Justine Siegemund. The Court Midwife. The Other Voice in Early Modern Europe. Chicago: University of Chicago Press, 2005. xxxi + 260 pp. $24.00 (paper), ISBN 978-0-226-75709-4.
Reviewed by Almut Spalding (Department of Modern Languages and Program of Gender and Women's Studies, Illinois College)
Published on H-German (January, 2007)
Diagnosing, Managing and Preventing Difficult Births: Justine Siegemund (1636-1705)
This fascinating book makes available in English the work of a seventeenth-century midwife who became famous for her skills in handling difficult births. Originally published in 1690 as Die Chur-Brandenburgische Hoff-Wehe-Mutter, this work discusses not routine labor, delivery and lying-in, but explicitly focuses on delivery complications, which then as now carried the potential for malpractice suits. Precisely because of this focus, The Court Midwife represents not only an illustrated textbook for seventeenth-century midwives, but, for today's readers, also provides a social commentary on the time. Lynne Tatlock's careful translation and edition of the text offer vivid insights into early modern medical and obstetric technology and care, social networks, women's lives, communal health care systems, educational institutions, the profession of midwifery, its legal implications and more.
An educated, though not formally trained daughter of a pastor in Silesia, Siegemund was to deliver, during the course of her life, over 6,000 babies, or perhaps one should say 6,000 women. At the time, childbirth arguably was the great equalizer across society, for whether they were rich or poor, princesses or peasants, when complications arose, all women faced the same risks. For Siegemund, a "happy delivery" meant one thing: the successful process of freeing a woman from her child. After all, this result alone gave the woman a chance to survive. Siegemund was usually summoned only when complications arose, that is, after two, three, even five days of labor. Yet she claims that she successfully delivered every single woman whom she attended. Not surprisingly, her reputation and skill made her very attractive to rulers, whose courts depended on the successful delivery and survival of dynastic offspring. As a result, following decades of delivering peasant women around Liegnitz, Siegemund became a midwife at the court of Frederick William, Elector of Brandenburg in 1683. Now working in Berlin and at other courts to which she was dispatched, she assisted in some twenty princely births across Europe. It was during this time and with the special encouragement by Queen Mary II of England that Siegemund decided to publish her extensive notes on midwifery.
Many midwives apparently were shockingly ignorant about the birthing process. As a result, according to Siegemund, when complications arose, they frequently could not help and often aggravated the situation. Siegemund's main objective for her book therefore was to teach midwives how to prevent, diagnose and manage complicated deliveries. The first part of her textbook, covering specific topics in nine chapters, was written in the didactically effective form of a dialogue between an experienced midwife and an apprentice. The second part, like an exam review guide, took the form of a catechism, with its eighty-six questions and answers. More than forty copper etchings illustrated the text, adding visual reinforcement to the written content. Siegemund's work almost instantly became a standard reference work, appearing in a Dutch translation immediately and in several German editions up to 1756.
The key to midwives' effective assistance, according to Siegemund, lies in modern terminology, in the manual examination of the mother during labor, in order to find out how far the mother's cervix has effaced and dilated, and determining the position of the child. Siegemund explains various scenarios for prolonged labor and presents ways of turning the child so that it can be delivered. All such cases involve manipulating the child with the midwife's hand in utero. For particularly complicated cases when there is no chance that the baby can change position by itself (as when the child is already dead, for example), Siegemund offers a successful technique new even to her physician contemporaries: After having located the child's feet with her right hand inside the uterus, the midwife then with her left hand guides through the vagina and into the uterus a long stick with a string attached to the end, then with her right hand takes the string and loops it around the child's feet, and finally gently pulls with her left hand on the string while with her right hand turning the child until it is positioned to be born feet first. Siegemund even found a technique for safely delivering a child when the placenta blocks the birth canal (placenta praevia, without intervention a sure death sentence for both mother and child); namely, by carefully making a hole through the placenta, then piercing and thereby draining the amniotic sac, which would prevent a massive hemorrhage. All of this, of course, was without anesthesia for the laboring mother. Who said that heroes were only made on the battlefield?
Not directly a medical focus, but equally enlightening for modern readers, are Siegemund's comments on relations among midwives and relations between midwives and physicians and her lengthy justifications for writing this book without ever having given birth herself. Like Dorothea Erxleben, who would later become the first female physician in Germany, Siegemund had to deal with colleagues who were jealous of her professional success. Surely one reason Siegemund could include so many case histories in this book was that she had retained detailed records and testimonies related to her legal battles with a Liegnitz town doctor. She also covered her bases on the theological front and assured the reader that she was not playing God by intervening in complicated births, citing in her book the approval of court chaplains. Similarly, she included commendations from various universities' medical faculties. Finally, the dedications of various editions of the book to various princesses demonstrated Siegemund's patronage by the high and mighty. Though to some degree this strategy was common, that Siegemund felt the need to include these multiple layers of proof for her competence in the subject says volumes about female authorship.
Tatlock's introduction to the volume, informed by meticulous archival research, sets Siegemund's work in historical context. For her translation, Tatlock also consulted contemporary English language texts, transforming dense, antiquated German text into an English that is both readable and at the same time faithful to the diction of the period. Some words that Siegemund used, of course, remain part of modern everyday language, such as Scheide, Muttermund and Mutterkuchen, and would not sound as strange to modern Germans as does the literal English terminology, which Tatlock retains as "sheath" for vagina, "mouth" for cervix and "cake" for placenta. By keeping some of this more literal terminology, Tatlock reminds the reader that this work stems from a different era, after all.
Part of the series The Other Voice in Early Modern Europe, this volume also contains the preface of the series' editors, Margaret King and Albert Rabil, which sets early modern women's writings in a historical context for modern readers, as well as a glossary, a bibliography and an index. This very accessible book should appeal to both scholars and students, particularly those interested in the history of medicine, cultural studies and the history of women and women's writings. Even in the age of C-sections and epidurals, however, expectant mothers may find this volume a better reading for the days after delivery.
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Citation:
Almut Spalding. Review of Siegemund, Justine, The Court Midwife.
H-German, H-Net Reviews.
January, 2007.
URL: http://www.h-net.org/reviews/showrev.php?id=12757
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