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At the 2015 Historical Novel Society conference, I served on the panel “Midwifery: Magic or Medicine” with authors Judith Starkston, Lisa Yarde, and Sam Thomas. Our moderator was the gracious Diana Gabaldon (yes, that Diana Gabaldon). Judith, Lisa, Sam, and I discussed midwifery in the eras we write about. Below is the script for my speech. I followed Judith, who spoke of ancient Hittites and their practice for swinging a ewe over a mother in labor.

Before we abandon the livestock and move a few centuries ahead to discuss midwifery in early medieval times, I have a question for you.

16th century Baptism

A 1513 depiction of the baptism of a baby born by a dead mother, provided by Wolfgang Sauber (GFDL via Wikimedia Commons)

True or false? The early medieval Christian midwife was the only layperson with the authority to baptize.

By a show of hands, how many think this is true? False?

The answer is true, and this truth reveals a lot. It reveals the inherent dangers of childbirth. It reveals how the fate of the soul was more important than the health of the body. And it reveals the midwife’s unique place in her society.

I became interested in midwifery because I needed to write childbirth scenes. I have two in my latest release, The Ashes of Heaven’s Pillar, and three in my work in progress. I would love to say I’m so organized that I knew this was a place to introduce tension and show how religion, magic, and medicine intersected—which is true. But the real reason is a character was about to have her baby, and she would rely on a midwife.

Before I talk about who the midwife was, let’s put midwifery into the context of early medieval beliefs and grim realities. Early medieval folk saw childbirth as a part of life, not a part of medicine. So a doctor would not be welcome in the lying-in chamber, nor any other man for that matter. Everyone involved would think the best place for the men, including the baby’s father, was the church, where they would pray for a safe delivery.

Medieval folk also accepted that young people died. In the days long before vaccines, half the children didn’t reach age 5. In addition, more than one of every three adult women died during their child-bearing years. With those kinds of statistics, it’s easy to imagine that everyone knew someone who died in childbirth or from its complications and everyone knew someone who had lost a child.

So it’s no surprise the faithful were concerned with what happened after death. They heard about hell during the sermons, and families paid alms to the Church so the deceased could avoid time in purgatory.

No matter where the birth took place—a dark, low-ceilinged lying-in chamber of a noble house or a one-room peasant’s hut—medieval people understood the fate of an expectant mother and her baby was far from certain. The process was so risky, mothers were urged to confess their sins as their time drew near. With no guarantee of what would happen to the body, the mother could at least make sure her soul was ready if things went wrong.

And as you’ve no doubt ascertained, a lot of things did go wrong. A common misfortune is that the uterus does not contract quickly enough to stop postpartum bleeding. A rare condition I used in The Ashes of Heaven’s Pillar is for the placenta to come out first, which would cause fatal hemorrhaging for the mother.

Today, this condition is caught in the ultrasound and the baby is delivered by Cesarean section. Midwives performed this procedure in the Middle Ages, but only as a last resort, when the mother was dead or close to it.

All these risks underscore the spiritual component of the midwife’s duties. If the newborn was in danger of dying, the medieval midwife would baptize the baby. The stakes were much higher than a blessing or an affirmation of faith. Early medieval Christians believed Saint Augustine’s teaching that an unbaptized infant, even one who died in the womb, would spend eternity with the damned, although they would receive the lightest of punishments. Harsh, I know, but Saint Augustine’s rationale was that they still bore Adam’s original sin, which only baptism could remove. The Church modified this stance in the 13th century, when schools adopted St. Thomas Aquinas’s argument for limbo, where unbaptized infants would not feel pain but still wouldn’t go to heaven yet be unaware of their loss.

Still, not being able to see your child ever again crushes the great hope of Christianity. So I can imagine a midwife would splash the water and say the prayer, or what passed for Latin, if there was any hope of life, no matter how faint. One documented case has a midwife baptizing a newborn when she saw the baby’s crown and giving it a name appropriate for a boy or girl.

So, who was the midwife? I must admit that the research amounts to a best guess, both by novelists and scholars. Midwives in eighth century Francia were illiterate, like most of the population. The skills were passed down from mother to daughter. Much of my research came from one of my daily life books and an academic paper called “Capturing the Wandering Womb.” The earliest explicit description of a Caesarean is from the 15th century, although I’ve not had to use that. Since all births until a few decades ago were natural, videos of natural childbirth from people with no sense of privacy also are a good resource.

Like Judith’s ancient priestess, the early medieval midwife’s tools included a birthing stool and a sharp knife. She didn’t use an onion or a ewe, but she might employ the foot of a crane, a piece of jasper, ointment with fennel to ease pain, and a potion with ergot to speed contractions and stop postpartum bleeding. She knew to wash and oil her hands and might order the mother’s hair be loosened and all pins removed, doors and cupboard drawers to be open, and knots to be untied. And she might use spells.

You might be surprised the same layperson with the sole authority to baptize would turn to magic. After all, didn’t the Church preach against magic? Well, yes, officially, but darn near everyone used it anyway. Even a priest might hire an expert to interpret dreams. The laity wore amulets alongside their crosses. They said special incantations for a good harvest or to heal a sickness.

Unlike the attitudes in Sam’s era centuries later, magic was seen as a tool for both good and evil. Now, there were severe penalties for evil magic, like being sealed in a barrel and thrown in the river, and contraception was consider sorcery. But good magic was a part of everyday life. A midwife who didn’t whisper a spell in the mother’s ear might have been seen as incompetent.

Some of the spells became Christianized. The Church perhaps decided that if you can’t beat them, co-opt them. One incantation for the lying-in chamber asks the child to come forth the way Lazarus emerged from his tomb.

The clergy seemed more upset if the midwife got the baptismal words wrong. I stumbled across a late 13th, early 14th century case in which a midwife was barred because she invoked God and Saint John rather than the Father, Son, and Holy Spirit. I’ve yet to come across anyone in my era angry that the midwife used a spell.

And it’s not like such a thing could be a secret. The midwife had assistants, and the mother’s friends attended the birth and lent their support. When the baby was born, the midwife would tie off the umbilical cord and cut it at four fingers’ length. She bathed the child, rubbed them with salt, and used honey on their palette and gums to stimulate their appetite. She was the one present the child to the father.

The midwife’s duties didn’t end with the birth. A surviving mother would remain in her lying-in chamber for a month. In a noble house, her only visitors were the midwife and some female companions.

What I’ve come to conclude is that medieval people understood forces greater than themselves were at work everywhere in life, and childbirth was no exception.


Daily Life in Medieval Times by Frances and Joseph Gies

“Capturing the Wandering Womb” by Kate Phillips, The Haverford Journal, April 2007

“The History of Cesarean Technique” by Samuel Lurie, MD, and Marek Glezerman, MD, AJOG Reviews, December 2003

Limbo” by Patrick Toner. The Catholic Encyclopedia, Vol. 9, 1910.

Saint Augustine’s On Merit and the Forgiveness of Sins, and the Baptism of Infants (Book I)