General practitioners and obstetrics: a brief history

If you had asked an English physician in 1700 about the connection between medicine and midwifery, he would almost certainly have told you that the two had nothing whatsoever to do with each other. Midwifery was an activity confined to uneducated female midwives from which men were rigidly excluded. Occasionally a surgeon was asked to use some kind of surgical instrument in an attempt to deal with an obstructed labour, but that was all. If, however, you had asked the same question at the end of the 18th century, you would have been told that an increasing number of women were choosing to be delivered at home by medical practitioners, especially the surgeon-apothecaries who were general practitioners in all but name. (It was, by the way, not until the early 19th century that the term ‘obstetrician’ came into common usage, replacing ‘man-midwifery’ and ‘accoucheur’.) By the end of the 18th century it is probable that about half the total deliveries in England and Wales were home deliveries by medical practitioners and the rest by midwives. Only a very small number of deliveries – well under 1% – were delivered in maternity hospitals.1