Part 14
I DO this writer this justice, with the more readiness and pleasure, for, that though he himself exercised the profession of man-midwife, and consequently in favor of his own practice, and of the pupils he was bringing up, was not without the injustice of adopting the prejudices of his cotemporaries too indiscriminately against the midwives; he does not suppress any truth relative to the art itself. But even, as to the midwives, the truth escapes him without any design on his side of its coming out. But such is the force of truth. And thus it appears. M. De la Motte wrote in a little sorry country-town at a great distance from the capital, being at the very extremity of the kingdom of France, on a sea-coast, where there were no other midwives than poor country-women, without knowledge, without skill, or any other qualification, than a little of the habit of attending women in labor. Yet with all these deficiencies it will appear, that the men-practitioners were far more to be dreaded than those poor ignorant creatures, who had scarce any thing but Nature for their guide.
I SHALL here give the substance of what he says in his preface, followed by some examples of the unskilfulness, or rather of the most profound ignorance of the most able men-midwives of his time, for forty leagues round his place of residence in the country.
“IT is (says M. De la Motte) astonishing, that the obstetrical art should, until the beginning of the preceding age, have been left either to ignorant women, or to surgeons, who had not (any more than too many to this day) any other resource in difficult labors, than some instrument guided by undextrous hands, always sure of killing the child, and endangering the mother. Do not these poor innocents deserve compassion for being exposed to operations of surgery, which one would rationally think they could not need, till providence should have at least given them leave to come into the world?”
HERE be it observed, that by the word “ignorant,” M. De la Motte should not intend the application of it to the midwives of the Hôtel Dieu at Paris, since, by his own confession, it is the best school of midwifery in Europe. Nor certainly is he in the wrong. Be it in honor of truth allowed me to say, that I know of those women who have served their apprenticeship in this hospital, who would think they made a wretched bargain, if they exchanged the manner of operating they learned there, for all the Latin, Greek, Arabic, or the iron and steel instruments of the best man-practitioner in Europe; even though his excellence in the manual function should be thrown into the scale for make-weight. The most constant success justifies their practice. In whatever situation the fœtus has presented, I have seen them, without having recourse to a man-midwife, and consequently to instruments, procure a happy delivery in very difficult labors. I have myself seen one deliver a child that had been dead in the mothers womb for near six weeks, without dismembering it; and though it was half-putrified, and the head so rotten-tender as to have no solid consistence, I dare advance this, without fear of being falsified, since I can name the mother, now alive in London, the witnesses, the place and year.
SUCH real midwives as I am here discribing, for I do not mean the spurious nominal ones, only fit to _create_ work for the instrumentarians, or whose cue of interest is to do so, have no reason to apprehend, that in the numbers they have lain, there can be any found, that can complain of having suffered, or of suffering any the least damage or inconvenience, after their lying-in, that might be imputed to ignorance or mispractice.
ON the contrary, I dare aver, that such, genuine midwives have cured many women who had received notable injury, before they came under their hands, in their having passed through those of the men-practitioners. Nothing being more agreeable to Nature, to Reason, to Experience, than that the method of practice of a skilful midwife is not only the most easy and gentle, the least painful, but assuredly the most safe both for mother and child. This is what the most severe examination will to those, who give themselves the trouble of making it, establish, in contempt of that fashion, by which so pernicious an error, as that of preferring men-practitioners, has acquired more credit and influence than so salutary and demonstrable a truth, as that for which I am contending. In the mean time, let us hear what M. De la Motte himself, a man-midwife, says of those brethren of his, of whom heaven grant there may not exist to this day too many resemblers!
“TO the shame (says M. de la Motte) of the profession they exercise, they have no guide but their avarice, while the grossest ignorance of the art of midwifery itself is their lot. Such are much to be dreaded by women in difficult labor; for (adds he) they having no help to offer them but that of their instruments, they employ them indifferently in all the situations in which the fœtus presents. Nay, even the hands of some who will use their hands, are not less dangerous when misconducted. The ignorant therefore should never meddle with lyings-in. It would save them from the reproach they may incur of murder, in undertaking what they cannot execute, and what surpasses their skill. They would not furnish _scenes_ that make one _shudder_ with _horror_.
“I SPEAK here of so many poor women, whose strength shall have been exhaust—by a great loss of blood, caused by the violences which an ignorant man-midwife shall have made them suffer, I speak of women, whose parts shall have been all bruised, and so vilely treated and torn, as in some to lay the anus and vagina into one, besides their children being dismembered, some their arms or legs plucked off, others the whole body, the head being left behind in the uterus.”
THIS is the language of a man-midwife himself, who candidly declaims against the errors of his fellow-practitioners, undoubtedly without designing that such their errors should be wrested into an objection to the practice of that art being committed to the men. Such a conclusion would in me be unfair, and a vain attempt to impose on the reader the laudable condemnation of an abuse, for an indiscriminate reproach to the whole set of men-midwives. This would however be but a kind of retaliative treatment of those, who, from the defective practice of the ignorant and unskilful midwives, of which if there was no more than one in the world, that one would be much too many, take the unjust handle of inveighing against midwives in general.
EVEN la Motte himself, who, as I have before with pleasure observed, was really as capable a man in the profession of midwifery as a man can be, at least to judge of him by his writings, has embraced every occasion of boasting the superiority of the men to the women in the exercise of midwifery. But while he taxes men of _scenes_ that make one _shudder_ with _horror_, the mistakes he imputes to the women, which are bad enough in all conscience, are not however of that atrocious nature, as those he relates of the men. Nay, with all his desire of under-rating the women, he falls into even pitiful contradictions. Let the reader himself decide on the following one.
UPON an article of practice, for which M. De la Motte blames the midwives, and what an article? not such as he reproaches to the men-practitioners, murdering, maiming the women, or tearing their children limb from limb, but purely for their applying certain bandages to the belly of women after their lying-in, in order to keep that part smooth from wrinkles; this very author, I say, who allowed the Hôtel Dieu at Paris, where the manual function is wholly confined to women, to be the best school of midwifery in Europe, where he himself wished, and wished in vain, to be admitted to practise, and, in short, from the head-midwife, of which Madam de la Marche he himself probably learned all that was worth any thing in his practice, thus speaks of the midwives bred up in that hospital.
“THIS prerogative of having served apprentice in the Hôtel Dieu at Paris, is not for these women, an _indifferent_ matter, for though they were to have no more than a _shadow_ of _sense_, they are persuaded, that in setting themselves off with a _title_ that does not render them more _capable_, they ought to be honored and respected above all others, which they would not fail of being, if they were to give some marks of sufficiency beyond what others can give.[28]”
THE nonsense of this objection of Mr. De la Motte is too glaring to need a comment. If an education in the best school of midwifery in Europe, does not give a woman a right to plead it for a title to reliance on her superior sufficiency, without any reason therefore to accuse her of vanity, what can give her a title?
BUT to return to M. De la Motte’s sentiments on the practice of the men-midwives; it will easily be seen, that the horrors he objects to their practice, and of which he himself undoubtedly endeavoured to steer as clear as he could, were of a nature, without the least breach of candor, to suppose liable to repetitions wherever so false a doctrine and practice prevail as the substituting steel and iron-instruments, or “artificial hands” to natural ones.
LET us now see what Mr. De la Motte thinks of the use of the CROTCHET.
“WHEN I settled in my province (says this author[29]) I found several ancient master-surgeons, who pretended to help the women in their difficult, or preternatural labors, solely with the use of the crotchet; without ever, in their life having made any _delivery_, but in that manner, and as soon as they had extracted the fœtus with their crotchet, they left the rest or the after-birth to be brought away by a woman, as they themselves knew nothing of the matter. When they were fetched to help a woman in labor, they took their crotchet, went to the woman, whom they put into posture, and whether the child presented the head, breech, arm or leg, whether it was dead or alive, a woman’s having passed a day and a half in labor was cue more than enough for them to go to work with their crotchet.”
THE following extracts from the same Mr. De la Motte, may serve to confirm the foregoing observation.
“OBSERVATION 187. I was sent for to lay Madam de ... about fifteen leagues from Valognes, the place of my residence, and there was at the same time a surgeon of the town where I then was, who had been fetched to lay a woman that had been in labor from the day before, whose child presented the vertex: he, without further examination, put her into a convenient posture, and with his crotchet brought away the child at several pulls, with much pain and labor, and threw it under the bed, with the after-birth, in the most severe season of the year: after which, the operator hugged himself prodigiously, for having so happily accomplished so difficult a labor. Having rested a little, and just as he was going, a woman curious, bethought herself of seeing whether it was a boy or girl: she found the poor child yet alive, though so mangled with the crotchet, and that after having remained, in this condition, an hour and a half, without its having been in the power of so violent an operation, or of the rigor of the weather to terminate a life which seemed to have held out against so many barbarities, only to reproach the detestable operator with the enormity of his crime. The child was christened and died soon after.
“REFLEXION. This is what may be called a cruel ignorance, &c.”——To the which I add, that if this wretched operator had had the patience to wait some time, the child would in all probability have come naturally with any the least help of the hand at every throw of the mother: for she had not been over-time in labor, and the head was not, it seems, stuck in the passage.
“OBSERVATION 196, p. 274. I was desired to go to Cherbourg to lay a poor woman there, whom a surgeon and a man-midwife by profession, belonging to that place, had given over.... I found the woman in a condition hard to describe, with an arm and a leg of her child pulled off, and the remainder of the body left behind in the mother’s womb. I put her into posture, and instantly delivered her of one child (it seems she went with twins) who had only an arm plucked off: I then sought out the other, whose leg had been torn away. Strange and fatal sight, which was seen by more than twenty women present, all ready to swear to the truth of this! I left the woman to their care, after having delivered her of the after-birth. She had been as much hurt as the children, of whom nothing remained in the uterus, by the care I took to evacuate it. I left the mother tolerably well considering her condition.”
REFLEXION. This was the more surprizing, for that the first operator was an old practitioner, who had been an out-surgeon to the Hôtel Dieu above eight years, before M. De la Motte was apprentice there. Yet this man neither was sensible of the being twins in the case, nor had dexterity enough in the manual function. Here I ask, could the most ignorant midwife have acquitted herself worse than this _man_?
“OBSERVATION 185. A tradesman’s wife of Valognes being taken in labor sent for a midwife. A little while after her coming, the membranes burst, the waters were discharged, and the child presented an arm. The midwife required help. (Probably she might be one of the ignorant and unskilful ones) and two surgeons were sent for, who passed for being the most expert ones in the town. They begun with plucking off the arm that presented, though the child was _alive_. The other arm, as soon as they got hold of it, underwent the same fate. After which they struck the crotchet into a rib, which they brought away, then two, then three, and, at length, struck the crotchet into the back-bone, and pulled so cleverly together, that they brought the child away doubled up. The midwife delivered her of the after-birth, and notwithstanding all this ill usage, the woman recovered; but it was a long while first.”
REFLEXION. (Mr. De la Motte’s own) “Was there ever a crueller operation seen both for the mother and child; the first terribly torn, the other barbarously dismembered?”
“OBSERVATION 186. The wife of a tallow-chandler of this town was taken in labor: the waters were discharged, after which an arm of the child presented. Help was sent for; one of the two operators (mentioned in the foregoing observation) came with his servant and crotchet. He began his operation, by plucking off the arm of this certainly live child, then, without further examination, he strikes the crotchet into its body, and pulled, without being able to bring away any thing. The master, whose strength was exhausted, made his pupil help him, and they both pulled as hard as they could: still nothing came, and I verily believe that the master would have called in some body else to his assistence, if the handle of the crotchet had been long enough, or that the poor woman had not given up the ghost under the cruel torments they made her suffer, to such a degree that they forced her to part with her life, sooner than with her child.
“REFLEXION. Here was a _delivery_ in intention, but the execution had something horrid, and perfectly odious in it. I never could have imagined, that two men could have pulled in this manner, without dislocating the bones of the woman into whom the crotchet had been struck: for so it was shown to be, upon the body being opened, in which the child was found with an arm plucked off, entangled in the umbilical chord round its neck, without the least mark of the crotchet upon its body: too plain a proof this of the crotchet having been struck into the mother and not the child, and consequently of the little circumspection, not to say rage, with which the surgeon had acted upon the body of this unhappy creature: for surely it must be granted, that it could be no part of the child that could have resisted the terrible efforts made both by master and man, jointly to bring it away; and yet this was one of the BEST[30] operators in the country for HELPING women in labor.
“I COULD make a VOLUME of these histories, if they were good for any thing but to excite horror.” Such is the witness born by M. De la Motte, as to the _ablest_ men-midwives of his time, in all his province. Now in order to invalidate the conclusion, so natural to be drawn from so unexceptionable an attestation, against the superiority of the practice of the men to that of the women, will it be said, that the men-practitioners, in this country, are in general better educated than such operators as have been above shown? If so great a falsity should be advanced, let the reader himself reflect on what he may easily find to be the common method of training up of men-pupils in this art. I have in the first part of this work, stated some reasons for their insufficiency, both in study and practice; and the more this point is examined, the more clear will that undoubted truth appear, that if the ignorant midwives are, as they undoubted are, a great evil, they are even blessings in comparison to the generality of the men-practitioners, bred up with the help of artificial Dolls, pretty prints, or even of their personal visitation of those miserable wretches hired, or under the mask of charity, forced to undergo, from apprentices or pupils, so many inhuman tortures and outrages in vain.
IT will also perhaps be said, as to the examples I have just produced from M. De la Motte, that since his time, that is to say, about the beginning of this century, that the art of midwifery has received so much improvement, as to cancel all impressions of fear from such examples. Yes! It has received improvement with a vengeance. If a vain endeavour to perfect instruments, impossible to be perfected, or against common sense to suppose, even when perfected superior to skilful hands, are an improvement, then the art may be called improved. In the mean time, infinite is the mischief done by so many pretending operators, with each his bag of hard-ware at hand, his only proof of superiority to a woman, in practice, confiding in those instruments. Their negative damage is almost as great as their actual one. For by occasioning the men, and even ignorant midwives to trust to the calling in their help, the methods of predisposing of the women to parturition, the proper precautions, and actual manual function in the labor-pains, which is a point of the utmost importance, are at best but slightly and prefunctorily, consequently not sufficiently, performed, or perhaps wholly neglected. And why? because the instruments, the _crotchet_, the _tire-tête_, the _forceps_, are considered as sure reserves to remedy such deficiencies. This, besides many other reasons, encourages the indolence, carelessness, and inattention of the men-practitioners, and even of the midwives, especially of those poor suborned creatures recommended by the men-practitioners, paid, as one may say in some sense, not to do their work so well, as that none should be left for their honorable patrons. Thence it has happened, that where an ignorant midwife has, through her unskilfulness, or for whatever other reason, been wanting in predisposing the passage, or lapsed the critical moments of the manual aid, so that she really is or pretends to be out of her depth, by the exigence being beyond her ability; the man-midwife is called in, who, with his instruments, forces that delivery, which might, if justice had been done to the patient, have proceeded in a natural way, with much less pain and danger. Be this remarked, without my speaking here of the extraordinary tortures and outrages, such as M. De la Motte himself has related. The woman then is, by the help of instruments, delivered by the man-midwife so called in. “If he had but staid a few minutes longer, both mother and child must have been lost”. So believes the father of the child, so believes the mother, so believe most of the parties concerned, and what is more, sometimes so believes the man-midwife himself. Though the strict truth has been, that the greatest part of the pain the mother endured, and every appearance of danger, either to her or to her child, were positively owing to nothing but the negligence and mispractice used, either by man or woman-practitioner, in reliance, if matters should come to the worst, on the supplemental aid or reparation of errors, by those miserable instruments, which constitute all the boasted improvements of an art, the true nicety and requisite accuracy of which they are so much more calculated to banish or destroy.
I HAVE however quoted the foregoing examples from M. De la Motte.
FIRST, Because that he himself being a man-midwife, and greatly partial to the practice being best in the hands of men, his attestation must be the less suspicious: but especially, because he was a professed enemy to instruments, and adhered as closely as Nature would allow him, to the imitation of those midwives from whom he had received all his _knowledge_, and abused them afterwards for their _ignorance_, as if their communication to him of their knowledge could not have been, without leaving themselves wholly destitute of it to enrich him.
SECONDLY, Because, the stories which he relates upon his own knowledge, leaving me the fairest room to infer the necessary repetition of the like tragical wents wherever instruments are admitted, it became less invidious to specify them, than incidents of the like nature here: especially, I say here, in London, or in England, where the use of those instruments grows every day more and more rife, and must consequently furnish the more examples of pain, destruction and danger caused by them to the women, weak or prejudice-ridden enough to prefer the men to the women-practitioners.
BOTH Charity then and Prudence prescribe to me the not pointing out particular persons to whom I could impute mispractice. If any one will affect to treat this suppression as not owing thereto, but purely to an impossibility of specifying cases of that sort, and of proving them; I appeal to the candid reader, whether the nature of the charge considered, such a specification can be expected from me, since, from the examples I have produced, I pretend to infer no more than a probability, the grounds of which I submit to himself, of the repetition of the like acts from the same, or even from increasing the same practice.
IT would not perhaps be otherwise impossible to give some instances. For example, I could expand a hint before given, of a man-midwife of this town, who passes for eminent in his profession, and who not above five years ago, was called to deliver a woman in labor, whose child presented an arm. This practitioner, instead of searching out for the feet, to extract this fœtus, that was quite alive, first plucks off one arm, then another, then, at length, gives over the job, and left the poor mother in this condition, who was forced to have recourse to a midwife to finish the delivery.
MORE than one operator, as I have before observed, in very natural deliveries, instead of bringing away the after-birth, tore out the body of the uterus; for all their boasted anatomy.
ANOTHER gentleman-midwife delivered a woman of a fine child, or rather received it, for it came naturally and easily. Upon which, he took it into his head that he would not deliver her of the after-birth, proposing to defer this work till next day. And so he would have done, if he had not casually met with a less senseless practitioner, who represented to him the danger to which, by so doing, he exposed the poor patient he had left, and advised him to go back as fast as he could to deliver her.[31]