midwifery education in 18 th century london anna bosanquet (supervisors: hilary marland and claudia...
TRANSCRIPT
MIDWIFERY EDUCATION
in 18th century London
Anna Bosanquet(supervisors: Hilary Marland and Claudia Stein)
BACKGROUND• Century of great social,
economic, political changes, affecting
• daily lives of women, including their experience of childbirth
• working lives of midwives and doctors, including their training, knowledge and practice
PROFESSIONAL RIVALRIES
Old tradition: a female midwife
New species:a man-midwife
TRADITIONAL HISTORYnegative view of a female midwife
J. Aveling ENGLISH MIDWIVES: THEIR HISTORY AND PROSPECTS. 1872, reprinted 1967
• ‘Very little is known of the early history of the English Mid-wif’... It is certain, however, that she was a woman of inferior education’.
• Superstitious, elderly, drunk and dirty women:
• ‘Ignorant of anatomy, and obviously unreliable in emergencies, they contributed considerably to the maternal and neo-natal death-rates; yet they flourished for lack of alternative facilities.’
THE ENGLISH
MIDWIFE?
Challenges to triumphalist medical history since 1980s
• Donnison• Marland• Versluysen• Evendeen• Croxson• Cody• Wilson• Harley • Grundy• Tew• Schofield
MIDWIFE TRAINING BEFORE THE 18TH
CENTURY• Traditional apprenticeship• Long period of training –
majority 5-10 years; (3-30!)• High literacy levels• Testimonials and witnesses• England different to the
Continent and Scotland• No structured / national
training• Various failed proposals• Always political:
humanitarian efforts but also vested interests and hidden agendas
RESEARCH QUESTIONS• What types of midwifery courses
and training were available for men and women in 18th century London?
• What was their content, structure, and what teaching methods were used?
• Who were the midwifery pupils and what was their experience?
• What were the consequences of new training methods for the professional standing of a female midwife?
SOURCES 1
• Midwifery textbooks, manuals and course syllabi published by man-midwives and female midwives
SOURCES 2
• Hospital archives, including minutes of Board meetings and published reports
SOURCES 3
• Hand-written lecture notes taken by midwifery pupils
• Personal letters describing training
SOURCES 4
• 17th-18th century Burney Collection newspapers
SOURCES 5
•Secondary analysis of original data provided by other scholars and re-analysis of published data
Lisa Cody: private communicationSusan Lawrence: 1996
Year accepted Last Name First Name
Husband's Name
AgeHusband's Occupation Cross References Address/Town Region/County
Widow spinster
1753 Fiddes Elizabeth George 36 1753 Fletcher 1754 Hall Margaret John 28 1754 Nettlefold Mary John 30 1754 Russell Anna Maria 26
1754 Preest Mary Richard 38Apothecary Kingston-upon Thomes (late of) Surrey x
1754 Butler Jane Pierce 30Surgeon and Apothecary
Appointed Matron of the British Lying-in Hospital
Chancery Lane, London London
1755 Emerton Sarah John 36Mariner
Hamlet of Ratcliff in the Parish of Stepney Stepney
1755 Evans Ursula Charles 36Farmer
Wellington in the County of Hereford Hereford
1756 Brightwell Agnes John 27Superviser of the Excise
Basingstoke in the County of Hants Hants x
1756 Boadger Catherine William Former patient 1757 Gyfford Elizabeth Edward 27Apothecary Barking Essex x
1758 Blackstock Mary Edwardsister of Matron, Mrs. Oakes
1758 Case Mary William 44Surgeon Lynn Norfolk1758 Prick Abigail John 40Bricklayer Queenborough Kent
1758 Tuffin Mary Charles 25
Cornet in the Regiment of Horse called the Oxford Blues
1759 VacryMaria Margaretta Nicholas John 40Surgeon
Albemarle Row, London London x
1760 Wright Susanna John 30Yeoman Feniton Devon x
1760 Webb Mary William 29Carpenter
St. Dunstan in the West, London London
1760 Fearnall Martha William 34Tallow Chandler Oakingham Berks1760 Randall Anna Maria Edward 30Yeoman Chawton Southampton1760 Maynard Mary William 30Hair Merchant Gloucester Gloucester x1760 Haynes Mary 25 x
1761 Turner Jane James 32Silver-Smith
late of St. Martin's Lane; but now of Jamaica Jamaica
1761 Powell Mary Henryc 42Coach Keeper
Old Bethlehem, London London
1761 Middleton Sarah Thos. 43Cabinet Maker Gosport Hampshire1761 Ring Mary James 25Mason Basinstoke Southampton1762 Coates Anne William Apothecary Theal Berks1762 Higgs Mary William Tallow Chandler St. Mary le Bone London1762 Boxall Ann John 35Carpenter Plestow Sussex1762 Williamson Esther John 41Mariner York x
1762 Cartwright Ann Jeremiah 31Mason of the HayCounty Brecknock
1763 Allen Elizabeth William 41Joyner Egham Surrey 1763 Ross Elizabeth William 30Merchant Aberdeen Scotland
1763 Garlick Ann William 28Maltster
Stelmet Court, in the Strand, London London
1763 Yewd Ann Thos. Secretary to this Charity
Wife of the Secretary of the British Lying-in Hospital London London
1763 Powell Elizabeth William 40Officer of excise of the HayCounty Brecknock x
1763 Bevan Ann Richard 29 Neith
County Glamorgan, South Wales
1764 Seyliard Mary Thomas 32Attorney
Serves as deputy matron through March 1766 Peckham x
1764 Jones Elizabeth William 44Wheelwright Old Brentford 1764 Guerrier Sarah William 34Tidesman Dockhead Southwark 1765 Racketta Sarah Alexander 30Surgeon Chester
1765Featherstone Mary Frances
upwards of 30Mariner Whitby York x
1765 Langcake Ann John
about 35Taylor
Windmill Street, London London
1765 Goff Mary John
about 28Surgeon
From the late 1760s onwards, Mr. and Mrs. Goff advertised in the London press their lying-in hospital.
Pall Mall, London London
Newspapers items relating to midwifery
YEARS Midwife or
midwives or midwifery
Midwifery and lectures
Midwifery and course
Midwifery and pupils
Midwifery and students
1700-1709 99 - - - -
1710-1719 144 0 0 0 1
1720-1729 771 1 15 8 2
1730-1739 1092 8 19 13 25
1740-1749 834 5 7 1 19
1750-1759 1152 152 80 102 21
1760-1769 2541 56 29 36 9
1770-1779 2715 50 15 47 25
1780-1789 2944 181 170 167 53
1790-1799 2377 362 365 69 51
1800-1809 436 178 211 101 70
1810-1819 401 165 203 164 80
Classified ads . World (1787) (London, England), Friday,
March 12, 1790; Issue 996
• Dr. Osborn and Mr Clarke’s last Winter courses in Midwifery and the Diseases of Women and Children will begin as follows:
• The MORNING COURSE at No. 10, Queen Street, Golden-square, on Tuesday next, March 16, at half past Ten o’Clock.
• The EVENING COURSE, at No. 12, Chancery-lane, Fleet –street , (for the concenience of Gentlemen living near the City, or who cannot attend in the morning) on the folllowing Monday, March 22, at half past Five.
• Proposals may be had, and farther particulars known, by applying to Dr Osborn, Hanover-square; Mr.Clarke, Queen-street, Golden-square, or at the Lecture-room, in Chancery-lane.
MEDICAL EDUCATION IN 18th CENTURY LONDON
• No university, no centralised training• Private medical courses• Advertising in newspapers• Increasing opportunities for pupils to
gain practical experience in hospitals• 1700-1820 at least 234 men lecturing on
various medical subjects (Lawrence 1996)
• 1 in 5 taught midwifery• 33 midwifery teachers between 1700-
1800
MALE MIDWIFERY TEACHERSin 18th century London
LECTURER 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800
Batty
Pole
Hall with Squire
Squire ?
Thynne
Walsh
Dennison
BlandLowder with Haighton
Lowder with Orme
Rowley
Osborn with Clark
Denman with Osborn
Leake
Cooper ?
Krohn ? ?
Harvie
Bengough
Martin
MacKenzie
Orme and Lowder with Lowder
Orme
Crawford
MacDonough
Kelly
Exton
Hunter ? ?
Smellie
Parsons ?
Manningham ?
Griffi ths
Chapman
Maubray
YEAR 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800
MALE MIDWIFERY TEACHERSin 18th century London
LECTURER 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800
Batty
Pole
Hall with Squire
Squire ?
Thynne
Walsh
Dennison
BlandLowder with Haighton
Lowder with Orme
Rowley
Osborn with Clark
Denman with Osborn
Leake
Cooper ?
Krohn ? ?
Harvie
Bengough
Martin
MacKenzie
Orme and Lowder with Lowder
Orme
Crawford
MacDonough
Kelly
Exton
Hunter ? ?
Smellie
Parsons ?
Manningham ?
Griffi ths
Chapman
Maubray
YEAR 1700 1701 1702 1703 1704 1705 1706 1707 1708 1709 1710 1711 1712 1713 1714 1715 1716 1717 1718 1719 1720 1721 1722 1723 1724 1725 1726 1727 1728 1729 1730 1731 1732 1733 1734 1735 1736 1737 1738 1739 1740 1741 1742 1743 1744 1745 1746 1747 1748 1749 1750 1751 1752 1753 1754 1755 1756 1757 1758 1759 1760 1761 1762 1763 1764 1765 1766 1767 1768 1769 1770 1771 1772 1773 1774 1775 1776 1777 1778 1779 1780 1781 1782 1783 1784 1785 1786 1787 1788 1789 1790 1791 1792 1793 1794 1795 1796 1797 1798 1799 1800
• 33 teachers• Never more than 6• Most specialised• 14 linked to hospitals• Others: Homebirths• From 1 to over 30 years• From 9 to 24 lectures• Similar content (but two
camps!)• Very different teaching styles• Using ‘machines’ for
demonstrations • Different costs 3-10-20 guineas• Smellie – 900 men, 1150 mothers in 10 years• Many publications
MAN MIDWIVES: PUBLICATIONS
• John Maubray 1730• Richard Manningham 1744• William Smellie 1752• Brundell Exton 1766• John Leake 1767• William Hunter 1774• Thomas Denman 1782• Colin MacKenzie 1789• William Lowder 1789• William Osborn 1792• John Haighton 1799
RULES AND REGULATIONS
• Clear rules about costs and privileges
• Attending women at home or hospital
• Strong etiquette
‘… all conversation tending to excite apprehension in the patient be avoided, such as descriptions of bad labours, anatomical dissections, the state of their experience in obstetrical subjects, &c.’ (Haighton 1799)
MALE STUDENT EXPERIENCE
letters of Thomas Bishopp of Leister25 /5/1793Mr Cruikshank lectures have finished.
He has now ‘entered with Dr Clarke - the surgeon to study midwifery, as well as Dr Pearson’s lectures on physic, chemistry and materia medica from eight till half past ten in Leicester Square’.
There are no other lecturers on midwifery so nearer and anyway, Thomas 'should not be so well satisfied with any other'.
17/9/94'I am sorry to say that I have failed in every attempt I have made to get any private patients in midwifery’…
COMPLETION OF TRAINING
letters of Thomas Bishopp
7/11/1794
'I shall be sufficiently acquainted with practical dissection and anatomy to undertake all the common operations in surgery with good confidence in my qualification and I am not at all doubtful but that I understand the theory and practical department of midwifery as well as the majority of those who settle in the country.
Anatomy Dr Baillie and Mr Cruikshank 4 courses
Mr Cline 1 course - dissected 14 subjects , 2 for Dr Bailleys lectures
Physiology Dr Heighton 2 courses
Surgery Mr Hunter’s lectures by Home, 1 course
The practice of St Thomas’ , Guy’s, St Bartholomew’s and St George's hospitals successively for 4and a half years
Midwifery Dr Clarke and Dr Osborne 6 courses
Chemistry Dr Babington 2 courses
Botany Dr Smith 1 course
Physic Dr Fordyce lectures 1 courseDr Crichton lectures 1 course
Fordyce’s and the practice of the other physicians at St Thomas’ hospital 2 years.
During attendance at the above hospitals took down about 1500 medical and surgical cases.
Natural philosophy Mr walker 1 courseRev Mr Roberts 1 course
Took out a diploma at Surgeons Hall in 1795
FEMALE MIDWIVES• Jane Sharp 1671,
1724&5Knew Greek and Latin
• Sarah Stone 1737Three generations, trained in dissections
• Elizabeth Nihell 1760
Two years training in Hotel Dieu in Paris
• Margaret Stephen 1795
Trained by man midwife, pupil of Smellie
• Martha Mears 1797‘Spent some years under the most eminent
professors of midwifery’
• Jane Wright 1798Pupil at the British Lying in Hospital
EDUCATING FEMALE MIDWIVES in 18th c
LONDON• Some of the male teachers
offered courses to women• Different costs and
conditions• Women expressing
dissatisfaction about unfair treatment of female pupils
• When successful: proud to be trained by men
• Evidence of only one private midwifery school run by a woman to train female midwives: Margaret Stephen
Margaret Stephen: MIDWIFERY TEACHER
• ‘I teach my own pupils the anatomy of the pelvis… and of the foetal skull, on preparations which I keep by me, with everything else relative to practice in nature, at labours; also turning, and the use of the forceps, and other obstetric instruments, on a machine which I believe few teachers can equal… and I make them write whatever of my lectures may prove useful to them in their future practice, for which they are as well qualified as men.’ (p 4)
• ‘I intend to continue my lectures as usual to women entering upon the practice of midwifery, until the men who teach that profession render them unnecessary, by giving their female pupils as extensive instructions as they give the males’ (p 6)
Lying-in hospitals in 18th century London
New Westminster Lying-in Hospital 1765[Westminster Bridge Road]
Female pupils 1758
Female pupils 1753Female pupils 1758
Female pupils ?1809
Female pupils 1769
Exton, Denman, Khron, Heineken W.Hunter, Sandys, Layard, Kelly
Heineken, Ball, Grundy
MacDonough, Walsh
Leake, Brickenden, Harris
Female pupils 1739 First Lying in Facility: Manningham’s private rooms 1739-1744 [?Marylebone Road]
MIDWIFERY PUPILS AT THE BRITISH LYING IN HOSPITAL
• Admitted from 1753• No more than 4-6 pupils at
one time• 3-6 months training• Resident in the hospital• High cost at 35 guineas• Taught by ‘Gentlemen of the
Faculty’• Delivering under the matron’s
and man-midwives’ supervision
• Certificate on completion
MIDWIFERY PUPILS AT THE BRITISH LYING IN HOSPITAL
1753-1819 175
3-176
3
1764-
1773
1774-
1783
1784-
1793
1794-
1803
1804-
1813
1814-
1819
Total
Number of new pupils
38 38 25 19 30 28 7 185
Range of admissio
ns per year
1-6 2-6 0-6 0-8 2-5 2-5 1-2 0-8
MIDWIFERY PUPILS AT THE BRITISH LYING IN HOSPITAL
• Mean age 37, most in their 30s, range 20-60
• 2/3 married, 1/3 widows, few spinsters from 1780s
• 1/3 from London, 1/3 close to London, 1/3 far away – North, Ireland, Scotland, Jamaica
• Economically stable social backgrounds
British Hospital MIDWIFERY PUPILS
1753-1819: HUSBAND’S OCCUPATION
TOTAL1:10 wives of medical men
42% artisans/ craftsmen
29% tradesmen /skilled workers
7% Gentlemen/professionals
Jane Wright
• Wife of a wine merchant
• In London for 6 years
• Has practised much among poor gratis on the continent and at home
• Enrols as pupil at the British LI Hospital in 1797, aged 32
• Publishes pamphlet 1798
• Later serves as Matron at the Westminster Lying-in Hospital
Jane Wright 1798Jane had ‘taken much satisfaction, for years, to acquire knowledge in female diseases under able instructors both at home and abroad’.
Intends ‘to practise midwifery, being entitled to it by my liberal certificates, from the physicians and surgeons of the British Lying in hospital in Brownlow Street’. She feels ‘sincerest obligations to them for their 'goodness and able instructions', as well as to the 'intelligent matrons of that useful charity' to whom she also offers her honest acknowledgements. (p 34)
THE LYING IN CHARITY FOR DELIVERING WOMEN
AT THEIR OWN HABITATIONS
1757
What was its role in training male and female midwives?
Further research is required
CONSEQUENCES?
• Enormous impact• Overly progressive
• Intrinsically regressive•Increasing control of training by men
•Removal from community to hierarchical institutions: embedding values of obedience
and conformity•Sub-servant role: less attractive to well-off
women
FROM PRIDE TO HUMILTY
18th century
Before the 18th century
Before the 18th century
End of 18th century
End of 18th century
Post-18th century
Post-18th century
Post-18th century