Attending the birth: competition for obstetrical training by medical students and midwives in nineteenth-century France

Abstract

AbstractThough male doctors gained prominence at the bedsides of pregnant mothers in nineteenth-century Europe, the clinical training they received in medical academies remained cursory. In France, to supplement the medical faculties, the government set up schools for both health officers and midwives which were meant to teach practical obstetrics. This paper focusses on the city of Arras, where these two groups of students competed for the limited numbers of pregnant patients on which to practice their future professions. Like many in their field, two prominent instructors in Arras at each end of the century promoted male obstetrical education over female, arguing that practical education for health officers would lead to safer births for mothers and infants. By the 1870s, the obstetrics instructor adopted germ theory, tying improved hygiene and thus mortality rates to male students’ access to hospitalised patients. Despite their arguments, in Arras, the male students never gained priority in clinical obstetrical training, which midwifery students kept. To keep male students out of maternity wards, local administrators used fears that gender mixing would lead to immoral acts or thoughts. In doing so, they protected the traditional system of midwifery rather than invest in more costly male medical education. Championing midwifery students’ rights to the spaces and bodies needed for their education, however, delayed adoption of hygiene and antiseptic practices that led to lower maternal mortality. Unable to adapt to changing requirements by the state, the medical school closed in 1883, while the midwifery programme thrived until the 1960s.