Download PDF | Avner Giladi - Muslim Midwives_ The Craft of Birthing in the Premodern Middle East-Cambridge University Press (2014).
212 Pages
Muslim Midwives
This book reconstructs the role of midwives in medieval to early modern Islamic history through a careful reading of a wide range of classical and medieval Arabic sources. The author casts the midwife’s social status in premodern Islam as a privileged position from which she could mediate between male authority in patriarchal society and female reproductive power within the family.
This study also takes a broader historical view of midwifery in the Middle East by examining the tensions between learned medicine (male) and popular, medico-religious practices (female) from early Islam into the Ottoman period and addressing the confrontation between traditional midwifery and Western obstetrics in the first half of the nineteenth century.
avner giladi is Professor of Islamic History at the University of Haifa, Israel.
Introduction
Ibn Khaldūn’s al-Muqaddima is distinguished, much like the author himself, by a number of features that are as striking to us today as they must have been to his contemporaries. Forming the prolegomena to a much larger work, Kitāb al-ʿibar, and serving as a highly sophisticated introduction to the historian’s craft, al-Muqaddima is the towering achievement of a man who undoubtedly ranks as one of the greatest thinkers in Islamic history.1 As a historiographer and philosopher of history, Ibn Khaldūn can claim to have laid the foundations, in the fourteenth century, of the discipline that we know today as sociology.2 That said, it still comes as a surprise to many of us when we find that in his monumental Introduction to History Ibn Khaldūn devotes a whole chapter to midwifery (Fasl f̣ ī siṇ āʿat al-tawlīd), one that is as original in conception as it is rich in detail.3
The chapter is included in part 5 of the Muqaddima, which discusses means of subsistence (maʿāsh), professions and crafts (saṇ āʾiʿ) – “the ‘accidents’ of sedentary culture” – that, Ibn Khaldūn points out, reflect the complexity of urban life.4 Within this survey midwifery ranks among the most basic crafts (ummahāt al-saṇ āʾiʿ), being “something necessary in civilization and a matter of general concern because it assures, as a rule, the life of the new-born child” and thus the survival of the human race and its culture.5 Moreover, like “the art of writing, book production, singing and medicine,” it is regarded as a noble craft because of the subject that is at the heart of it (sharīf bi-al-mawdụ̄ ʿ), that is, newborn children and their mothers (al-mawlūdūna wa-ummahātuhum).6 Ibn Khaldūn defines several areas of the professional expertise of the midwife (qābila7 ): (a) “How to proceed in bringing the new-born child gently out of the womb of its mother and how to prepare the things that go with that” (al-ʿamal fī istikhrāj al-mawlūd min batn ummihi min al-rifq f ̣ ī ikhrājihi min rahimih ̣ ā wa-tahyiʾat asbāb dhālika).
This involves “some succor”8 the midwife offers when the mother is in great pain “by massaging the back, the buttocks and the lower extremities adjacent to the uterus” and by stimulating “the activity of the (force) pushing the embryo out.” Then, post partum, how to carefully cut the umbilical cord and treat “the place of the operation with cauterization or whatever other treatment she sees fit.”9 (b) How to care for the mother after delivery – to massage and knead her “so that the membranes of the embryo may come out” and to support her “for the weakness caused by the labour pains and the pain that the separation causes her uterus.”10 (c) How to attend to the newborn child (mā yasluḥ uhu ba ̣ ʿda al-khurūj)- “to massage and correct (it) until every limb has resumed its natural shape and the position destined for it,” to anoint its limbs with oils and dust it “with stringent powders, to strengthen it and to dry up the fluids of the uterus,” to smear “something upon the child’s palate to lift its uvula” and to put “something into its nose, in order to empty the cavities of its brain.”11
With striking familiarity and in great detail, probably the result of extensive and meticulous reading in medical manuals and/or information he had collected from female informants,12 Ibn Khaldūn describes female anatomy and physiology and outlines the techniques of midwifery. He is conscious that, given what we today call “the modesty code,” this craft “is as a rule restricted to women” since they, as women, may see the pudenda of other women (al-zạ̄ hirāt baʿduhunna ̣ ʿalā ʿawrāt baʿd).̣ 13 Moreover, “midwives are better acquainted [with obstetrics] than others”14 and “we likewise find them better acquainted than a skilful [male] physician with the means of treating the ills affecting the bodies of little children from the time they are sucklings until they are weaned” (wa-hādhihi kulluhā adwāʾ najidu hāʾulāʾi al-qawābil absar bi-daw ̣ āʾihā wa-ka-dhālika mā yaʿridu li-al- ̣ mawlūd muddat al-radạ̄ ʿ min adwāʾ fī badanihi ilā hị̄n al-fisạ̄ l najiduhunna absar bih ̣ ā min al-taḅ īb al-māhir).
Based on the observation that, due to God’s way of creation, “the [mother’s] opening is too narrow [for the embryo] and it is difficult for it to come out” (wa-yadị̄qu ʿalayhi al-manfadh fa-yaʿsuru) 16 or, as physical anthropologists today put it, “human beings have a difficult birth because evolution has matched the size of the new-born human brain very closely to the limits of the mother’s body,”17 Ibn Khaldūn concludes the first part of his chapter by saying that “this craft is necessary (daṛ ūriyya, “essential”) to the human species in civilization. Without it, the individuals of the species could not, as a rule, come into being” (lā yatimmu kawn ashkhāsihi f ̣ ī al-ghālib dūnahā).18 Rather unexpectedly, Ibn Khaldūn turns at this point to a theological argument about the possibility of re-creating the human species if it were to become extinct.19 He brings in al-Fārābī and “Spanish philosophers,” who argue that the end of created beings, especially the human species (al-nawʿ al-insānī), is inconceivable because that would make “a later existence of them ... impossible.
Their existence depends upon the existence of midwifery (li-tawaqqufihi ʿalā wujūd hādhihi al-siṇ āʿa), without which man could not come into being[!]”20 Although he does not accept their notion, claiming that, as in certain animals, “the instinctive kind (of births) is not unknown” in humans (wa-ammā shaʾn al-ilhām fa-lā yunakaru),21 Ibn Khaldūn’s theological deliberations take him far from his initial discussion of the practical aspects of the craft and lend the role of the midwife an almost cosmological-existential dimension, placing her, at least theoretically, in a highly elevated position. To be sure, medieval Muslim doctors and religious scholars alike recognized medicine as an important, in fact indispensable occupation, regarding the presence of a professional physician in any town or city as absolutely necessary. According to Abū al-ʿAlāʾ Sạ̄ ʿid b. al-Ḥasan (d. after 1071), a physician from Rahba in northern Iraq, medicine has ̣ become a universally appreciated vocation through accumulated experience and thanks to general consensus (qad ajmaʿat al-umam wa-ittafaqat al-shahādāt ... wa-al-tajārib al-mustamirra bi-fadl ṣ iṇ āʿat al-tibb wa-h ̣ ạ̄ jat al-nās ilayhā). What makes a city or a town a good place to live in is not only a just ruler, a flowing river and a market, he says, but also a knowledgeable physician (taḅ īb ʿālim). Moreover, attributed to a divine origin and applied for the benefit of, amongst others, prophets and devoted believers, the study and practice of medicine have been sanctioned and encouraged by religion (wa-idhā kānat hādhihi al-siṇ āʿa qad wadạ ʿahā Allāh taʿālā wa-istaʿmalahā al-anbiyāʾ wa-al-atqiyāʾ wa-amarū bihā wa-lam tuhadhdhirh ̣ ā sharīʿa wa-lā haramath ̣ ā milla fa-qad bāna fadluḥ ā wa-jalla qadruhā). All this explains the prestige medicine enjoys, the honor conferred on its practitioners and the efforts invested in preserving and copying medical writings (fa-li-dhālika tarā al-nās li-idṭiṛ ārihim ilayhā yujillūnahā wa-yubajjilūnahā wa-yahtạ fizụ̄ na bi-mā yaqaʿu lahum min kutubihā wa-yansakhūnahā ...).22 Abū Ḥāmid Muhammad al-Ghaz ̣ ālī, the wellknown jurist, theologian and mystic of the eleventh-twelfth centuries (d. 1111), supports this approach from a theological point of view. He regards the body as a sort of carrier (“a riding animal” – matiyya ̣ ), a material platform for the spirit – namely, the divine element planted in human beings and whose perfection brings believers close to God. Physical health in this world and consequently longevity should therefore be seen as preconditions for achieving the ultimate human goal in the hereafter.
No wonder then that al-Ghazālī defines medicine as one of the non-religious (ghayr sharʿī) yet praiseworthy (mahṃ ūd) sciences and sees its study as one of the collective duties (fard ̣kifāya) imposed on at least one (male) believer in any Muslim community.23 However, while sharing the idea that “the craft of medicine (siṇ āʿat al-tibḅ ) is needed in settled areas and cities – not in the desert,” where the Bedouins adopt a healthier diet and are more physically active24 – Ibn Khaldūn is unique in that he explicitly includes midwives in the medical profession whose practice is of special socio-religious significance. With his enormous appreciation of – not to say admiration for – midwives, those agents thanks to whom women become mothers and the human species survives, Ibn Khaldūn represents one side of the ambivalent male attitude towards the creative power of the other sex. Also exceptional, yet from a different point of view, is a text by Ibn Khaldūn’s contemporary, Muhammad b. Muh ̣ ammad Ibn al-H ̣ ̣ājj al-ʿAbdarī (b. 1336), a Cairene Māliki jurist of Maghribi origin, who represents an opposite, probably more prevalent, male approach towards women in general and midwives in particular.
His Introduction to Religious (sharʿī) Law, al-Madkhal, 25 is one of the most well known compilations within the genre (particularly popular in the Mamluk period) of treatises condemning innovations into the beliefs, customs and religious practices of the people of the time (bidaʿ, sing. bidʿa).26 The comments that open the chapter on childbirth (Fasḷ fī dhikr al-nifās wa-mā yufʿalu fīhi) leave no doubt as to the extremely misogynous world view of the author: “This chapter should have been placed before the one preceding it, which deals with washing a dead body, since in real life birth is the beginning and death comes next. However, because religious rules pertaining to birth are exclusively connected with women, I followed the Prophet Muhammad ̣ ’s instruction to ‘place females behind, just where God has placed them’” (akhkhirūhunna haythu akhkharhunna All ̣ āh).27 The chapter as a whole is characterized by the tension that clearly exists between, on the one hand, the author’s awareness of the religious significance of birth as the beginning of life (which, like the last moments on earth, is crucial for determining a believer’s destiny in the Hereafter)28 – thus implicitly reflecting his recognition of the essential role of the mother – and, on the other, the contempt he feels for the female body, the vehicle for creating new life, and for the allfemale milieu in which deliveries take place. Moreover, it is obvious that for Ibn al-Ḥājj al-ʿAbdarī the happenings behind the curtain of this closed, mysterious “world of birthing ritual,”29of which the midwife is an indubitable representative, constitute a source of deep concern and fear.
An embodiment of the strict legalistic approach of Muslim scholars, Ibn al-Ḥājj vehemently criticizes the midwives who, being in most cases outside the circles of the ʿulamāʾ, lack religious knowledge (fa-li-ajli buʿdihinna ʿan al-ʿilm wa-ahlihi ghāliban ...); for adopting countless disgraceful practices (ʿawāʾid radīʾa mutaʿaddida qalla an tanhaṣ irạ ) and popular customs in contradiction of the sacred law, the sharīʿa30; he blames them for breaking hygienic and purification rules, for superstitiously using magical devices and for their greed.31 Against this background, Ibn al-Ḥājj calls on Muslim males not to observe midwives’ advice, to reject their practices (fa-yanbaghī li-waliyy al-mawlūd ... an lā yarjiʿa ilayhinna wa-lā ilā raʾyihinna wa-lā ilā ʿawāʾidihinna) 32 and to spare no effort to break the midwives’ monopoly – or, rather, to break into their isolated realm – not by replacing them, of course, but by carefully selecting them, instructing them in the spirit of Islamic law and ethics, and by continually supervising them: “It is fit for the child’s guardian, or rather imposed upon him, to obey God and follow the prophetic pure example in this regard [i.e., childbirth] so that the [divine] blessing will come back to the new-born infant at the outset of its life and later on” (fa-yanbaghī bal yataʿayyanu ʿalā waliyy al-mawlūd an yakūna mumtathilan li-amr Allāh taʿālā fīhi [fī al-nifās] wa-yatbaʿa al-sunna al-mutṭahara f ̣ ī haqqihi li-ta ̣ ʿūda barakatuhā ʿalā al-mawlūd fī ibtidāʾi amrihi wabaʿdahu).33 Unlike Ibn Khaldūn who, I assume, had in mind a highly professional midwife working for elite families, Ibn al-Ḥājj offers us a vivid description of the manners and customs of midwives serving women of wider social circles.
For instance, he fiercely attacks midwives for neglecting the basic rules of hygiene when they touch the newborn and its clothes without first washing the secretions of its mother off their hands and, moreover, when they let the newborn infant lick their fingers covered with the mother’s blood (bal baʿd ̣al-qawābil yulʿiqna al-mawlūd mimmā yataʿallaqu bi-asạ̄ biʿihinna min al-najasāt), claiming that these practices are beneficial to it.34 Ibn al-Ḥājj also denounces midwives for being greedy and superstitious: they steal the garment with which the newborn is first wrapped, attributing to it powers of blessing or simply out of covetousness when, for instance, it is made of silk; also for believing in the magical power the act of cutting the umbilical cord has on other infants who are brought into the house when this is taking place.
Regarding the moral behavior of midwives Ibn al-Ḥājj is no less critical. According to him, some of them refuse to fix their wages well in advance, which they claim as beneath their dignity ... (bal baʿduhunna yarawna anna ta ̣ ʿyyīn al-ujra ʿayb wa-qillat hishma ̣ wa-tark riyāsa) 36 and prefer to leave the negotiations on this matter to the time of the delivery, presumably in the hope of extracting more from the thrilled and confused family members. Others reject the intervention of another midwife in a (probably complex) delivery they themselves started to deal with (wa-yanbaghī an yahdhara mimm ̣ ā yafʿaluhu baʿd ̣ al-qawābil wa-huwa anna al-wāhida minhunna idh ̣ ā dakhalat ilā bayt wa-qabilat fīhi lā yumkinu ghayruhā an tadkhula ʿalayhā fīhi).37 All in all, al-Madkhal depicts, in what appears to be a realistic way, the time and place of childbirth as an arena for a power struggle between males and females: husbands and wives, masters and concubines, medical women and the surrounding society with its patriarchalIslamic ethos. One can discern in the texts I have cited here different types of midwives active in the medieval Muslim world. More importantly though, these texts reflect the contrasting images and views of midwifery held by prominent fourteenth-century Muslim thinkers, images that embody two sides of the ambivalent attitude of males towards this typically female occupation and its representatives. To what extent are these views based on earlier Islamic sources and shared by other thinkers? Do they reflect aspects of social reality? In answering these questions through a survey of mainly theoretical and literary writings, in what follows I trace the attitudes toward midwives on the part of male Muslims – biographers, physicians, and jurists – to a mixture of awareness of the midwife’s essential role in society with her obvious marginalization, which sometimes results in a total absence of midwives in those texts in which they might be expected to appear.
For it is a perennial puzzle why no woman wrote a word of that extraordinary literature when every other man, it seemed, was capable of song or sonnet – Virginia Woolf, A Room of One’s Own (London: Hogarth Press, 1967), 62 Available in relatively large numbers and varied in their character, written and other sources have enabled historians in recent years to develop a “history of birth” and a “history of midwifery” in the context of premodern Western-Christian societies. These sources include belles-lettres; medical, legal, and theological writings; records of sainthood and exempla (tales illustrating sermons); archival documents such as records of legal proceedings or documents of orphanages; personal diaries and testimonies of travel writers; as well as art works from late medieval through early modern times.38 Most of this corpus of texts written before the seventeenth century is the product of urban male scholars. Midwives, like other women, were socialized to regard themselves as innately inferior and subordinate to men.
Therefore, even literate women who could have left records did not consider their work worth reading.39 However, the seventeenth century saw the first signs of a significant change in Europe. A few midwives left memoires and manuals, “precious pieces of evidence ... an island in an ocean of documentary silence.”40 The Midwives’ Book by Jane Sharp, the first handbook for midwives written by an Englishwoman, was published in 1671. 41 Moreover, the writings of Louise Bourgeois (1563–1636) the midwife of Marie de Médici (wife of King Henri IV of France and mother of King Louis XIII), includes, in addition to a specialist guidebook, personal memoires.42 And the diary of Catharina Geertruida Schrader, a midwife in the small market town of Dokkum in Friesland (north of the Netherlands), sheds light not only on professional concepts but also on midwives’ world-view, experience, practice, and emotions. Schrader’s diary is a remarkable example of this rare sort of text. Covering fifty-two years of a provincial midwife’s professional activity (1693–1745), it is a mine of information: on how midwives were trained, on their relationships with male doctors, on their social status, on the methods they applied at the scene of childbirth, on the use they made of instruments and drugs, on the ways they coped psychologically with difficult situations, on their other roles in the community, and so on.43
The questions raised by Jacques Gelis,Monica Green, Peter Biller, Jean Donnison, and others on the value of different sources and how to assess and use them, as well as their findings, can serve as an inspiration for any scholar delving into the history of birth and midwifery in other cultural contexts. They deal with such issues as the division of labor and competition between male and female medical practitioners, the scope of women’s medical practice, the distinction between female doctors and midwives, the medical education and licensing of women, the role of women in the processes of medical professionalization and professional organization, the social background of female doctors and midwives, and the relations between learned medicine (mostly represented by males) and popular medicine (mostly represented by females). All relate to wider questions of the struggle for social status and economic rivalry between the sexes, of literacy and, naturally, of the control of knowledge. The search for relevant Arabic sources yields much less promising results than in the case of pre- and early-modern Europe. The historian’s ability to explore such topics in Islamic contexts is therefore limited. Remarkable is the almost total lack of archival records of any sort – such as the account of the first stages of an inquest initiated in 1403 by the criminal court of Marseilles against a Jewish midwife – and other legal documents through which European midwives’ activity can be reconstructed.44 Even the Geniza documents do not shed much light on the concrete physical and medical aspects of childbirth, or on the role of the midwife.45 But Arabic legal and medical sources, as well as works of belles-lettres (adab), leave no doubt that midwifery was recognized as a craft in Mediterranean Muslim societies as early as the eighth–ninth century. 46 Arabic medical writings (which I present and examine in Chapter 3) and the detailed chapters, sometimes whole treatises, on gynecology, obstetrics, and pediatrics they contain can be useful for the history of midwifery – albeit largely for the theoretical aspects of the profession, as these works were compiled exclusively by and for male physicians. No Arabic systematic manual for midwives comparable to Soranus’ treatise on women’s illnesses and its medieval elaborations is known in the lands of Islam prior to the nineteenth century.47
Religious sources, on the whole, offer us relatively little in this regard. Surprisingly, the comprehensive and rich collections of legal responsa (fatāwā, sing. fatwā), such as Ahmad Ibn Taymiyya ̣ ’s Majmūʿat fatāwā (13th to 14th century) and Ahmad al-Wanshar ̣ īsī’s al-Miʿyār al-muʿrib (15th to 16th century), otherwise very helpful in reconstructing aspects of everyday life in medieval Muslim societies, contain very few references, if any at all, to midwives. In these circumstances, the theoretical discussion of legal rules concerning midwives, particularly their status as witnesses in court and a few testimonies on their actual application (see Chapter 5), as well as isolated references to midwives in biographical and hagiographical collections (see Chapter 4), prove essential. Like their counterparts in Renaissance Italy, fifteenthcentury historians of the Mamluk period in the Middle East such as Ibrāhīm al-Biqā‘ī and Shihāb al-Dīn Ahmad Ibn T ̣ awq ̣ – both authors of chronicles combined with personal diaries – as well as biographers such as Muhammad b. ̣ ‘Abd al-Rahṃ ān al-Sakhāwī (see Chapters 1 and 4) record the birth of children alongside other familial events. However, excluded, as males, from the birthing scene, they cannot supply any detail on the events taking place within this domain and say nothing on the midwife’s activity, the feelings and behavior of the mother in confinement, and the roles of the helpers (see Chapter 4).48 Collections of belles lettres and moral tractates, with the anecdotes they contain on midwives – dispersed and largely imaginary as they are – sometimes reflect contemporary popular concepts (see Chapter 2).
Moreover, those elements in the stories that are based on their authors’ lives can be taken as historical evidence, depending of course on the extent to which we succeed in identifying these elements. In any case, anecdotes seem to give more detailed and more accurate impressions on the female subcultures49 within medieval Muslim societies than do normative texts. Thus by using Boccaccio’s Decameron to reconstruct everyday life in northern Italy during the fourteenth-century’s plague, the “Black Death,” David Herlihy showed how fruitful anecdotal materials can be for the study of history.50 The findings of ethnographic-anthropological research on midwifery in the contemporary Muslim world, if cautiously used, are helpful in filling some gaps left by the classical and medieval sources, although in this field too, the socio-cultural aspects of the midwife’s role have not drawn much attention, at least in comparison with other “key preservers of life’s wisdom.”51 In any case, it should be emphasized that we are dealing here with the longue durée, with ways of life, beliefs, and practices that persisted for centuries.52 For instance, the entry Dāya (“midwife”) 53 in Qāmūs al-siṇ āʿāt al-shāmiyya (the dictionary of Damascene crafts compiled in Damascus in the 19th–20th century), relies heavily upon Ibn Khaldūn’s relevant chapter in the Muqaddima (see above), as if the information he supplies on the practice of midwifery in the western parts of the Islamic world is still applicable five or six hundred years later in the eastern parts of the Islamic Mediterranean.54 Quite a few similarities are identifiable between descriptions in early sources on the one hand and ethnographic-anthropological reports from the nineteenth–twentieth century on the other, of the setting of the delivery, the position of the woman in confinement, the equipment used, the direct or indirect role of men, the division of labor among the helpers, and the roles the midwife plays outside the childbirth scene (in birth and adulthood rites, as a female circumciser, etc.). These can serve as a starting point for a more comprehensive comparison without, however, changing the focus of this book on premodern times (see below). Reports such as those by Hilma Granqvist and Carla Makhluf-Obermeyer (see Chapter 6), complement the information we can derive from the early texts in two ways:
They describe the everyday practices of childbirth and midwifery in communities in which tradition has remained more or less unchanged for a very long time and, more importantly, they focus on female activity as observed by female researchers from within the scene. Finally, although I have not used non-textual sources here, I would like to draw attention to their potential for future research. Discussing the value of illustrations of birth in European manuscripts from the thirteenth through fifteenth centuries as a historical source, Sylvie Laurent concludes that si les sources écrites sont le reflet d’une élite, l’image révèle plus largement les non-dits du texte. Elle indique souvent les préoccupations inconscientes de l’imaginaire collectif médiéval. Ainsi, elle dévoile des aspects réalistes et d’autre plus symboliques concernant l’accouchement. 55 She demonstrates how illustrations of birth contribute to our knowledge on Caesarean sections, on the position of the mother during childbirth, on the roles of midwives and their assistants, and on the magic and ritual surrounding birth in medieval Europe.56 Illuminating also is the work of Jacqueline Marie Musacchio on objects associated with pregnancy and childbirth that Renaissance women possessed. Musacchio shows how the importance of childbirth in the life of women and families, particularly in the wake of the demographic decline caused by the Black Death, is reflected in the density of the material culture associated with it. The “art of childbirth” included a wide range of decorative and utilitarian objects very popular in Italy from the fourteenth through the seventeenth centuries, such as wooden trays and bowls and ceramic wares painted with birth-related images.57
I am not aware of any survey of such objects in the lands of Islam. And it seems that the surviving and catalogued Islamic illustrated manuscripts can offer much less than the nearly two hundred presentations of birth (in the Bibliothèque nationale de France alone!) surveyed by Laurent. But the few examples that I have come across are nevertheless illuminating. It is also clear that these, like the textual sources, should be analyzed carefully within the context of their production.58 Most of the theoretical-normative sources at our disposal date back to the classical period of Islamic history (7th–12th centuries) whereas sources that reflect social reality to a greater extent originate from the Islamic Middle Ages (12th–15 th centuries), two periods that I designate here “premodern.” New developments in the domain of Middle Eastern midwifery in the nineteenth–twentieth century are referred to in order to contrast the status, roles, and images of the traditional midwife with those of her modern counterpart.
I have used texts written in the central parts of the Muslim world and the Mediterranean, extending from Transoxania and Iran in the East, to Muslim Spain (Al-Andalus) in the West. The literary-theoretical character of the large majority of available sources, and the almost total lack of “documents of practice,” raises questions that, formulated by Monica Green in the context of the history of European medicine, should nevertheless be kept in mind by every historian: To what extent do these writings reflect real experience? Do they simply reiterate beliefs and practices the authors have found in other writings – for instance, in ancient medical texts? Is what we find in medical texts merely “armchair gynecology”? What role do rhetoric and polemic play, and how are we to filter out their influences? Who wrote these texts and, even more important, who read them?59 *** The purpose of the present study is to uncover, through the limited evidence offered by Arabic-Islamic sources, the prevalent images of and attitudes toward midwives and to show, to the extent these sources make possible, how midwives functioned professionally, socially, and culturally in medieval Muslim societies.
I hope in this way to contribute to a better understanding of the gender relations that existed in these societies. To achieve this aim, even partially, I first identify prevalent attitudes towards women and femininity, sex, childbirth, and children, and examine interfamilial relationships and the division of roles in the context of childbirth. Against this backdrop I deal with the midwife’s position, first vis-à-vis the family of the woman in confinement, her husband, and other family members, and then in relation to the outside participants in the childbirth – an event at the center of the female subculture. The question of the midwife’s social status is then raised: her role as a mediator between the male authority in patriarchalpatrilineal communities on the one hand and the isolated female domain on the other, inspecting, as an agent in the service of the former, women’s behavior. In this context, the midwife’s privileges as a witness in court and her relationship with male doctors are discussed. Last but not least, the cultural role of midwives in the context of the competition between learned medicine as opposed to popular medicine and magic is dealt with, including a reference to the confrontation between Western obstetrics and traditional midwifery that has been taking place in the central parts of the Muslim world since the nineteenth century.
It goes without saying that many of the things we take for granted and that simply seem part of being human have in fact a history, and often a fascinating, conflictual, momentous history at that.60 My previous research on medieval Islamic views on breast-feeding and their social implications was based on the assumption that lactation is not merely a biological-instinctive routine but an aspect of “mothering,” the culturally constructed bonding between mother and child, “grounded in specific historical and cultural practices.”61 Childbirth is another case in point. “The way in which a society receives a newborn child into its bosom tells us a great deal about the fundamental attitudes of that society towards the experience of living,” says Jacques Gelis in the introduction to his History of Childbirth. 62 “Because birth is the main form of recruitment to families and to kinship groups, the modes of conducting delivery, the acceptable persons in attendance, the degree of intervention for survival, the treatment of the woman herself and then her infant, are all under cultural stricture, sets of beliefs and rules about ‘how things are done’.
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