It is an art to provide women with good support during pregnancy, labour and breastfeeding. In the history of the midwifery profession, this art was reserved exclusively for women for thousands of years. They passed on their skills from generation to generation, constantly accumulating knowledge and experience along the way. Therefore, every pregnant woman could always be sure: When I'm in labour, I not only have other women from the neighbourhood at my side, but above all an experienced midwife. For a very long time, expectant mothers have therefore received one-to-one care from a midwife during labour. You can find out more about the history of the midwifery profession in this article. If you are interested in what it looks like today, you can here read more about it.
Midwives are irreplaceable companions
In the past, midwives were also known as "labour mothers" and always played a prominent role - both as skilled helpers to women giving birth and as a social institution. To this day, midwives with all their in-depth knowledge are important - and I think irreplaceable! - companions for women on their journey from pregnancy to birth to the end of the breastfeeding period.
This is sometimes also reflected in other languages. In English-speaking countries, for example, we are called "midwife", meaning "the woman who goes with you". In French, midwife is called "sage-femme", which means "wise woman". The German word "Hebamme" originated around the 9th century from the Old High German term "heviana". Here, the word part "hevi" is a form of "hevan", which means "to lift", while "ana" stands for grandmother or ancestor. So "heviana" refers to an elderly woman who picks up the baby. The name was probably inspired by a Germanic ritual in which the midwife lifted the newborn from the floor and presented it to the father. If the father willingly accepted the child, he accepted it.
But there is much more to tell about the history of my profession. Probably for the first time, the responsible task of midwifery was recognised as early as the third millennium. before Christ was publicly honoured - on a temple painting in ancient Egypt. It shows how a midwife helped the children of the sun god Re to come into the world. At around the same time, the Sumerians, who settled in what is now Iraq, are even said to have paid homage to a goddess midwife. The important role of midwives was also recognised in antiquity, and they also found their place in the Old Testament of the Bible.
Oral tradition in the history of the midwifery profession
The first "midwifery textbook" dates back to 117 AD. As was customary in the art of writing at the time, it was written by a man, Soranus of Ephesus. Among other things, the ancient Greek physician wrote a comprehensive gynaecological work, which also contains texts on obstetrics and midwifery as well as embryology and infant care. The author presumably compiled and recorded traditional midwifery knowledge. His knowledge could hardly have been based on his own experience and observation, as for many centuries it was forbidden for all healers to look at or touch intimate female areas during examinations or even to be present during a birth. The fathers of the children, on the other hand, had the important task of providing the midwife and the helping women from the neighbourhood with everything they needed during the birth, such as food, warmth and hot water.
There is another reason why the ancient author and later others had to painstakingly gather the available midwifery knowledge: there was nothing written about it. For a very long time, all in-depth knowledge about labour, birth, abortion and contraception, among other things, was only passed on by the older, experienced midwives. verbal to the younger ones. In the Middle Ages, however, this could quickly become a problem for such "knowledgeable women". If they were targeted by the church, there was a real risk of becoming a victim of witch-hunts. Nevertheless, there is no evidence that the proportion of midwives who were actually burned as witches was higher than that of other groups of women.
However, the midwives had to swear an oath to lead a Christian life. This included renouncing "magical powers", which meant that they were no longer allowed to administer abortifacients to women. They also had to personally baptise babies, find out the name of the father of unmarried mothers and report newborn babies with disabilities as a "punishment from God". However, they were allowed to perform emergency baptisms.
The state of midwifery is born
From the 15th century, the first professional regulations for midwives were established in Regensburg and Ulm and ensured standardised training. However, women had to take their exams in front of men, even though they usually had little knowledge of female anatomy and the birth process for the reasons mentioned above. Nevertheless, the profession of so-called sworn midwives was now "born".
From the early 17th century, obstetrics became more professionalised. It was the French midwife Marie Louise Bourgeois who caused a sensation with a textbook and her scientific documentation and is considered to be the one who led obstetrics into the modern era. Gradually, more and more doctors began to take an interest in practical obstetrics. Some midwifery schools were even run by men. And it was also men who invented the obstetric forceps at this time, which were used to grasp a baby by the head and pull it out in the event of complications in the birth canal.
In 1779, the "Accouchierhaus" was established in Jena, the second German maternity centre with a midwifery school that was affiliated to a university. It was here that a start was made on analysing traditional midwifery knowledge to determine the extent to which it could be scientifically substantiated.
Technical assistance paves the way for doctors to enter the female domain of childbirth
With the advancement of science, especially in medicine, in the 18th and 19th centuries, the culture of childbirth changed: slowly but steadily, it became mechanised. The increasing use of forceps by doctors and caesarean sections performed on live women in labour also contributed to this. At the time, however, this method of delivery actually cost more lives than it saved. The deeper male physicians delved into the field of obstetrics, the more controversial they made the midwives' field of work. Although the surgeons and wound specialists knew how to utilise the midwives' knowledge for their own benefit, they strove for authority. From then on, they claimed to be in charge of deliveries and tried to demote the midwives to assistants.
This development continued in the 20th century. In its wake, a new trend emerged that took hold in the 1950s: births increasingly took place in hospital and less and less at home. Bringing a child into the world was declared a risky affair and thus even more of a medical procedure mechanised by doctors. There was not much left of the midwife's view of a natural physiological process. Individual wishes or treatment of expectant mothers during labour were not on the agenda in the clinic.
Fathers being present during hospital births was also unthinkable. Until the 1970s, the role model of an expectant father was a nervous man who paced up and down somewhere separate from the woman giving birth, possibly smoking one cigarette after another. The new dad regularly took his first look at his child through a pane of glass into the hospital's nursery, where a nurse stood with the little bundle in her arms. It wasn't until the 1970s that the first fathers began to accompany their wives to the birth.
Today, around 98 per cent of all children in Germany are born in a hospital. If a woman giving birth there experiences a continuous One-to-one support by a midwife, she can count herself lucky. However, this is not guaranteed, as many clinics are short of staff both in the area of inpatient midwife support and medical specialists. However, the relationship between the two professions is now regulated - and largely on an equal footing and with the pregnant woman in mind.
Midwives are there for mums and babies throughout the entire period of pregnancy and birth, long after the puerperium, i.e. until the end of the infant and breastfeeding period. A midwife must always be present at the birth. This also applies if the baby is born by caesarean section.
The assumption of costs is also regulated for women. The Fifth Book of the German Social Security Code clearly states that every woman "during pregnancy, during and after childbirth Entitlement to medical care and midwife assistance including examinations to determine pregnancy and prenatal care."
Traditional midwifery knowledge has always been under threat over the course of time. It has not been lost over the years. Midwives empower (expectant) parents with their knowledge. Their knowledge is valuable for families, but also for society as a whole.
Oh yes, and something else has changed: Fathers in the delivery room are the rule today and no longer the exception. Only the One-to-one support of the woman giving birth by a midwife - and this means that she should be there exclusively for the one woman giving birth from the active labour phase onwards. This does not mean that the midwife should and can be there for mum during the entire birth. It is all the more important that partners are allowed and willing to actively accompany the birth. This is why it is also important for dads to familiarise themselves with the topic of birth and the needs of mothers and babies. The Online courses by midwife Katharina are particularly suitable for this purpose.
