HHH Column: Shifting Roles: The Decline of Midwife Testimony in Early Modern Sexual Offence Trials
The HHH column is a monthly blog in which History, Health & Healing members share their thoughts on research, current affairs, or anything to do with medical history. Each edition is written by a different member — in due time, we hope to offer everybody a chance to publish a contribution. This month, the floor is for Marlies Couch, PhD candidate at the Huygens Institute, researching the careers and personal histories of migrants working for the Dutch East India Company (VOC). However this column centers on a very different topic: the decline of midwife testimony in early modern sexual offence trials, based on the Master’s Thesis Marlies has written about Sexual Violence and Medical Care in 17th- and 18th- century London.
Shifting Roles: The Decline of Midwife Testimony in Early Modern Sexual Offence Trials
By Marlies Couch
Please note: this article contains references to rape and sexual assault.
On 30 August 1694 Thomas Mercer stood trial at the Old Bailey in London for raping and assaulting eight-year-old Bridget Gerrard. After her examination of the girl, a midwife testified that she found Bridget “in a very sad condition, and much abused”, which she said must have been done by a man. The child’s female neighbours also believed that a man had raped her. Despite the forcefulness of the midwife’s observations, the absence of a surgeon’s examination was noted during the trial. An “eminent surgeon” was sent for by the court. This distinguished male practitioner argued there had been no penetration – a legal requirement to convict a rape – and that Bridget had contracted venereal disease merely by touch. Thomas Mercer was acquitted of the rape charge.[1]
The ever-complex role of physical evidence was a crucial part of early modern sexual offence trials. Medical experts – surgeons, apothecaries, physicians and midwives – were deemed ideally qualified to interpret bodily proof. The experts were asked whether the prosecutor’s body and undergarments had been inspected, or whether any signs of forced intercourse or venereal disease had been found. The professional status and knowledge of all experts was under scrutiny by testifying, but none faced more scrutiny than midwives. If the testimony of a female midwife contradicted that of a male practitioner, the man’s evaluation often took precedence.[2] The overruling of the midwife’s opinion in Bridget Gerrard’s trial is one of many such cases at the Old Bailey.
As the central criminal court for the City of London, the Old Bailey was where people indicted for serious crimes such as murder and rape were tried. The published court records, the Proceedings, contain a wealth of information about non-elite lives and have been studied extensively, but there is more to uncover. By exploring, for example, the hierarchy between various medical court witnesses, we stand to gain more insight into early modern English medical practice. My study of 265 sexual offence trials held between 1674 and 1800 has revealed a striking phenomenon in this field: the presence of midwives in the London courtrooms gradually decreased during the period. What caused this decline?
Table 2. Trials featuring female and male expert witnesses at the Old Bailey, 1674-1800
| Number of female practitioners (midwives and nurses) | Number of male practitioners (surgeons, doctors, male midwives and apothecaries) | |||
| Age of prosecutors | <14 >14 | <14 >14 | ||
| 1674-1750 | 30 13 | 43 | 56 8 | 74 |
| 1750-1800 | 8 5 | 13 | 41 12 | 53 |
| 1674-1800 | 38 18 | 97 20 | ||
These figures are based on the present sample of 265 accounts from the Old Bailey online archive.
In the 1970s, when academics began investigating historical healthcare practices, they found that the disintegration of a long-standing ecclesiastical licensing system for female midwives in the first half of the eighteenth century changed European midwifery. But this was just a partial explanation. The academics further discovered that the simultaneous advancement of formally educated male practitioners excluded women from professionally practicing medicine. Historians challenged perceptions that were largely shaped by the uncritical acceptance of accounts written by contemporary medical men. These accounts had resulted in the enduring stereotypical portrayal of midwives as ignorant and incompetent. The empirical knowledge and abilities of midwives were slandered by university-trained physicians, surgeons and apothecaries, who were eager to establish their professional competencies in an increasingly competitive medical marketplace.[3]
Some of these practitioners ventured into midwifery to diversify their skills and expand their clientele. The emergence of these men-midwives, likewise propagating ‘modernity’ and scientific progress, contributed to major transformations in childbirth across Europe. One of these was the use of intervention instruments. Female midwives would occasionally use emergency tools but, mid- eighteenth century, increasingly left such tools to their male colleagues just as the use of forceps would become widespread and instruction in their use became the monopoly of London men-midwives. The associated changing propensity for the lithotomy position for childbirth helped to instil concepts of the natural passivity of women and encouraged the infantilisation of expecting women.[4]
The restriction of non-professional opinions and practices also coincided with a gradual increase in the authority ascribed to medical evidence presented at the Old Bailey. Juries demanded a degree of certainty with which medical witnesses articulated their opinions and the professionally trained male health workers seemingly provided this to greater satisfaction than empirically trained female practitioners.[5] Interestingly, prior to the persistent efforts toward professionalisation, male medical practitioners were regarded with suspicion by contemporaries because of the private realms and secrecy in which they operated. Manual labour was also negatively associated with female tasks and many medical activities – such as physical touch and dealing with disagreeable bodily substances – were consigned to the realm of women and servants.[6]
Women were generally expected to have knowledge of common illnesses specific to women and children. Trained midwives would diagnose disease, undertake minor surgical procedures and administer medicine, and many were highly literate before their decline in licensed practicing. Through their understanding of the distinctively female bodily functions and standing within communities, midwives had an important role in educating and supporting other women.[7] For these reasons, parish officials and justices initially called upon them to act as expert witnesses in trials on bastardy, infanticide and rape. But they were gradually supplanted in one of their most prominent public roles by male surgeons as the professional training and licensing of the latter became preferred and autopsies more common.[8] This shift affected female prosecutors then and its lasting impact is evident through fewer midwives’ voices in legal records today.
Midwives’ knowledge of female physiology might, paradoxically, have contributed to their declining involvement in legal proceedings. Women drew on their expertise of “those natural Symptoms that are incident to Women”, as Bridget Gerrard’s midwife had said.[9] Their usually authoritative testimonies on sexual violence reveal a profound contradiction: women’s knowledge of rape often did not suffice to convict it. According to contemporary ideas, women’s bodies were inherently mysterious and dubious. This meant that assessments of rape were not necessarily regarded as objective truths by the court. Female practitioners were regarded as interpreting ambiguous signs on deceptive bodies to discern objective truths. Their experience of sexual matters and women’s bodies was precisely what made their observations suspect.[10]
This mistrust is particularly prominent around evaluations of venereal disease, which was a major focus of physical observations because it could prove rape. Midwives and lay women often made the connection. Male practitioners, however, who enjoyed more authority than their female colleagues, rarely testified to rape as the sole cause for infection or injury. The medical men would not rule out other modes of transmission or attributed symptoms to sexual assault.[11] Crucially, assault was not a capital offence in the early modern period, but rape was. Midwives’ testimonies could thus carry life-or-death consequences, and this power is precisely what made these women threatening. Whilst judges generally exercised caution regarding capital crimes, the tendency to favour male practitioners’ opinions (reflected by low conviction rates) suggests a reluctance to send a man to an early grave on the basis of women’s words.[12]
Shifting midwifery practices in England coincided with broader trends early modern Europe. Historians found that female medical practitioners became increasingly marginalised across the continent between 1500 and 1800 by the rising tide of professionalisation, which emphasised formal education, occupational titles and licensing mechanisms.This impacted midwifery most significantly, though other female practitioners were also forced out of more regulated areas of the economy. The women carried on with their healthcare work, albeit within less visible structures, thus inevitably leading to gaps in the records.[13] Focusing on male and female practitioners at the Old Bailey has given a glimpse of the socio-medical framework in which both operated and illustrated the reality of midwives’ professional regard in their own domain. Their exclusion reaffirms the importance of integrating female healers into women’s history as well as medical history, looking beyond the historical records where they disappeared from.
[1] The Proceedings of the Old Bailey (hereafter OBP), August 1694, trial of Thomas Mercer (t16940830-9). The defendant was acquitted for rape, but a new indictment was ordered for the offence of assault on Bridget, for which Mercer was tried, found guilty and fined.
[2] Esther Snell, ‘Trials in print: narratives of rape trials in the Proceedings of the Old Bailey’, in: David Lemmings ed., Crime, courtrooms and the public sphere in Britain, 1700-1850 (Abingdon 2012) 37-56, at 37-38; Wendy D. Churchill, Female patients in early modern Britain. Gender, diagnosis, and treatment (Farnham 2012) 85; Olivia Weisser, ‘Poxed and ravished: venereal disease in early modern rape trials’, History Workshop Journal 91:1 (2021) 51-70, at 65.
[3] Margaret Pelling, Medical conflicts in early modern London: patronage, physicians, and irregular practitioners, 1550-1640 (Oxford 2003); Margaret Pelling, ‘Compromised by gender: the role of the male medical practitioner in early modern England’, in: Hilary Marland and Margaret Pelling eds., The task of healing: medicine, religion and gender in England and the Netherlands, 1450-1800 (Rotterdam 1996) 101-134, at 120; Sharon T. Strocchia, Introduction: women and healthcare in early modern Europe’, Renaissance Studies 28:4 (2014) 496-514, at496-497; Mary E. Fissell, ‘Introduction: women, health, and healing in early modern Europe’, Bulletin of the History of Medicine 82:1 (2008) 1-17, at 1-6; David Harley, ‘Provincial midwives in England: Lancashire and Cheshire, 1660-1760’, in: Hilary Marland ed., The art of midwifery: early modern midwives in Europe (London 1993) 27-48, at 39-40.
[4] Harley, ‘Provincial midwives’, 40-42.
[5] Stephan Landsman, ‘One hundred years of rectitude: medical witnesses at the Old Bailey, 1717-1817’, Law and History Review 16:3 (1998) 445-494, at 449 and 454.
[6] Pelling, ‘Compromised by gender’, 107.
[7] Harley, ‘Provincial midwives’, 28-29 and 34; Hilary Marland ed., The art of midwifery: early modern midwives in Europe (London 1993) 6; Patricia Crawford, ‘Sexual knowledge in England, 1500-1750’, in: Roy Porter and Mikuláš Teich eds., Sexual knowledge, sexual science. The history of attitudes to sexuality (Cambridge 1994) 82-106, at 96.
[8] Harley, ‘Provincial midwives’, 36-41.
[9] OBP, August 1694, trial of Thomas Mercer (t16940830-9).
[10] Weisser, ‘Poxed and ravished’, 65-66; Crawford, ‘Sexual knowledge in England’, 100.
[11] Weisser, ‘Poxed and ravished’, 64-65; Strocchia, ‘Introduction’, 508 and 511-513; Fissell, ‘Introduction’, 11. The link between venereal disease and penetrative sex was not straightforward – infection was thought to spread in both sexual and non-sexual ways.
[12] Weisser, ‘Poxed and ravished’, 64-65; Antony E. Simpson, ‘Popular perceptions of rape as a capital crime in eighteenth-century England: the press and the trial of Francis Charteris in the Old Bailey, February 1730’, Law and History Review 22:1 (2004) 27-70, at 65; Garthine Walker, ‘Rape, acquittal and culpability in popular crime reports in England, c.1670–c.1750’, Past & Present 220:1 (2013) 115-142, at 125; Sara Mendelson and Patricia Crawford, Women in early modern England 1550-1720 (Oxford 2003) 53.
[13] Strocchia, ‘Introduction’, 496 and 511; Fissell, ‘Introduction’, 2-4 and 8-9; Marland, The art of midwifery, 1; Doreen Evenden, The midwives of seventeenth-century London (Cambridge 2000) 174-176.