themselves^[22]. The midwives whom these men-practitioners would perhaps gratiously allow to subsist, might to their own insufficiency add the dangerous circumstance of creating, or at least of not preventing, by duly exerting themselves in the predisposing part, the necessity of calling in their protectors, especially where recommended by them. Not that I imagine even these mock-midwives would wilfully be guilty of such prevarication in their duty. For them not to deserve such a suspicion, it is enough that they are women, consequently tender-hearted. But that does not exclude the idea of weakness. But where so fair a virtue as gratitude may disguise even from themselves the fouler motive of interest lurking at bottom, if that tenderness is not even destroyed, it may not impossibly be made a tool of, and join in persuading them, that things had really better be left to the men-practitioners, whose creatures and devotees they are. Thence a negligence superadded to their defect of skill. Such subalterns then would, at least, not be dis-inclined to the “FINDING” themselves “AT A LOSS”, or yet worse for the patient, have by their omissions, if not commissions, bred the occasion of “finding” themselves “at that loss”, even mechanically, and without the direct design of paying their court to their recommending “accoucheur, their man of honor and real friend,” in a candid recourse to him. Pity it were indeed that so charming a harmony should not subsist between the accoucheurs and such midwives, for the “MUTUAL ADVANTAGE” of both! A harmony, which however could hardly be established but at the expence of the sacrificed patients.

And here I appeal to the reader’s own fair judgment, whether I over-strain the consequence against such wretched creatures as they cannot but be who must, for bread, be so subservient to the men-midwives, and be what the French call, their âmes damnées (souls sold). Can any thing be more probable than that these good women dignified by the men-practitioners, out of their special grace and favor with the title of midwives, will on all occasion consult the “advantage” of their kind patrons and “real friends”. And how can that advantage be better consulted than by bungling their work so as to make it appear necessary to have a candid recourse to the good Doctor, who recommended and warranted them? can it, in short, be imagined, that they will be less mere machines than Dr. Smellie’s Dolls, or indeed furnish less occasion, than the education under those Dolls, for the iron and steel instruments, which are the most part understood to be indispensably necessary where the midwife shall have failed. And as to such midwives as have been formed or recommended by the men-practitioners, their not failing would indeed be the wonder!

I know indeed that Dr. Smellie (page 2. of his introduction) attributes the opposition made by the Athenian women^[23] to the prohibition of midwives, and to the acceptance of men-practitioners in their room to “mistaken modesty.” It may however with more reason and truth be averred, that the admittence of men to that function by women, would be in the women a most egregiously MISTAKEN IMMODESTY. Since, surely the virtue or grace of female modesty is not an object to be held so cheap, as to be sacrificed for worse than nothing, for nothing better, in short, than the purchase with it of danger or perdition to both the mother and child. After so valuable a sacrifice as that of modesty itself, it may perhaps sound mean to add any thing comparatively, so trifling as that of the hire not given to the person who prostitutes herself in some sort on a so much mistaken hope, but to the very person to whom she is prostituted in that hope of superior safety.

I am not then here to assume a character, that would become me so ill, of a Casuist or Divine, by pretending to fix the degree of moral turpitude in the submission of modest women to a practice, which, I will even allow might be justified by the superior consideration of safety to two lives, if that consideration was not a question most impudently begged, with so little foundation, that the very contrary thereof is the truth.

Neither would I here incur the just charge of impertinence, in giving my private and insignificant opinion on an undecency so unwarranted by any necessity. That would look too like dictating to others, what they are to think of a practice, of which every one will doubtless judge for himself. The boundaries of female modesty are so well known, and so ascertained by common consent, that surely it little belongs to me to offer new lights upon that subject.

What I have then to say, on this head, is purely in justification of that modesty, which the men-midwives are for obvious reasons pleased to call a false one, though so far as it pleads for excluding them, it is an ingratitude to that Nature, of which it is the peculiar gift to the female sex, not to term it even a wise virtue.

Society especially stands indebted to Nature for her suggestion of modesty in this point. If in all ages, in all civilized countries, the wife is considered as the peculiar property of a husband, insomuch, that all laws human and divine consecrate, if I may use the expression, to him alone, exclusive of all other men, the access to the reserved parts of the wife’s body, certainly such a privilege can hardly be thought lightly communicable. And what can be more so than suffering a man, mercenarily or wantonly, or perhaps both, to invade that so sacred property, under the mask of a service, for which he is by Nature so evidently disqualified? While Nature too has made so ample a provision for this very service, in fitting the women for it, with so much more propriety and safety, both to the concern of the public in the welfare of population, as well as to the domestic honor of families, which is not without some danger, at least, from the practice of midwifery being in the hands of men.

As to this last averment of mine, the truth of it is so glaring, that it does not even need Dr. Smellie’s own implicit confession of it, in his instructions to the men-practitioners in general, or, if you please, to his more than nine hundred pupils.

“He (the Accoucheur) ought to ACT and SPEAK with the utmost DELICACY of DECORUM, and NEVER VIOLATE the TRUST reposed in him, so as to harbour the least IMMORAL or INDECENT design; but demean himself in all respects suitable to the DIGNITY of his PROFESSION,” p. 447.

Here I confess myself so smitten with the propriety and sanctity of the precept of the good Doctor’s, and particularly with the needfulness of it, that I would advise every man-practitioner of midwifery, of a certain age that might require it, to have the said commandment wrote out in gold letters, and wear it about his arm, especially on his proceeding to officiate, by way of amulet, phylactery or preservative against any incident temptation to violate his trust, or to fall off from the high dignity of his profession. All that I fear is, that its virtue may not always be to be depended upon, against the energy planted by nature in the difference of the sexes. No one would be farther than I from the cruel injustice of drawing consequences unfavorable to any set of men, from the misconduct of any particular individual in it.^[24]Errors are purely personal. If I then so much as mention the case of a man-midwife convicted of having debauched a gentleman’s wife, in consequence of his admission to the practice of his profession of midwifery upon her, it is by no means neither with a design to insult the unhappy criminals, nor to draw from thence an inference to the disfavor of the men-practitioners in this point, beyond what I am authorized by the constancy of the temptation from Nature, to all, yes, to all, who, by their age, in one sex, are not past it: I say in one sex, because in the other, the female, the very circumstances of a woman’s needing a midwife, shews that she is not past the age of, at least, causing a temptation. Further, it would even be a matter of argument on the side of the men-midwives, that so few instances come to the knowledge of the public, of the ill-consequence of a practice which breaks down the capital barriers of modesty; if those ill-consequences were not, in the nature of them, not only a secret, but easy to be kept secret. Who would complain but the husband or relations of transactions between a man-midwife and his patient? But then how seldom need a third to be let into such a secret?

I would not then have the men-midwives to be too forward to treat the modesty of the women on this head as a false one, or their scruples as a weakness. Modesty in this case is not only the safeguard of the lives of themselves and children, but of their own honor, which if it does not receive an actual fall in such a subjection to a man-midwife, had perhaps better not be so unnecessarily risked so near the brink of the precipice.

I am not writing here for Italians or Spaniards, or any of the inhabitants of those countries who are so prone to jealousy, perhaps because they know their women. I am now addressing myself to Englishmen, not jealous, because, if they know theirs, they must know that, in proportion to the number, no women on the earth have more of the reality of virtue and modesty. I will not suppose then any thing so offensive, as that the chastity of the generality of them is not infinitely superior to the advantages or overtures for design afforded the men admitted to such a privacy, as that of attending them in their lying-in and delivering them. But would the honestest woman, or one however sure of herself or of her virtue, think it eligible, without a full satisfactory proof of that superior safety, which is her object in preferring men-midwives, to be herself the occasion of temptation to those people? How can she answer that she will not be it? In that so formidable army of mercenaries, actually continuing to form itself under the banners of Fashion, and headed by Interest, can she answer that the insensible stoics of it, will fall to her share? Would a woman, I will not say, of strict principles of honor, but barely of not the most abandoned ones, submit herself in the manner she must to a man-midwife, on her employing him, if she would but satisfy herself, as she easily may, that his aid cannot be more effectual than that of a woman? But what! if it is most undoubtedly a less safe one?

But this is far from all to be objected on the head of modesty to this practice. The opportunities, if not of temptation, if not of seduction by it, at least of offensiveness to female reserve are such, as would make even a husband, the least susceptible of jealousy, so uneasy for the outrages to which the employing of a man-midwife in the course of his wife’s pregnancy and delivery might expose her, as would make him think it no indifferent point for his judgment to settle whether such outrages might not better be spared her. It will not I presume be denied, that all female modesty is a flower, the delicacy of which cannot be too much guarded against any tendency to blast it, and that nothing can threaten more that effect, than such infringements of the unity of a husband’s privilege in the sole incommunicable possession of his wife’s body, as are implied in the course of a man-midwife’s attendance. An unity of privilege, which, when broke in one point, does not always stop at that, but may proceed to farther breach, where there is art on one side, and weakness on the other. Many women are doubtless proof against the slipperiness of such an overture: but all have not alike strength of mind.

But lest I should be here taxed with forging of phantoms merely for the honor of combating them, I shall only entreat all parties concerned to consider the following so probable circumstance, and then let them decide as their own judgment will direct them: a circumstance taken (can any thing be fairer?) even from a man-midwife’s own stating, as well as from the nature of things, of which none need be ignorant that will think at all about them.

It is then to be observed, that during a woman’s pregnancy, and before the labor-pains come on, one of the principal points of midwifery is, what is called the art of Touching. Thence are derived the surest prognostics for preparation, and especially from the signs it affords of rectitude or obliquity of the Uterus. I have already offered reasons needless to repeat, why the men can never arrive at the excellence of skill in the women in this particular. But as to the importance of this faculty of Touching, hear what Dr. Smellie himself says.

P. 180. “The design of touching is to be informed, whether the woman is or is not with child; to know how far she is advanced in her pregnancy; if she is in danger of a miscarriage; if the os uteri be dilated; and in time of labor to form a right judgment of the case, from the opening of the os internum, and the pressing down of the membranes with their waters, and lastly, to distinguish what part of the child is presented.”

Again, P. 448. speaking of a midwife, he says, “she ought to be well skilled in the art of touching pregnant women, and know in what manner the womb stretches, together with the situation of all the abdominal VISCERA: she ought to be perfectly mistress of the ART of EXAMINATION in the time of labour”.

Here you have from an unsuspected authority a certainly not over-rated importance of the expedience of preliminary TOUCHING. Now granting, only for argument’s sake, what is assuredly false, that a man-practitioner can be equal (superior he would not in this point, at least, have the impudence to pretend himself) to a midwife; let a husband, let a wife, but reflect on the difference, every thing else being equal, there must be as to modesty, between the function of touching being performed by a man or by a woman. Let a husband, I say, for an instant figure to himself what a figure he must make, what a figure his wife must make, under such a ceremony performed by a lusty HE-MIDWIFE, exploring those arcana of the female fabric, and especially to so little purpose, with his natural disqualifications for so much as knowing what he is about. Will the husband be present? What must be the wife’s confusion during so nauseous and so gross a scene? Will he modestly withdraw while his wife is so served? What must be his wife’s danger from one of those rummagers, if she should be handsome enough to deserve his attention, or a compliment from him on such a visitation of her secret charms, the more flattering from him, not only as he must be supposed so good a judge from the frequency of his occasions of comparison, but as it must imply a superior corporal merit in the woman so visited, as could overcome that satiety which a fastidious plenty of patients might so naturally be imagined to create in a man-midwife? Will any one say, that these suppositions are over-strained, or out of Nature? I fancy, that if the secret histories of many families were ransacked, of the practice on which the men-midwives were in possession, it would not be always found, that those preliminary visitations were not turned to some account of interest or seduction. And yet an omission of that touching might be dangerous. How kind is it then in Nature, to have of herself so far consulted the good and tranquility of society, in palpably bestowing upon women a faculty, which she has as palpably refused to the men, in whom the exercise of it would for obvious reasons be big with so many inconveniences? Is there any breach of charity in the taking for granted the existence of such inconveniences, unless indeed, all of a sudden, in favor of this lucre-begotten sect, the men were ceased to be men, and the women women?

But allowing that nothing was to pass between a man-midwife and his patient, in this act of touching, beyond the necessity of the practice, or in a merely technical sense, that in short no such libertine impression should make itself be felt in the course of such touches, as should discompose the good Doctor’s DIGNITY, and endanger the patient’s honor, by present or future attempts derived from such a strange privity; is it not to be feared, that a designing or interested person may take other advantages besides that of gratifying sensuality? May not a woman, the more attached she is to her modesty, the greater sacrifice she has made of it, in her innocence of intention, only imagine herself but the more subjected to a man, to whom she has submitted in the manner she must do to a man-midwife, and let him take an ascendant over her and her family, of which a midwife would not so much as dream, from her office being so much in course, and too little extraordinary for her to have any extraordinary pretentions or designs? On the contrary, a man-midwife need scarce set any bounds to his. In any differences in a family, especially between man and wife, must not a man-practitioner, from such a familiarity with the wife’s person, have such a footing in the confidence of the wife, as may enable him to dispose of her will almost in any thing? He may be her apothecary, physician, surgeon, privy-councellor, what not? What can a woman refuse a man, to whom she is so deluded as to think she owes her own life, or that of a darling child, all his merit, in which I have before explained? What can a woman in short refuse a man, to whom nothing of that has been refused, in which consist all the preliminaries of granting every thing? She may indeed refuse him the sacrifice of her virtue, if he should think it worth designing upon, but how few things else could she refuse him? Once more the greater value she put on the sacrifice of so much of her modesty, the less would she be able to deny him any thing else, as any thing else must comparatively appear so inconsiderable.

But hitherto I have spoke only of those outrages and dangers to modesty from the preparatory attendance of the man-midwife as occasion may require, during the pregnancy. But as to his officiating in the crisis of the labor-pains and delivery, there are two very essential points of consideration.

The first. The modesty of the women, unaccustomed to the approaches of other men than a husband, must be in great sufferance in the moments of their labor-pains. All Nature agonizes in them. They are at once weakened in the flesh and in the spirit. The bare presence of a man to officiate at such a time, may excite in them a revolution capable of stopping the labor-pains caused by the expulsive efforts of delivery, which thus becomes dangerously retarded, and may so overpower them, as to put them in the greatest peril of their lives. This is what has often happened. You may see frequent examples of this revolt of Nature against the ministry of men-midwives in Dr. La Motte himself, a man-midwife. If Nature then suffers so much in women at that juncture, when a person, nay even of the same sex, offers her aid, in certain indispensable occasions, to which humanity is subjected; how greatly must the presence of a man increase their constraint and embarrassment, and rob them still more of that so necessary freedom in the animal functions! But how greatly ought the women to thank that their instinctive repugnance of Nature to such a prostitution of their persons, if they consider those tortures, which, by the listening to that same repugnance, may at once be saved to their modesty, and to their personal feeling. Let them paint themselves the following posture prescribed by a man-midwife. “The patient must be commodiously placed, that is to say, on the bed-side, her thighs raised and expanded, her feet drawn up to her posteriors, and kept steady in that posture by some trusty helpers.”^[25] Levret, p. 161. On the use of the new crooked forceps. Here it may be said; “why there is nothing in this attitude, however shockingly indecent, but what may be sanctified by the extremities of necessity”. Very well. But what must a husband, what must a wife think at her being spread out in this manner, under the hands and eyes of a man-practitioner, with his helpers, perhaps his trusty apprentices, only for the experiment of a forceps of a new invention, the merit of which too is a so contested an one, that Levret himself is forced to own that, “that same FORCEPS would be^[26] an instrument of pure SPECULATION, and not of PRACTICE, IF (N. B. that IF) a certain general precept should be true,” which, by the by, is most certainly so! So that, in this case, for example, you see how a woman may be treated, only to ascertain the merit of some new-fangled gimcrack of an instrument. But to how many occasions of as little, or even less necessity than this, for putting a woman into postures of this sort, might not wantonness, interest, or other motives give birth? Or can pretexts for such insults to modesty be wanting to designingness?

The second consideration is this. Those moments of weakness of spirit, and infirmity to which the labor-pains subject the women may, in some of naturally the weakest of them be, liable to leave impressions in favor of a man-midwife, the less suspected of harm, and consequently the more dangerous for their being suggested by that gratitude for his imaginary^[27] contribution to their deliverance, which is itself a virtue, though the object of it is so miserably mistaken by them. Let any one image to himself what must often happen in Nature, a woman sinking under her pains, her mind all softened and overpowered with her present feelings, and looking up for relief to the man, employed, as she imagines, to procure it her, though the real fact oftenest is, that he will not have enough prevented her pain, or perhaps greatly occasioned its increase. Of this however she knowing nothing, sees him in the amiable light of her deliverer from her actual and intolerable state of pain. In the mean time, those aukward uncouth endeavours of his to relieve and deliver her, even though they should aggravate her torture, pass upon her for master-pieces of art or skill. “Who would be without a man-midwife?” At length, Nature sometimes, even in spite of all his omissions, or bungled operation, proceeds in her favorite task of delivery, that is to say, if he has not hurried or made tragic work of it, with his mispractice or his instruments. The patient then is rid of her burthen, and what are then her feelings? Those of exquisite delight, from the comparison with what she was induring but the instant before. It is a transport of joy, not unmingled with gratitude, to the person to whom she fancies herself in any measure obliged for it. The ugliest wretch on earth, so he could but be imagined the cause of such a delivery, would, in those instants, assume in her eyes the form of Loveliness itself. Even with the greatest innocence of heart she could hug, she could kiss him in the ebullitions of her joy and gratitude. Let no one imagine these expressions are over-strained. Such a rapture of felicity, in the sudden case of being taken as it were down from a rack, is not of a Nature to know any bounds of moderation, nor can be conceived but by those who have felt it. Her gratitude would even extend to inanimate things, much more to the dear Doctor, to whom she conceives she owes so much. She eyes him with all the intense eagerness of a gratitude so fond, that its transiency into a passion of another nature would not appear such a prodigy, to those who consider how apt passions of tenderness are to confound motives and run into one another. The melting-softness of those moments of infirmity and weakness of spirit, affords a susceptibility of impressions, which may not afterwards be so soon worn out, and of which the usual affection from the difference of sexes, in the parties, may sooner or later come in for its share. Dr. Smellie has, as I have before observed, implicitly allowed the possibility of a temptation to men, and shall I not follow his laudable example of candor, and confess that there may also be weak women?

They will decide, in short, whether, upon the whole, the plea of the men-practitioners, founded upon the ignorance of a few midwives which, bad as it is, is more than balanced by their incompetency in the manual function, and to which a remedy might easily be found, is a valid one for driving out of the practice of midwifery a sex, to which the faculty of it is self-evidently the genuine gift of Nature herself, only to make way for a set of interested male-practitioners, whose so boasted art is oftenest signalized by the most barbarous and horrid outrages upon Nature, with this aggravation, that they are needlessly committed under the specious and plausible pretext of flying to her assistence.