The Rest Is History - 191. Childbirth

Episode Date: June 2, 2022

In today's episode, Tom and Dominic talk to Sara Read about the history of childbirth. Sara unveils the origin of the word 'gossip' and its connection to midwifery. As well as this, they discuss how someone would qualify as a midwife; the relationship between religion and childbirth; and the average age of becoming a first time mother. They also look into the changes in the maternal mortality rate throughout history. And, finally, they touch on the authenticity of 'Call The Midwife'.   Sara Read is the author of two works of historical fiction: The Gossips' Choice and The Midwife's Truth, available from all good bookshops. Join The Rest Is History Club for ad-free listening to the full archive, weekly bonus episodes, live streamed shows and access to an exclusive chatroom community. Editor: Scarlett Murray Producer: Dom Johnson Exec Producer: Jack Davenport *The Rest Is History Live Tour 2023*: Tom and Dominic are back on tour this autumn! See them live in London, New Zealand, and Australia! Buy your tickets here: restishistorypod.com Twitter:  @TheRestHistory @holland_tom @dcsandbrook Learn more about your ad choices. Visit podcastchoices.com/adchoices

Thank you for listening to The Rest Is History. For weekly bonus episodes, ad-free listening, early access to series, and membership of our much-loved chat community, go to therestishistory.com and join the club. That is therestishistory.com. hello welcome to the rest is history and um this is an episode that i have been looking forward to a long time um dominic ever since we we began doing this series there's been certain episodes that uh we've kind of mapped out um and this for me is definitely one of them because my wife sadie is a midwife um and so you have talked of nothing else i think it's fair to say i have very very much wanted to do uh an episode on the history of childbirth the history of midwifery because of course being married to a midwife it makes you very very interested in the subject but also

you've been sending me endless messages saying i will get so much credit at home when we do this childbirth episode i can't wait i don't know what you what benefits or rewards you think are going to be flowing your way tom well i i think that the joy of seeing my beloved wife listen to um an absolutely splendid episode listen to yourself listen to you no because we have we have a wonderful guest to talk about. We do. Do we not? Who do we have? So obviously it's two men. We're not really equipped to talk about the history of childbirth.

I mean, admittedly, a lack of knowledge and experience has never happened to us in the past. But we thought that this time we'd have a proper expert. So we have Sarah Reid, who is, I'm very happy to say, who is a literary historian, senior lecturer from Loughborough University. And not only has she written loads about women's experiences and women's bodies in the early modern period, she's also the author of a historical novel called The Gossip's Choice, which I think she's going to tell us the interesting link with midwifery in a second. And she's got a book called The Midwife's Truth out in September. And that's what we're after, Tom, isn't it?

The Midwife's Truth out in September. And that's what we're after, Tom, isn't it? The Midwife's Truth. It is. So I'm hoping you're going to tell us all about the midwife's truths, as it were, today. So welcome to the show. Thank you. That was nicely done. Yes, The Gossip's Choice is about a midwife practicing in 1665 against the backdrop of the Great Plague.

And it's called The Gossip's Choice because gossips were the women who attended other women in childbirth. So my midwife is the best midwife in the area. She's the Gossip's Choice. She's the one you want. So a gossip, hold on, is that where the word gossip comes from? Yes. So gossip derives from the same root as godparent and is God's helper, if you like, it's God's representative. And so the women who accompanied other women through their labour and supported her, propped her up quite literally, you know, sat behind her and gave her strength, were known as gossips. And then, of course, you've got people worrying about what's going on in these all-female environments and the conversations that may or may not be going on. And so you get the sort of broad use of gossip as we know it today.

Oh, Tom, I bet you didn't know that did you know that i didn't know that um but it's so i mean it's a kind of interesting point that for men in a sense childbirth is the the sphere perhaps where men are most likely to feel excluded and that therefore men have written the histories. And so, to an extent, in looking at the kind of the broad sweep of how men have written about childbirth, have you picked up a kind of sense of suspicion, of hesitation, of doubt, of uncertainty of the kind that would explain how it is that gossip comes to have the kind of pejorative term that it does today? Well, men have written about childbirth with confidence over the years. So even in the 17th century, you've got midwives pushing back on men writing about childbirth.

So famously, Nicholas Culpepper, the hypocrisy that we've all heard of from the Civil War era, wrote and translated a number of midwifery textbooks, but was widely believed never to have been in a birthing chamber himself. But that didn't stop him writing with authority on the topic. Interestingly, after his death, his wife then registers as a midwife. So there was a family interest in it, but he personally hadn't got any experience, but that didn't stop him writing. And so nearly all the contemporary texts that I work on are written by men. So if you go all the way back, and I'm going to do Melfin Bragg, go back to ancient Greece.

Was that your Melfin Bragg, Tom? Yes, back to ancient Greece. All this time, and it's a terrible impersonation. I thought it was quite a good one. Well, what do you think, Sarah? I'm going to be discreet, yeah. That tells the same story. Brilliant.

So am I right, Sarah, that the first named midwife is an Athenian called Agnodike? Who may not have existed at all. It's largely now thought by classicists that it's a myth rather than a real historical figure. And one grew up from the idea of women being excluded from the academy and not being able to have the formal training in medicine that men could receive at that time but sort of she disguises herself doesn't she as a man um so when is this is this in sort of classical the age of century bc okay so century after pericles so yeah this story grows up that um this this woman wants to attend women and the only way she can do that or she can send women in but to get the advanced knowledge she needs to be um in the company of physicians um and she can't get access

without disguising herself as a man um the story falls down on um on the idea that there was no formal registration process for men at that time either so you know it's all a little bit woolly about where where it came from and what was going on with that story but it's certainly um a myth that's that's been passed down through the ages but because because what's what strikes me about that is that i had always assumed that women were the midwives that that this was this was pretty much a given but is that not the case in say I don't know, in the ancient world in Greece or whatever? Is it men who have a responsibility for attending women in labour? It's always been the case that women have attended other women. So again, it adds another layer to the confusion of

the story, where men and physicians were called in is if there were complications, if things were going wrong, if they needed some sort of you know advanced care and that carried on right throughout time so it may well be that um to get the rudimentary sort of everyday caring skills that a midwife needed at the time that was that was fine and that was done sort of with knowledge transfer between women but um this character who probably wasn't real wanted to get more knowledge, more theoretical knowledge. And to get that, she would need to pass herself off as a man. I see. So I'll tell you who is absolutely a brilliant expert on midwifery and has some absolutely splendid advice.

Dominic, can you guess who it is? He's a top Roman mansplainer. The Emperor Caligula? No, it's Pliny the Elder. OK, that doesn't surprise me. So here is some top midwifery advice some uh from plinny um it is said that it is said that a difficult labor comes immediately to term if over the house where the woman giving birth is lying someone throws a stone or a missile that has killed with a single stroke three living creatures a human being a boar and a bear and he goes on to specify that the best um missile is a light cavalry spear sarah how plausible i mean that's laughable isn't it i mean did people were

people out spearing boars and bears on the off chance that in a few years they'd need this missile to guarantee them an air or something? It seems very unlikely to me. But it's a very specific item to find as well, isn't it? It's got to have killed three different kinds of creatures. And you've simply got to get hold of one. I mean, that phrase pops up in quite a lot of the texts that I read, simply get hold of this, that or the other. And you think, well, that doesn't sound remotely simple, actually. Where is that kind of stuff coming from? Because presumably the kind of the border zone between midwifery care and magic, there's always been

a sense of blurring there, do you think? I think there is in every situation where there are unknowns and things seem quite miraculous. I mean, the birthing process is one of those, isn't it, where it just seen quite miraculous and therefore it leaves itself open to these to the magic uh line blurring but the idea that objects inanimate objects took on qualities was broadly held so the the the stone then takes on certain qualities from the experiences it's had let me ask a a question that we got from Karis, I think it is, on our Discord channel for the Restless History Club members. So Karis says, what do we know about the average age

of first-time mothers over the centuries? And what is the optimal age for giving birth? So in other words, when we're talking about childbirth and midwifery and so on, in periods before our own, we're generally talking about people who are giving birth much younger than the average British woman woman does today aren't we well not in the early modern period no popular understandings of this are skewed by the fact that aristocracy and people of higher ranks got married much younger than the average Joe in the street did

so the average age for marriage in the early modern period so we're talking about the 17th century mainly was which was about 24 for a woman 26 for a man all right so so much later than you would but does that does marriage map on does the age of marriage and maybe this is a too too banal a question does that map onto the age of childbirth in other words some people presumably would be giving birth before marriage obviously um so do we know what the average age was where people had their first child um not not really but we do know that up to a third of women were pregnant when they got married in the 17th century yeah yeah in 16th 16th 17th century it's been estimated from looking at marriage lines and birth records in church records you can see i mean people like famously william shakespeare and hathaway um she was expecting their eldest when they uh when they got wed so that's that's quite normal and the reason

that it is quite normal is because of the betrothal um arrangements whereas when a couple get engaged now it's sort of just you know an understanding between them whereas betrothal was a bit more than that in the past it was um a firm promise a commitment and once that had been shared between the couple and their families and the wider community then um often people would begin sleeping together because you know they were married in all but name at that point you're responsible for childbirth in the 17th century are you drawing on folk wisdom when you you attend a labor or are you drawing on the kind of legacy that Pliny gives you and you're chucking stones over houses and things? Or are there other traditions that you're

drawing on? To what extent is it formalised? Where are these traditions coming from? The first English language midwifery guide appears in 1540. And it's a translation of a much translated text that originally comes from German and appears in 1540. And it's a translation of a much translated text that originally comes from German and appears in nearly every continental language. And it's at some point translated into Latin. And it's from the Latin that we get the English translation. And so from 1540, that text in various forms stays in print for well over 70 years. You're still seeing versions of it in the 1620s. What's it called? called the birth of mankind the birth very good the birth of mankind or the woman's book is its subtitle um and so that that appears all across europe and there's a whole um flurry of midwifery texts

from this time onwards in the english language and they draw their learning, their theoretical knowledge, from the ancients, so from Galen and from the Hippocratic texts. Nearly all the theoretical knowledge in these books is quite similar. And it's all drawing on that body of knowledge that's been handed down from the ancients. So that's where medicine is coming from. Midwifery is coming slightly differently. It's coming from training that's hands-on you know so mothers training their daughters um and and that sort of thing so when you get the first midwifery guide that's written with a woman's name jane sharp

in 1671 she's drawing on a lot of the ideas that are present in certain of the texts, so certainly ones that were translated by Nicholas Culpepper and people like that who is taking works from a body of authors. But also she's reading widely. She's picking the best bits that she thinks are the most applicable. But what she says is that to be a good midwife, you need to have speculative knowledge, so you need to have theoretical knowledge, and you need to have theoretical knowledge and you need to have practical knowledge. You need to have the hands-on experience.

And she said the very best midwives have got a combination of both. So that's why she's coming into print in 1671 with that idea. So talk us through, you become pregnant at the end of the 16th century or the beginning of the early modern period, let's say, and you're of the middling sort. What happens? So do you withdraw to your... I mean, I have the haziest,

most probably utterly inaccurate view of what happens. So I have this sort of sense that you withdraw at some point and are not seen for weeks before your due date or whatever. And then there's people sequestered in the room with you and your husband is waiting outside but is that completely wrong i mean what how does it work yeah that that doesn't apply to sort of middling sorts or um everyday people some of that may have come from accounts of royalty um and aristocracy that tells you the way my mind works who've got access to the funds to live from you know that sort of a life but for

most women it would be a question of carrying on working in the family business as you know most families ran cottage industries from home most trade was done like that wasn't it so everybody participated in the family occupation whatever that might be and there wasn't the finances or the wherewithal generally for women to retire and stop working. And so what you would find was that women would carry on pretty much as normal until their labour pain started. And then what happens? Then what happens is that you call the midwife. And normally your husband is the one who sent off. So you see in men's diaries from the era, People like Ralph Jocelyn will write how they were sent off to find the midwife because the

woman had gone into labour. And at that point, certain ritualistic processes can kick in. So the midwife, we might think that the first thing the midwife does is to do a medical assessment and things like that. But in the 17th century, your midwife is much more likely to gather everybody to say a prayer because the link between religion and midwifery is very strong. And so there would be a sort of communal prayer for happy delivery, for a happy outcome. And from then on, the midwife was in charge. This was her domain. And around the woman who was labouring would be a group of friends neighbors the gossips that we started out our conversation talking about they might be her mother they might be her mother in law they might not all be her choosing it might not not be um you know might be politic

to have certain people there surely the last person you want is your mother-in-law but it would be a public affair would it i mean it would be a community affair a community affair yes definitely and that was important because part of what you're doing is you're introducing the infant into your community acknowledging them in a very public way and so the father sending for the midwife is all part of that process of making this baby be born into its community rather than just now in this sort of nuclear family that we often live in. That's very alien to people in the 17th century. So yeah, so it would be a very

community-led process. So you would have neighbours, as I say, some family, and the midwife was in charge. You talked about the role of religion. Just two questions on that. One from Amy VC. How has the Christian idea that childbirth ought to be painful, as described in Genesis, so that's the curse put on Eve by God, influenced medical developments and obstetrics? But just before that, this is a question from Sadie, my wife, who has an incredible collection of medieval paintings of the Virgin giving birth to Jesus, in which there are midwives. And she asked, she wanted, is there anything useful that can be learned about the history of childbirth from all the medieval paintings that show midwives attending the Virgin's labour? So I guess the idea that childbirth should be painful, which you get in Genesis,

and the idea that the Virgin giving birth to Jesus then kind of washes away that sin, it makes childbirth very, very important in the way that Christians understand the world. It absolutely does. So thinking about the medieval paintings that have got lots of midwives and the virgin, midwives are all associated with religion and with it being part of a religious duty, going back to the sort of early Christianity. And Jane Sharp, who I mentioned a few moments ago, opened her book by claiming the role of midwife as set out in, giving an example from Exodus. And she says that, and let me read a little bit of here. She says, you know, it's extremely requisite that a midwife be both fearing God, faithful, and exceedingly well experienced in

that profession. Her fidelity shall not only have reward here from man, but God has given special example in Exodus 1 in the midwives of Israel, who were so faithful to their trust that the command of a king could not make them depart from it. And she goes on to say that, you know, because of their behavior in Exodus, God gave them this special status.

Oh, that's brilliant. I would say you'd be delighted to know that. And just on the question of midwives, because you said, you know, you had this sort of image that I think we're probably all kind of familiar with of the sort of the husband rushing to get the midwife. Who are the midwives? So at what point do you decide to become a midwife? Is it random? But what I mean is, is there somebody in a given village who is absolutely the midwife and everybody turns to that person? Or could the midwife be a more informal kind of role?

Yes, both. So in every parish, generally, there would be a former midwife. And that's somebody who's got a license to practice as a midwife. A license? A license. And who is issuing the license? Well, the licensing came in in the early 16th century so it's a tudor thing and it's an ecclesiastical license to practice so the bishop

decides if you're going to be a good midwife or not how does the bishop know i mean he's a bishop yeah he knows because to get a license it's a complicated and expensive uh fairly um arduous ordeal to get a midwifithery license. So you need to have testimonials. You need to have about six women who can vouch for you. And normally it'd be their husbands writing a letter of recommendation or signing their name, even if it was with an X, to say that you had attended their birth and that you behave properly as you would expect, and everything was fine. So you need testimonials. And then you need to take an oath, the midwife's oath. There's various versions of this throughout the two

centuries that it applied, because it sort of dies out in the 1730s. It never comes to a formal end, but it just stops happening. And these oaths include things like promising that you will treat rich and poor alike, that you won't go off mid-attendance of a poorer woman to go and attend to a rich woman where you'll get a much greater fee. Promising that you'll be a good, godly woman, and that's part of what the church is looking for. And you have to also promise things like that if the child dies in the delivery, that you will make sure they're decently buried. And that involves finding a decent place, not in consecrated ground because the child wouldn't be baptized, but somewhere they couldn't be dug up accidentally by a dog or a pig, for example. So treating the child's body with respect. And that would be your responsibility. So this midwife is quite involved, you know, and some of them have got up to 15 clauses that you're agreeing to.

But this is all done by the church. So it's a church that keeps the register. And every visitation, when the bishop goes on his tours and visits parishes, the licences come up for renewal. Not in a formal sense that you present something, you're given something. But, you know, is Mrs. So-and-so still doing well? And can I see her and talk to her and this sort of thing. So the church was very much involved for a 200 year period. And again, it comes back to the importance of midwifery as a religious duty. So you have licensed midwives, they may be depending on the size of the area, you know, there may be more than one of those, but they're trained by a sort of apprenticeship system. So up to six years,

sometimes as little as three. In 1737, Sarah Stone, who's a midwife from Bristol, originally from Somerset, she writes that three years is enough. Other people thought six. And midwives often called their apprentices their deputy. And they traveled around together. And eventually, the deputy would gain enough experience to do a delivery. And once they'd got a certain number, then they could start thinking about applying to be a midwife in their own right. But at the other end of the scale and where there wasn't a licensed midwife, there would be hand women, sort of the same derivative as farmhand. And they would just be the local woman who'd got lots of experience in childbirth. She probably had a number of children herself. She was was the one that people called to but she'd never

gone down the formal licensing route and that sort of raises a question from simon g another of our club members he says um to what extent were midwives marginalized as witches by a predominantly male clerical and medical establishment as medicine began to be codified in the early modern period so were were some midwives sometimes seen as witches no sarah no no that's a myth yeah in right back in the late 80s um david harley writes at length about this and finds no evidence for midwives being treated as witches so that's a sort of urban that's an urban myth yeah because i i mean anyone who has seen call thewife, an incredibly successful drama set against the backdrop of the East End in the 50s and 60s, will know how central the fact that it is under the aegis of nuns is. I mean, the religion is really important there.

And I hadn't realized quite how kind of interwoven it was even back in the in the 16th and 17th centuries but i guess kind of obvious that it was could we take a break now and and perhaps sarah we could at the end of the second half look at call the midwife but we should there are a couple of um questions on say cesarean sections and on swaddling which would be wonderful to come to after the break and then look at how the midwifery evolved the course of the 17th, 18th century into the modern period. So we will be back after the break. Thanks very much. I'm Marina Hyde. And I'm Richard Osman. And together we host The Rest Is Entertainment.

It's your weekly fix of entertainment news, reviews, splash of showbiz gossip. And on our Q&A, we pull back the curtain on entertainment and we tell you how it all works. We have just launched our Members Club. If you want ad-free listening, bonus episodes and early access to live tickets, head to therestisentertainment.com. That's therestisentertainment.com. Hello, welcome back to The Rest Is History. We are talking childbirth, midwifery, all that kind of stuff. And there's an excellent question here from Dr. Crom, who is a classicist. And he says, I trust there'll be a cesarean section. Very good.

Very good, James. That's the sort of wit we expect from Alison. So we've had a lot of questions about this. Huel, is it true Julius Caesar was the first baby born by Caesarian section? David N., could you pass the history of the Caesarian section and the use in various cultures? Also, is there any truth to the idea this is how Caesar himself was born? And so on. So Julius Caesar, Caesarian sections, what's going on there? Yeah, it's a funny one, this, because you see repeatedly the idea that it was Julius Caesar. Well, if it was Julius Caesar, it wasn't the person that we're thinking of.

It was one of his ancestors. Because his mother lives, doesn't she? Exactly. And that's where the rather closes the case. But you do see in every culture, as far as I can say, there is examples of great people supposedly being born through surgical interventions, so through caesarean sections. So it's something that comes into most cultures, this idea that a person born to greatness would have been born in this exceptional way.

So there's no... Not duff. Not from a woman, that's right, not from a woman born. Absolutely, yeah. So, yes, it's very pervasive, but very unlikely. Up until the, really up until the 19th century, the late 19th century at that, what we think of as a modern cesarean didn't have any precedence,

you know, with the invention of sort of anesthesia and antisepsis that people could have cesarean sections and still thrive. You will see stories throughout history of people who, you know, supposedly had them and went on to have more children and survive. But how, you know, how true these are, we just don't know but it's not until as i say we get into um the late 19th century we've got what we called you know documentary evidence for it happening babies were born by surgical means but as tom alluded to it was when

the mother we'd given up hopes for the mother so it was a way of saving the child and it was very successful for that so if the mother was going to die anyway then let's try and save the child by surgical means so that that happened yeah so let's talk about mortality because we had loads of questions about that so for example dave walters has asked did mortality rates improve over time or did they actually get worse and just following up so that's one question and then the follow-up question is is from tim basby bernie and he asks given that there were obviously high risks of death compared with the figures now did men and women prepare themselves for death i.e did husband and wife kind of say almost a tearful farewell and the expectation that things might

go horribly wrong so so yeah what's the story with mortality yeah so i'll do the second part um first they they did prepare themselves and um there's a beautiful poem by the american poet anne bradstreet who published her poems published in the 1650s and she's got um a poem called before the birth of one of my children and it's written to her husband and i regularly reread it I teach it every year and I can't get through it without um tearing up it is just so touching she talks about how if if she is to die that she hopes her husband will look after their existing children she knows he'll remarry um because that's what you do but she says you know if you ever loved me then look after these children and don't let them come to any harm from this new stepdame.

But she lived. Please tell me she lived. She lived. Oh, my God. I thought Tom was going to dissolve then. Yeah. So I can't recommend that more highly, really. So people did prepare themselves. There were whole publications. The Mother's Legacy is a genre of publication in the early modern period in which mothers would write instructions for their children so that if anything happened to them there's even one from the early 17th century where the mother suggests names for her grandchildren

this is what i want to happen um but you often get you know instructions for good behavior and and things like that in these mother's legacies more generally there were prayers that were written especially for laboring women in the early stages or that she could offer up throughout her pregnancy to prepare her soul for the worst. So absolutely, it was something that was very much on people's minds. Having said that, the statistics are very much lower than we think. And they do get worse, as your questioner suspected. So in the late 17th century, the figure is 1.7% for maternal mortality in some studies that have been based on church records. We're talking about one to two per hundred, which sounds lower than we tend to think, but still means if we think about our wider network that we're going to know somebody

or know of somebody aren't we even if it's second hand or third hand removed um but childbirth generally um was very safe and you know we're talking we're talking over 98 out of 100 having a happy outcome for the mother and then and then you said it gets worse though that's the interesting thing so why would it get worse well the figure that I've got is that in 1933, it's 5.94. So why is that, do you think? Well, it's to do with, I want to say men getting involved. I don't mean very. Just say it.

It's fine. It's to do with the medicalization and the way that physicians were routinely involved in childbirth. And they're going from, the classic example is they've gone from post-mortem or from chopping somebody's leg off, wipe their hands down on their apron and go to the birth. And they're introducing germs into the birthing chamber, which wouldn't otherwise have been there. So the rates of pupper or fever, childbed fever, go through the roof. Oh, so that's interesting. So it's not because the men are recommending techniques that are too invasive or too intrusive or or sort of aggressive it's because they have been operating on other people

and they they're basically bringing in you know the infection that's that's the the major thing yeah that is that just seemed to be the major thing. But also that they would be the ones who came into a difficult birth. So if surgical intervention in the form of forceps or something was needed, then it would be a man who would do that. So, yeah, so there is higher cases for things going. So that process by which childbirth comes to be medicalised is obviously really interesting. But just before we come to that,

could I just ask one other question from Nikki Rathbone? And she's asking about swaddling. Why was it so universal from the Middle East to Native Americans for thousands of years? And why is it no longer practised? Is it still practised? It is still practised, yeah. I mean, I remember one of mine not settling in the hospital and the midwife came in and wrapped them up very, very tightly in their blanket and handed me back a pacified infant. And I thought something miraculous had just taken place. But swaddling is incredibly effective for soothing infants. So it's as simple as that. It works is basically the answer. It works. And that's the simple answer answer but it also had theory behind it um so midwives

would write jane sharp would write for example that um swaddling children is essential for their limbs to grow straight and that's what you want is strong straight limbs so if you swaddle them tight you know you lay them out nicely and swaddle them tightly then that would encourage their limbs to you know to settle into a straight formation and then um it was there was timetables for unswaddling so at about four months you might then release the infant's arms and then move on so so it talks a lot about midwives i have a question about fathers right what are they doing are they helping or are they loitering outside looking at their phone talking about the football having a cigarette. Yeah, yeah.

Yeah. So are there some who get involved? Or are they never welcome? They're not really welcome. I mean, you do get odd examples of a father being there because something's happening and they need to get involved. But also, you know, if you're thinking about people who live in quite close confinements, then people were trying to get on with their lives

around these continual births every couple of years um so yeah it wasn't that they were completely absent they weren't welcome in the birth chamber it's go and find something to do we'll let you know well actually dominic that sets up this question perfectly it's another question from sadie and i very much get the impression that she's asking on behalf of a midwife because she says that this is apparently a common myth among midwives is it true that Louis the 14th had a fetish for watching women give birth and that this led to the practice of women giving birth on their backs well I wouldn't like to um comment on what louis the 14th's fetishes were but um he certainly is on record as having watched deliveries and insisted on being present um and again i mean in a way

royal births are very different from everyday births so there would be a chamber full of people i mean um royal women have the sort of ordeal of giving birth in a sort of public way, don't they? And the royal physician would be at hand. Because otherwise bedpans and all that malarkey. But the story goes, doesn't it, that Louis XIV wanted to be there at all the births, including his mistresses and things like that. And he was just fascinated by the process. But it wasn't him really who had any influence over what the wider population were doing. But one of his contemporaries, so a Parisian physician,

Francis Mauricio, who wrote a book in French in 1668 on childbirth, and it was later translated into English. And in his book, he talks about women getting onto the bed when they're due to go into the final stages and start pushing. All people at this time believe that the best thing, what we would now call an active labour, that women are encouraged to go for. To squat. To walk about, squat, yeah, absolutely, birthing balls.

Because they used to have birthing chairs, didn't they? Yeah, absolutely. And there's examples of that going back to antiquity of birthing stones being these sort of passed along um you know the family and birthing chairs was part of a midwife's kit would be um to have some sort of a stool like they could be very simple affairs like a dairy dairy stool three-legged dairy stool um and the ones you see with with examples like that they've got no back and think well that can't be very comfortable but that's where your gossip's coming of course they're stood behind you they're being the back they're supporting the friend or the family member in labor and somebody else might be holding her arms and even if a woman did give birth on a bed at the

time that we're talking about in the late 17th century it would often be with with one of the gossip sat behind her, holding her. So it'd be semi-recumbent. So what we're talking about in Lewis' 14th time is a move towards a sort of semi-recumbent position. And what's driving that? Well, Mauricio is writing that that's the most optimal position for opening the pelvis. So he says that women should sort of become semi-recumbent and put their feet against something solid and and sort of bring their legs up open and that will that will give the best sort of way for the baby to be born and the best air the best way of the mother breathing so that's his that's his motivation for writing that but why he's had the reputation

for being the person who wrote this and was the first person and he is practicing at the same time as um lewis 14th was was in charge that passage um came from aristotle right right so um yeah so it's a long-held sort of view in some sort of circles but i think the reason you don't see it circulating more widely is because it's just not what people routinely did so women now lie down on their backs to give birth because of aristotle well they don't live they don't lie down on the backs now though no they did for a sort of period in the 20th century when it was it was the only way it was sort of allowed um so i've got a question actually from from a friend of mine called marina colville um and uh she and her husband are great fans of the show and she sent me a long email with her question

which is about the medicalization of childbirth and she says you know has has it does a lot of historical research concentrate on it as a kind of medical event rather than as where a natural event and have we moved on as a society? Or why haven't we moved on, sort of taking it out of the realm of the medical where you needed to the doctor on hand and seeing it as more natural? Where do you think the sort of the focus is at the moment? Do people still see it as medical? Or do they see it as more part of, as it were, the natural processes of life? I think that there was a time when, because the medical textbooks were the most easily accessible source that we had to hand, that there was a tendency to go down that

route and look at what these textbooks were saying and to take that as if that was necessarily what happened in all cases. And then there was also the structural changes in society. So you start with the lying in hospitals in london from the mid 18th century and a process that takes actually hundreds of years to get to get women into hospitals but there are now a lot of people who are focused primarily and i think probably um you know going back to what i said about you know the work in the 80s of people like dayla fitharley we were looking at midwifery there was always um a sort of acknowledgement about what women's experience was what women's lived experience was and there's a brand new book that only just came out last month giving birth in the 18th century um which

is very much interested in women's experience and what it was like to be part of a community and what happened and that um is yeah is investigating what it was actually like and the title's brilliant because it just is about giving birth in the 18th century um so yeah so yeah we've sort of addressing that in print a lot now and she asks a follow-up question which is why haven't all the research that's been done on the experiences of women and the lives of women and the sort of primacy of women's own experience of childbirth rather than that of the doctors and of the kind of medical profession why hasn't that improved maternity services the question is i guess why is it still sort of quite top down and quite sort of focused on the doctor rather than on the the

the mother or is that actually not a fair um description of it i think yeah i mean i think it can feel like that i think when you get into the system you can very much feel like it's top down and that women struggle to get their voices heard. I don't know that that's, you know, that's the universal experience. There's a great new program, isn't there? The Yorkshire Midwives, it's just started now. And it's about community midwives in Yorkshire and how they're facilitating home births. And it's a wonderful reality show. I think it's only had a couple of episodes aired, which shows what's going on in Bradford to listen to women and to facilitate wherever possible them giving birth at home, those who would like to. Well, so could I ask now about Call the Midwife?

He's been dying to do this. Well, I think it's a fabulous piece of historical drama because it takes you up close to look at how cultural assumptions evolve and change. But also it's about the infrastructure of how midwifery services are provided, isn't it? And how women come to give birth, because what you're seeing is simultaneously the improvements that a national health service bring to people in the East End who previously, I assume, are often at great risk. But at the same time, it's a group midwifery practice centered in a nunata's house, a kind of religious community of nuns.

The difficulty of ultimately of integrating that kind of approach with a more kind of top down nationalized approach. And do you think that, I mean, what is your impression as a historian of childbirth and midwifery? What do you make of Call the Midwife? I draw Call the Midwife. The early episodes episodes the early series which are pre-nhs you can see how important that service that was offered by the nuns was um to assisting the women of poplar who were amongst the poorest in the country living in overcloud overcrowded in sanitary conditions and they are based on the memoirs of jennifer worth

who was herself one of the nuns. She wasn't a nun. She was one of the midwives who worked in that sort of an environment. And so they are based on firsthand memoirs. And so, I mean, the later episodes, obviously, they're imagining a continuity. Because they're going into the 60s, aren't they? But, you know, people sort of think of it as being sort of a little bit saccharine. But it's the opposite of that, I think, as a historian. You know, they deal with flamidamide and things like that.

You know, tackling that sort of prime time viewing is very brave and very important, I think. And so, yeah, I think we know that the birth scenes on Call the Midwife are authentic because the clinical editor, Terry Coates, is involved in every aspect. So she oversees every single birth presentation. She's there working alongside the production throughout. She looks after the babies because the babies, you know, are taken from really newborn babies that are starring roles.

Terry oversees the way that this happens to make sure that it is authentic and realistic. I'm sure I wouldn't have watched it had Zadie not made me watch it. I was gripped absolutely from the beginning. And I think the reason why it's completely gripping, it's not just the kind of Dickensian blend of, you know, make him laugh and make him cry, which it does very effectively on both levels. I can't think of a drama series that has shown the process of social change in Britain quite so brilliantly. And it brings home to you how central midwifery and childbirth is to a culture, the way that it is understood and the way that kind of approaches to it evolve yeah absolutely it does so you get the the very early parts of it when there was no concept of um an nhs and women who couldn't afford to get help generally would would be managed sort of in social groups wouldn't it's basically with with going back to the hand woman

um and you see the regular um the way that the nhs comes in and intervenes and like you say that then that's got to be negotiated hasn't it Because now we've got this sort of monolithic organisation saying this is what's going to happen. And it tackles all that head on. And it shows that the tensions that exist around the foundation of this new way of doing things. So we've got one last question, I think, Tom, which I think is the question that everybody's been looking forward to.

So it's from Anthony Buck. This is probably a slightly harsh question to ask you sarah but i think everyone wants to know the answer which of the two presenters of the rest is history do you think would be the most effective birthing partner well i think i i think that's a very unfair question to spray on sarah who's only met us for under an hour. I think first impressions are often very revealing, Tom. I think it would be Tom, actually. I've seen more episodes of Call the Midwife.

Right, because all those hours spent watching Call the Midwife can't, you know, they've got to count for something. It's all about the hot water. Hot water and towels, Dominic. That's what it's all about. That's what I would have assumed.

I'd do the prayer at first, I think. I'd kick off with the prayer. It worked in the 17th century. Actually, I've got one last question, and it's a very broad one. As a historian of childbirth, which is such a primal experience, what's more significant, the commonality of the experience or the differences that have affected how women give birth over the course of the centuries and across the

sweep of the globe? I think it comes back to the commonalities for me. It is a physical process that, you know, is essentially the same over the years. The way that it's culturally determined through how you give, you know, the environment in which you give birth, so whether you're in a very sterile medicalised environment, whether you're at home with support, or whether you're in a very sterile medicalized environment whether you're at home with support or whether you're just surrounded by a group of friends and doing it as as your body's dictating essentially the process the physical process of giving birth is the same throughout time and reading women's letters and diaries from the 17th century as I do they don't talk very much about the physical experience of giving birth, but they do talk about the processes as their family grows. And they do talk about the feelings towards

the impending labour. And they do talk about the physical recovery afterwards and things like that. And you get a sense, you know, that you're reading the accounts of women who've been through this much the same as I did. It connects you in a way with women who lived hundreds of years ago. Brilliant. Well, as you have connected us to them, thanks so much for coming on. I hope everyone's enjoyed this and we will be back again with more in due course. Thanks ever so much. Bye-bye. Goodbye. Bye-bye. Thanks for listening to The Rest Is History.

For bonus episodes, early access, ad-free listening, and access to our chat community, please sign up at restishistorypod.com. That's restishistorypod.com. I'm Marina Hyde. And I'm Richard Osman. That's restishistorypod.com