In medieval and early modern Europe, there was often a division between practical and theoretical obstetric care. Men were the ones who attended universities and performed dissections, and as such they often had a greater understanding of female genitalia than women themselves. However, it was female midwives who were responsible for the actual birthing process. They had practical experience in how to deliver children, but did not have the technical and theoretical knowledge of anatomy that male doctors did.
This did not mean that men worked solely in the theoretical field and while women provided practical services in childbirth. New developments in the field of medicine allowed men to take a more prominent role in what was traditionally seen as a feminine arena. A key example of this is the use of obstetric forceps. Developed in the 16th century by the Chamberlens, a family of French Huguenots who fled to Britain in order to escape persecution, the obstetric forceps were a valuable tool for use in an obstructed birth. That said, the forceps was an instrument invented and controlled by men, and female midwives did not have access to it.
Surgery was another area in which women were at a disadvantage, particularly during the medieval and early modern periods. In France, women were officially prohibited from practicing surgery with the exception of widows who continued their husband’s practice, which was itself discontinued after 1694. The situation in England was no better. Women were barred from the Company of Barber-Surgeons that was given formal recognition by Henry VIII in 1540 did not recognize female practitioners. While women still served as midwives and wet nurses, and were generally seen as in charge of childbirth except when surgical intervention was needed, but they were barred from advancing through the professional ranks due to their exclusion from medical school. It was not until the 19th century that women were finally accepted as medical professionals.
An illustration from Jakob Rueff's De conceptu et generatione hominis shows women attending to a birth in the foregorund, while in the background men perform the intellectual exercise of casting the child's horoscope.
Midwifery has a long history. During the medieval and early modern periods, midwives were predominantly women of middle age who had given birth themselves, and were therefore seen as able to help younger women through the process. They often lacked formal training, but could have knowledge of herbal remedies and occasionally perform other medical functions.
The practice was widely seen as "women's work" until the first part of the 18th century. The term "man-midwife" was seen with increasing frequency from 1720 onward, indicating that men were now aiding in regular childbirths instead of just removing a dead baby or assisting in an abnormally difficult birth (see column at left). Toward the middle of the century, the Scottish practitioner William Smellie took great strides in advancing male midwifery by forming close ties with female practitioners and training students of his own.
Midwives are by no means confined to the pre-Industrial era. In 20th century Great Britain, midwifery existed as an independent professional alongside of, but not subsumed by, nursing and medicine. Midwives were required to attend a training program, and were only allowed to attend to normal births - a complicated birth needed to be referred to a physician. In the United States and Canada, midwives were often found working at the fringes of society, particularly among immigrants and the poor, giving it the appearance of being unhygenic and unscientific. However, as 21st century women began to ask for more options on where and how to give birth, midwifery has made something of a comeback in North America.
The Witch by Albrecht Dürer.
Midwives were often one of the most common victims of the witch crazes that occurred during the 16th and 17th centuries, particularly in the Holy Roman Empire. The Malleus Maleficarum, a treatise on how to identify and torture witches written by the Dominican Inquisitors Heinrich Kramer and Jakob Sprenger that was first published in 1486 and become the de facto manual for witch hunters, is particularly damning toward midwives. The Inquisitors accuse those midwives who are witches of killing the baby in the womb or offering them to the devil, or even eating them and drinking their blood.
While Kramer and Sprenger don't explicitly state that all midwives are witches, in a time when infant mortality was high and sickness was easily contracted, midwives tended to be in the worst possible place at the worst possible time. To be an old woman who was present when a newborn got sick and died was to be an easy target, which, compounded with increasing restrictions on who was allowed to marry and have children, could make midwivery a very dangerous occupation.