Towards the end of the Dark Ages women midwives or ‘healers’ were tortured and killed. Since women had no access to formal education, it was thought that the midwife or ‘healer’s’ power must come from ‘supernatural’ sources – she was in league with the devil. A frenzy of witch- burning was responsible for the killing of several million women during this time, and according to Jeanne Achterberg (1990) this was
“….an evil that surpasses rational understanding. Here was, indeed, the worst aberration of humanity, and it trickled down the hierarchy of authority” (Woman as Healer, 1990)
Women’s roles in Western Medicine - 17th to the end of the 19th century.
We can safely say that so far throughout history, women had played a central role in society as midwives or ‘healers’. They were seen as ‘wise women’’. At times this role was revered, at times feared, sometimes women were even acknowledged and seen as a leader in the society. However, with the advent of new scientific knowledge the 17th, 18th and 19th centuries saw some really radical developments in medicine, with some equally radical changes to women’s traditional ‘healing’ roles. Developments such as: De Humanii Corporis Fabrica (On the Structure of the Human Body) the book by Andreas Vesalius, which marked a turning point in Western Medical, specifically in the scientific study and understanding of anatomy; the theory of the circulation of blood; the discovery of new drugs; the invention of new surgical instruments and techniques (for example the forceps in 1620 and the first blood transfusion). The study of medicine was revived with these new discoveries and was accompanied be the process of “professionalisation” of medicine and healthcare. These developments along with the dominant beliefs, attitudes and laws, all served to put the role of healing and midwifery firmly in the hands of ‘trained’ physicians who were predominantly men. This brought about struggles by some women for equality within the medical profession, and their traditional roles gradually disappeared along with the relative status that being a midwife or healer had brought.
Women’s traditional roles as healers, caregivers and nurturers within their families and communities led quite naturally to an interest in the practice of medicine outside the home, and before formalised training in universities, it was possible, in some places, for women to practice legitimately as a doctor or surgeon, and for men to be nurses. In Colonial America for example, anyone skilful in the art of healing, both men and women, were pushed into service, not only as a doctor, but also as a nurse, dentist, midwife, or surgeon. Formal training was largely unavailable, and those that wanted to be medical doctors, both male and female learned through ‘apprenticeships’. (Juliet H Mofford, 1996)
Women in the West still played a significant role within their communities, particularly in childbirth, during the 17th and into the 18th century. Early diaries frequently refer to “calling in The Women” to deliver babies. According to Juliet Mofford (1996) a few midwives in America even advertised that they had received special instruction in the profession and could produce qualifications as proof. “ Mrs. Grant from Scotland declared in the December 29th, 1768 edition of the South Carolina Gazette that she had “studied that art regularly and practiced it afterwards, and could produce certificates from "the Gentlemen whose Lectures she attended, and likewise from the professors of Anatomy and Practice of Physick in that City." The midwife was still the preferred, and at times revered, person to deliver babies. in Western society. “Lucretia Lester of Southold, Long Island, who practiced midwifery from 1745 until 1779 was ‘conspicuous as an angel of mercy; a women whose price was above rubies’. It is said that she attended the birth of 1300 children, and of that number, lost but two . . . ” (Women in the Workplace: Medicine, 1996)
Standards for medical practitioners were established during the nineteenth century, and once this occurred women were forced to fight strenuously for equal access to training, as well as for respect in their chosen profession. This affected all women, but especially those of the middle class, who in the mid-nineteenth century, started to demand the right to become physicians together with the right to vote. Fierce opposition met them, as they were thought to be “going outside the proper sphere of women”. (womenshistory.about.com)
Although male physicians had long been summoned by midwives to deal with risky births, it was the use of forceps after 1773 that brought men into delivery rooms and eventually relegated the use of midwives to rural areas or among poor, city-dwelling families Although women had been tolerated by the growing ‘profession’ during the 18th into the early nineteenth century, they had never enjoyed the same status as their male counterparts. Increased competition from newly ‘qualified’ male doctors led women to seek formal training. But, with women barred from the most of the new medical schools during this time, and male physicians closing ranks, it became increasingly difficult for women even to serve apprenticeships. In America in 1858, only about 300 of the 18,000+ medical school graduates were women. Juliet Mofford (1996) argues that despite such a difference in numbers, male physicians began to view women practitioners as a threat and concocted elaborate rationales to justify keeping women out of the profession.
Females were thought to be unreliable due to their monthly “instability.” One respected male physician described menstruation as an “infirmity” similar to “temporary insanity.” Another said: “It was as if the Almighty, in creating the female sex, had taken the uterus and built up a women around it.” (Juliet Mofford, 1996)
Dr. Walter Channing, professor of obstetrics at Harvard Medical School, expressed his belief that “no one could be qualified to practice obstetrics unless that person had been thoroughly trained in medicine” then he closed the door to any women who applied for medical training. In 1820, Channing boasted that “It was one of the first and happiest fruits of improved medical education in America, that . . . (women) were excluded from practice . . .. “
Medical students at Harvard proclaimed that no women of “true delicacy” would consider attending lectures with men and declared their unwillingness to “mix with any women who ‘unsexed’ herself, thereby sacrificing her own modesty.” (Juliet Mofford, 1996)
In addition to fearing the effects that the practice of medicine would have on women, male physicians worried that the presence of women doctors would “feminize” the profession, which they saw as requiring such “male” characteristics as strength, control, and efficiency. Then there was the question of intellect: Dr. Charles Meigs declared that women’s heads were “almost too small for intellect, but just big enough for love.” (Juliet Mofford, 1996)
However women were prevalent in some areas of medicine. Labelled “irregular physicians” by the medical establishment, practitioners of alternative medicines relied on herbal remedies and stressed the natural healing abilities of the human body. Of the approximately 2,500 homeopathic physicians in the United States in 1860, two-thirds were women. Harriot Hunt was one such “irregular physician,” and she developed a thriving Boston practice but rebelled against the medical communities condescension and arrogance. It was clear to Hunt and other hopeful female physicians that if women were to reclaim their place in mainstream medicine, they would have to gain access to the country’s medical collages. The answer to such discrimination seemed to be the creation of all-Female medical schools.
Samuel Gregory founded the Boston Female Medical Collage in 1848; it was the first medical school especially for women. Gregory however did not found the school because he believed in equality. On the contrary, he thought it was indecent for men to be delivering babies, and was reluctant to allow women any say in the management of the college.
But this and other all-female institutions helped women achieve a level of training that would not have been otherwise possible. There was however some women, who against all the opposition managed to fight the system and enter the ‘mainstream’ medical universities.
Elizabeth Blackwell, born in England in 1821, was the first woman to obtain a medical degree. Elizabeth, although well educated, was rejected by all the leading medical schools, and was only accepted at a medical school in Geneva, New York because they thought her application was a practical joke. She had few allies and was an outcast in the school. At first, she was even kept from classroom medical demonstrations, because they were looked upon as inappropriate for women. “The whole idea is so disgusting,” said the father of one prospective woman physician, “I could not entertain it for a moment.” (womenshistory.about.com). It could be argued that what was at stake was not the exposure of women to ‘disgusting and unpleasant’ physical ailments, but that women should have authority over treatment of those ailments equal to that of men. Women, as nurses and midwives, had long been involved in many of the most horrific and disagreeable of medical tasks.
Elizabeth graduated in January 1849, at the very top of her class, and went on to study further. She complained of her “prison life” when she attended a course of study in Paris, because she was made to do the most unskilled tasks. She was also restricted to the grounds of the hospital, leaving her with none of the freedom of the other medical students. When she was there she suffered a serious eye infection, which left her blind in one eye. She gave up the idea of becoming a surgeon, but against opposition, such as being barred from working in the New York city Hospitals, she set up her own practice in 1857 staffed entirely by women. The success of this practice proved that women could run an efficient medical service, and in 1896 she founded the London School of Medicine for Women.
(Western Medicine. An Illustrated History, 2001)
Elizabeth Garrett Anderson, like her role model Elizabeth Blackwell, also did much to encourage the acceptance of women into the male –dominated medical world. Elizabeth Garrett Anderson changed medicine in Britain. She was the first British woman to qualify as a doctor. In 1874 she established the London School of Medicine for Women. Her determination paved the way for other women. In 1876 an Act of Parliament was passed which permitted women to enter all of the medical professions. Even today one of the leading hospitals for women in London is named after Anderson as a tribute to her part in breaking down prejudice in the medical profession.
Women also played a role in raising the status of other roles they were prescribed within medicine. The ‘poor relations of the medical profession, needless to say, was nursing and midwifery. We have seen how, with the use of forceps in the delivery room, and women’s exclusion from formal training, that midwifery became a low status job for women. Even lower than that role was the job of nursing. This role was undertaken by poorer, uneducated women. Nursing in the mid-19th was not even regarded as a profession. Nurses were generally uneducated and poorly trained. Stories about nurses in the early 19th century suggest that they often did little to help their patients recover. One of the women who changed that image of nursing was Florence Nightingale.
Florence Nightingales big opportunity came when the Crimean War broke out in 1854. The British army suffered horrific losses from the new exploding shells and from lack of medical support. The Secretary at War, who knew the Nightingale family, asked her to go to the Crimea to take charge of the hospital at Scutari in Turkey. When she arrived, with a team of 38 nurses, she found the wounded lying on bare boards among piles of filth. Although she was met with hostility from the army doctors, she transformed the hospital by improving sanitation, cleanliness and supplies to patients. Within 2 years the death rate had fallen from 40% to 2%. Florence Nightingale used her reputation gained during the Crimean War to improve standards in nursing back at home. The public donated £44,000 to set up a nursing school, at St Thomas’ Hospital, London. By 1887 Nightingales nurses were working in all over the world in places like Australia, Canada, India, and Sri Lanka.
During this time another pioneer, Mary Seacole, worked in the Crimea among the troops. However, Mary not only suffered discrimination from the males within the medical profession, she was also rejected by men and females alike because she was black. On the battlefield she nursed the wounded and was known by the name of ‘Mother Seacole’. Even though she met Florence Nightingale, she was not invited to join her nursing team. When she returned to England, she was not recognised for the work and achievements in the Crimea and after suffering from bankruptcy she decided to publish her life story to raise money. In comparison to Florence Nightingale, Seacole did not come from a wealthy middle class background or have any formal training. Not only did she suffer from the restrictions placed on middle class women at this time but she was also hampered by the colour of her skin.
Another women who did much for the nursing profession, was Elizabeth Fry. A well-known prison reformer, she set up the first nursing school in Britain in 1840. Because of the efforts of these women, nursing gradually began to gain in status by the second half of the 19th century.
Conclusion
We can see that up until major technological and theoretical changes occurred in the 17th century within Western medicine, women’s traditional role as midwife or ‘healer was relatively secure and at times enjoyed high status within their local communities. Nevertheless, it was always males managed who organised in such a way as to have power of ownership over medical knowledge and ideology. This fight for power over knowledge led to women being burnt as witches in the Middle Ages, and being discriminated against within the evolving medical profession during the 17th, 18th and 19th centuries.
Although some women during this time managed to fight opposition and gain legal access into mainsteam medicine, this was predominantly into what had now become lower status roles – midwives and nurses.
Bibliography
.