AN

ADDRESS TO THE PUBLIC

ON THE PROPRIETY OF

MIDWIVES, INSTEAD OF SURGEONS,

PRACTISING MIDWIFERY.

BY J. R. PICKMERE.

Nothing ought to be held laudable or becoming, but what nature itself should prompt us to think so."-STEELE. Spectator, Vol. 1. No. 6.

The Fourth Edition, intended for the PAMPHLETEER, with considerable additions.

IN presenting to the public a new edition of my tract, intitled as above, I will compress the preface, the address, and the postscript into one view; and will introduce some elementary discussions confirmatory of the subject, which, since the last edition was published, have occurred to me as being requisite ; at the same time, adding a brief notice of some relative circumstances which have since transpired, and adapting the whole to the exigencies of the present period. I have, in this edition, expatiated on the nature of delicacy, as connected with midwifery and the marriage-state. In taking a philosophical view of delicacy thus related, and partly in some other respects, I have been passing through a region, which from the general novelty of the subject of this tract in print, has not, I believe, been before attempted to be fully explored. I may therefore by inadvertency have committed some errors in expression, or left some points incomplete; defects which my friends will oblige by notifying to me, and which I hope the readers' candor will prompt them to excuse.

In again declaring my sentiments publicly, I am aware that I am still contending against a phalanx of men, who are united by their profession, in one common feeling and interest, to support the present accustomed practice of midwifery; nevertheless, I am emboldened by a consciousness that my efforts are founded on*

a due sense of religion, virtue, and decency; and it affords me pleasure to find, that since I first commenced an open attack, able coadjutors have renewed it with increased vigor. Let it be understood, however, that my censures are general: for I am informed that many respectable and disinterested members of the profession are disposed for a change; and I do not intend to question the great worth and usefulness of medical men, when they apply themselves with skill and integrity to an attentive discharge of the duties properly belonging to their vocation.

It is an incontrovertible axiom, that a mere custom, however ancient and prevalent, which is not founded on natural necessity, and which is intrinsically bad in its principle and effects as respects society, ought to be suppressed by all prudent and justifiable means. Such a custom is man-midwifery, when contrasted with the practice of midwives, as I shall plainly show. It will be readily admitted by all well-disposed persons, that, naturally, the fair sex have a greater sensibility to modesty, and especially as respects personal delicacy, than the other; that their natural modesty possesses, in the estimation of both sexes, an ideal excellence, the preservation of which materially contributes to the innocent enjoyments allotted to our temporal state by Providence, and that the moral purity of women forms a part of their religious obligations. Modesty, in its most extensive sense, is peculiarly graceful in the fair sex: their eternal welfare, and even their worldly reputation, are not the only points in which its preservation concerns them. Besides its ideal excellence, it imparts a winning and uniform decency to general behavior. There is, generally, that habitual loveliness in the aspect and manner of a lady of genuine modesty, contracted from the sympathy of the mind with the exterior person, which confers an additional grace on virtue and mental accomplishments, and adds an indispensable lustre to beauty and every personal attraction. Being enjoined in the exercise of our social duties to be active in doing good, besides refraining from the commission of unjustifiable harm, I am -solely urged in this Address, by a sincere wish to defend some of the most amiable properties and shining ornaments of the sex from the plausible attacks of the ensnarer, to expose and deter the gross abuses and various great evils irremediably incidental to a continuance of the present system of midwifery, and to recommend, in their stead, innocent and effectual means of alleviating one of the many distresses to which human life is subject, in our present fleeting and probationary state of existence. Childbirth, like the parturition of females in every kind of viviparous animals, is purely a natural process, equally as remote from an artificial operation as the pulsation of the heart. In

ninety-nine cases out of a hundred, the labors of women are perfectly regular; and were they in such situations left each to herself, quite alone, without indelicate intrusion, or other accident to protract or disorder the process, nature would nearly always successfully accomplish its own purposes. Numerous have been the instances eventually discovered in our country, in mơdern times, of poor females having been intentionally alone during labor, for the purpose of concealing the birth of illegitimate children. Civilisation has the general effect of strengthening the bodily powers in some classes of individuals, by means of constant hard exercise, and an ample supply of wholesome provisions; and, on the other hand, by producing the poor manufacturing and the inactive classes, it has the effect of weakening these powers: but, whether the bodily powers be strong or comparatively weak, so long as there is no disease, nor extreme debility, peculiarly affecting the organisation of nature, with reference to the involuntary corporeal actions in childbirth, the organisation is perfect; and the respective forces of the various actions are so modified and tempered together, as to suit the natural strength and occasion of the individual. Such particular disease, or extreme debility, is not more prevalent in civilised, than rude nations; therefore civilisation has not the effect of altering the nature of women, in respect of childbirth. In a state of rude nature, as well as in that of civilisation, mankind are social beings, mutually assisting each other; and therefore, in both these states, it is natural and proper that women should be attended, with a view to assistance or convenience, during childbirth. In a state of civilisation, such attention is not more essentially necessary, but it is more expected, on account of the refinements consequently introduced into habits and manners. Even, if civilisation had tended to create a necessity for more frequent essential assistance, and whether it does or not, the interests of society demand that those persons should be exclusively encouraged in the practice of midwifery, who are by nature adequate to administer this assistance most advantageously for mothers, and most congenially to the inclinations of husbands. I now, therefore, come to the immediate discussion of the present subject; to prove by comparison that women alone are the proper persons to render this assistance; and then to recommend the general adoption of midwives, and the consequent subversion of man-midwifery.

In our nation medical men rarely interfered in accouchements till within the last seventy or eighty years. The subsequent prevalence of man-midwifery never having become requisite, it must have had its origin in the lust and avarice of medical men of the VOL. XXVÍI. Pam. -E NO. LV.

period when it commenced; by which they were prompted to exercise every insinuating art, and urge pretences of necessity for accomplishing their purposes, and establishing their practice. Doubtless they were accustomed then, as they now are, to be admitted into families on much freer terms than other male visitors. It is probable that they did not then, in general, act with the unblushing effrontery of their successors of the present age. Their practice in midwifery would generally be first introduced amongst young females only, on whose comparative artlessness and timidity they could most easily impose; and then a sense of delicacy having placed these completely and permanently under their restraint, as respects complaining of a breach of it to their husbands and the world, as I shall presently show, the next generation of females, by the arts of medical men, aided by the force of example, would more readily fall into their snares. In the mean time, the husband, as in the present day, being totally unacquainted with the business of midwifery, and hoping and fully expecting, in the ordinary course of events, that his wife's labor would be quite regular, and that the chance of a necessity for artificial aid was barely possible, confidently anticipated that the surgeon, though present, would not have occasion to offer more than a very slightly offensive assistance; and therefore made no objection to his attendance. The medical man well knew, by reflection on the properties of the human mind or by experience, that having once gained a point, delicacy would seal the mouth of the wife, and those of her female confidential attendants; and would even so far restrain them from complaining of the particular case, that in general they would not even do so to others of their own sex. He also well knew, that the husband, being entirely ignorant of the real character of the affair, or in case of unexpected or pretended difficulty, presuming on necessity, would manifest no objection. Thus the general practice of man-midwifery was established, and has been continued to the present time.

I am certain, that had husbands in general been aware of the nature and long continuance of the ordinary assistance personally given by the accoucheur, uniformly, in the later periods of even a perfectly natural and easy labor, the abominably gross indelicacy of it, as administered by a man, would have prevented the origin, or at least have speedily shortened the continuance of man-midwifery. Though this particular interference is exercised by every common midwife, as well as accoucheur, and has more relation to the temporary ease, than the safety of the mother; and though nature alone would operate effectually in nearly all instances, as it does throughout the whole viviparous creation, yet as it is of so simple a nature, that with a midwife it is quite harmless,

should it even be useless, I do not wish to be understood as censuring its adoption in proper hands.

Having taken a cursory view of the origin of man-midwifery, and of the primitive causes of its present continuance, the reader will not be surprised that the practice should be so very prevalent in this country as it now is, more especially if he advert to the present situation of affairs connected with it. The facility afforded to young men in late years of instruction in surgery and midwifery, the numerous anatomical lectures, and lectures on midwifery at the same time provided for their improvement, the great advances, both real and pretended, which have been lately made in the science of midwifery, the surprisingly increased number of surgeons, and even of physicians in the country who practise as such, have combined, as the immediate causes, almost wholly to extinguish the ancient and salutary practice of midwives, in consequence of their not having kept equal pace in improvement. It is well known that medical men, in general, have hitherto exerted all their influence to prevent women from acquiring a scientific knowlege of midwifery.

I will now proceed to point out the various great evils peculiar to the present system.

Besides the ordinary abuse arising out of man-midwifery, as before mentioned, licentious tricks of enormous depravity are sometimes committed, and others highly objectionable are very frequently practised by accoucheurs, in the course of their professional avocations. In entering on this part of the present subject, I will, with a view to prove the frequency of these extraordinary abuses, in the first place, quote the convincing arguments on this point, expressed in an excellent tract, published since the last edition of my pamphlet appeared, and which is intitled, "Observations on the impropriety of Men being employed in the business of Midwifery." The author's words are as follows:

"1st. Lust is the most powerful of all the appetites: to whatever extent it may be gratified, its demands are soon again renewed, especially if attracted by variety in its objects; and when the body has lost its power of indulgence, the mind frequently retains its desires, sometimes even heightened in a great degree. Therefore men advanced in years, when inclined by their vicious propensities, are empowered by their experience, and consequent subtleties, to contaminate the minds of women more than younger and less experienced men. Lust being thus the most powerful of all the appetites, it is, and it is necessary for natural purposes that it should be, less under the influence of the reason, than any other appetite; for if we had the power of coolly deliberating on the effects of indulgence, the intentions of nature would be