Saturday, October 8, 2016

Porodní Bába

Midwifery is an occupation as old as time. As long as people have been having babies, there have been people to help assist with the birth. Traditionally, this would be the midwife.

Not only did midwives deliver births, but they also had a legal duty in terms of witnessing births established in Roman and medieval law, which was enforced by the Catholic church.

Women were generally not allowed to form or join guilds, so midwives worked alone or with one or two assistants under a licensing system, and eventually also "midwives oaths." Their work was performed at the homes of their patients, where they helped with the birth and stayed until after the baby was born. Many midwives "apprenticed" under older, more experienced women, but did not have formal education until the 19th century.

Apparently, Charles University in Prague had medical school lectures about obstetrics and gynecology as long ago as 1348, but they were mostly just theoretical, and of course, for men.  

The first Czech textbooks for midwives were written in 1519 and 1577. But it seems that they were probably not widely used because midwives of that era were usually older illiterate impoverished widows that turned to midwifery to avoid begging.

In 1753, Empress Maria Theresa forever changed the field of Czech midwifery when she released "Generální řád pro Království České" ["General Regulations for the Czech Kingdom"] which specifically urged women to be honest, forbade them from drinking wine or other alcohol, and penalized premature abortion or infanticide. Not only was Maria Theresa in general an "enlightened monarch" who was greatly interested in health and social reforms, but she was also particularly keen on improving pregnancy and neonatal care. Perhaps this was due to the influence of her own personal obstetrician and mentor, Gerard van Swieten (1700-1772), who was himself an enlightened physician. 

Later, Anton Jungmann was the pioneer in Czech obstetrics and gynecology teaching. In 1804 he wrote úvod k babeni, which though its Czech was slightly primitive, declared that midwives should receive obstetrics education on a collegiate or at least a secondary education level, after which they should receive a diploma and must do a 2-month residency in a hospital.

Jungmann describes the characteristics of an ideal midwife as follows:
1. By bába k náležitému konání ouřadu svého při dobrém zdraví byla, neb churavá a rozmazaná bdění noční a jiné nesnáze denní těžce snese. Budiž tělem čistá, bez ohavných osutin, bez svrabu a jiných neřestí. Ruce bába měj jemné, citlivé.
2. Mimo tělesnou tu vlastnost, budiž bába prostředního věku, 20 - 30 let, totiž ona jenžto do učení teprve přichází. Mladá obyčejně bývá nepovážlivá, ztřeštěná, bez důvěrnosti obecné. Příliš letitá zapomnělá, nedostatečná, nevrlá a často předsudků plná.
3. Cenu báby povyšuje a množí nápodobně: šlechetnost a čitelnost srdce, bedlivost v jednání, opatrnost, střídmost, povážlivost, trpělivost, přívětivost, svědomitost ve všem konání. Budiž bába nepřítelkyně žvanivosti, klevet, opilství, milovnice čistoty."
[Rough translation:
1. Ideally, midwives should be in good health, because every day they encounter disease, groggy awakenings in the night, and other difficulties. 
2. Besides her physical qualities, midwives should be middle aged, between 20-30 years old, because she is still teachable. Younger women [than 20-30] are typically presumptuous, brash, and lack general confidentiality. However, do not forget that older women are often poor, surly, and full of prejudices. 
3. [Qualities] that worthy midwives promote and magnify are: generosity and purity of heart, concern in her dealings, prudence, temperance, caution, patience, friendliness, conscientiousness in every venue. Let the midwife be a lover of purity/innocence, and an enemy to chit-chat, gossip, drunkeness.]
Personally, I find it highly frustrating that what survives and is easily accessible is, as usual, a male version of history. Wouldn't it be interesting (and refreshing) to have some midwife records? I know that if you go deeper in the past, pre-Maria Theresa reforms, then illiterate midwives likely did not even keep records, let alone have them survive for us to peruse across the centuries. But surely, later midwives kept records, and surely, they must exist somewhere. Wouldn't it be interesting to have an account from a woman's point of view, detailing her role caring for women and dealing with women's problems? Hey, it could happen: "czech" out these Italian midwife diaries from 1907-1939. Why not in the Czech lands?

Anyway, apparently by the time this 1890 encyclopedic entry was written, however, midwifery had been systematized and regulated for nearly a century and a half:
bába porodní, též babička jest žena, která na některé porodnické škole státem k tomu učela zvláště zřízené se po několik měsíců cvičila, pak zkoušku s prospěchem odbyla a osvojila si takové vědomosti, aby nejen dovedla patřičně ošetřovati matky a novorozence při normálním těhotenství, porodu a šestinedělí, nýbrž hlavně aby záhy a bezpečně poznala každou odchylku od pravidelného průběhu v různých těchto stavech, aby bezodkladným povoláním lékaře postarala se o rychlé odčinění nebezpečí hrozícího matce nebo plodu a jen za jistých nutných okolností sama dle pokynů na škole jí vštípených pomocně zakročila.
[Rough translation:"Birth grandmother" [midwife], also grandmother [midwife], is a woman who attends an obstetric school set up specifically for this purpose by the state, practices for several months, then tests and receives a diploma which declares that she has the knowledge that she can not only properly care for mothers and newborns during normal pregnancy, childbirth, and confinement, but also can quickly and securely recognize any dangerous deviation from the regular course of these various states and can quickly call for a professional who can deliver urgent care, and who only under certain necessary circumstances intervenes by using instructions instilled to her in her school training.]
In the United States and Britain, there was little "official" professional support for female midwifery until the 1950's, though this statement is a gross oversimplification that borders on falsehood; groups of Mormon Midwives in Territorial Utah did actually, "travel east to Philadelphia to study medicine. Upon their return, holding degrees from an accredited college, schools of obstetrics and nursing branched out until by 1900 there were scores of trained midwives throughout the state."

It is very common for Czech parish registers to include the name and residence of the midwife. Here are a few examples, first from a 1792 Vsetín baptism record:

Here is a 1796 Hážovice baptism record. See where it says "hebamℓ:"? That last little curly thing on the end is a symbol that looks like and it means, "this word is abbreviated."

Here is an 1880 Vsetín baptism record, different words (zkouš[ka] bába, "attending midwife") same meaning:


Side notes:
I have to wonder if the etymology of the words babička and bába are related to the English word "baby." Maybe someday I will buy an etymologický slovník in Czech, since there doesn't seem to be a really comprehensive one online.

Strangely, today in the Czech Republic, midwives are legally prohibited from attending women at home births!

Other sources:
http://stastny-usmev.cz/lakar-u-porodu/ 
http://is.muni.cz/th/176665/lf_b/Bak.prace.txt
https://spirituality.knoji.com/the-art-and-practice-of-midwifery/ 
https://www.babble.com/pregnancy/childbirth-images-spanning-hundreds-of-years/


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