Bedside Manners 12: The Beginning

Humans have been mothering and midwifing since the beginning of humanity. Why, then, did something so natural become so fiercely under fire? 

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Episode Transcript

Speaker 1 (00:05):
Heinrich was having a bad time. For two years, he
had been an inquisitor in southern Germany and was involved
in the witch trials that had begun to sweep western Europe.
But Heinrich ended up not being a good fit for
his role. Although he had a profound sense of duty,
he lacked any sense of professionalism. For one thing, he
had become deeply obsessed with the sex life of one

(00:27):
of the women he accused and brought to trial. It
was all too much, and his unhinged displays were deeply embarrassing.
Because of this, the bishop, his boss, set free every
last woman on trial that day, fired Heinrich and publicly
declared him to be insane. Heinrich, who had been looking
forward to making a name for himself, was mortified, inconsolable.

(00:49):
Even The next course of action, it was decided, would
be to put his truths down on paper. He would
write a book. The year was fourteen eighty six, and
it would be a clap that would echo for centuries
to come. Heinrich took to his study and got out
his ink his order of business created a guidebook that
would help solve for this world that he felt was

(01:10):
perverted by women. He wrote hundreds of pages on how
to spot treacherous ones, on how women often caroused with
the devil, on how they practiced witchcraft and were generally
up to evil doings. It acted as a guide for
identifying witches and suggested different kinds of torture, prosecution strategies,
and punishments for those convicted of the charges outlined in

(01:32):
its pages. The ones he cautioned his readers to fear
the most, he wrote, were the concubines, domineering spouses, and midwives.
The latter, he wrote, was the worst of the worst.
Heinrich wrote that midwives not only killed babies at birth,
but hungered to drink their blood. He claimed that midwives
were in the business of actively recruiting young women to

(01:53):
join their ranks, and had the best luck with ones
who were already morally corrupt by signing over their souls
to the devil, giving over the souls of the babies
in their charge. He believed that Europe was under spiritual siege,
and if only people knew the satanic midwives could be stopped.
It was a madman's treatise with an academic flourish, and

(02:14):
Heinrich Cramer wanted to get his writings into as many
hands as possible. The advent of the printing press indeed
allowed this to happen, spreading copies of his Malleus Maleficarum
far and wide. The book was condemned by top theologians
and decried by the Catholic Church. They saw these accusations
as reprehensible and suggestions of torture to illicit confession as unethical. Midwives,

(02:40):
after all, were often the local healers. They were in
the business of helping people get well, birthing babies, and
even legally allowed to care for their spiritual wellbeing through baptism.
But still the book gained momentum in the secular courts
and with lay people who could afford to purchase it.
By sixteen oh four, King James the First declared that

(03:00):
he would rather his child was baptized by an ape
as by a woman, repeating Heinrich's idea that midwives were
in the business of trickery and soul stealing. But to
some it was clear that it wasn't the souls of
a nation that were under attack, but rather the midwives themselves,
the very people who tended to their survival I'm Aaron Manke,

(03:24):
and welcome to bedside manners. Giving birth is an incredible feat.
Of course, I haven't done it myself, but I hear
that words sometimes fall short in describing how profound of
an experience it truly is. And for as long as

(03:45):
women have been giving birth, midwives have been present. The
word quite literally means with women. Written and oral traditions
across ancient cultures affirm the importance of midwives in their societies.
In ancient Rome and Greece, the formally educated midas wives
were held in such high esteem that the writings were
often cited by male physicians. We see reverence for them

(04:06):
in Egyptian carvings. Communities have long looked to their midwives,
who were often versed in all matters of life and death.
They worked in the homes of expectant mothers or made
private spaces for them to come give birth. To be
a midwife was in honor. It was long a position
of power, respect and expertise. So it was a curious
moment when in sixteen fifty eight English physician Perceval Willoughby

(04:30):
sheepishly crawled on his hands and knees into the birthing
room of an expectant mother. Had the laboring patient been
made aware of his arrival, she probably would have been horrified.
Having a man in the birthing chamber was considered indecent.
Perceval's own daughter, a midwife, had asked him to advise
on what she believed to be a particularly difficult case
of a baby in the breach position. The record tells

(04:52):
us that he merely took a quick look, supposedly unnoticed,
and slunk away. Perceval gave his thoughts on the baby's position,
but he was wrong. How could he have known about
what the baby was doing by simply looking from across
the room. But still his advice was sought. Perceval's story
was emblematic of the moment you see beyond that birthing room,
something strange was happening. Although midwiffery had long been the

(05:16):
domain of women, men were beginning to encroach in what
amounted to a business opportunity. Women had the market cornered,
and they saw that there was money to be made.
Perceval and his medical school cronies got into the business
of publishing midwiffery manuals. They were going to great lengths
to assert their authority over the long standing female domain,
even though this particular striving was far out of step

(05:38):
with the social norms. Then, in sixteen seventy one a
response came. A woman named Jane Sharp published The Midwives Book,
or the Whole Art of Midwiffery Discovered in England. At
almost one hundred thousand words long, the book was revolutionary.
Jane's book documented actual practice, anecdotes and observations of birth,

(06:00):
wrote expertly about anatomy and sex, conception and disease, and
pregnancy and delivery. What made this text so novel was
that it was written in plain language for everyone. You
didn't have to have a medical degree to understand it.
Her voice was authoritative and her stance was confident. For millennia,
women's knowledge of bodies and how to care for them

(06:21):
had been passed down orally kept in diaries or shared
in letters, but never had such a grand treatise been
made so widely available. It was an answer to all
of the men who were writing and selling midwifery books
without having ever delivered a baby. In the pages of
her book, she asserted the rights of herself and other
women to continue doing birth work. It's possible that she

(06:42):
sensed what was coming for midwives and edging out by
the medical establishment. She wasn't going down without a fight, though,
so she set out to prove that the pen was
indeed just as mighty as the sword. Two centuries later,
and across the world, in America's Ozark Mountains, a granny

(07:05):
woman caught a baby. This wasn't her first and surely
wouldn't be her last. Laboring women always called upon her
when their birthing time drew near. She was a mother
many times over, and a grandmother too. She was an
auntie beloved by her neighbors, young and old, and knew
everyone and everything that lived within her community. From her

(07:25):
gardens and woods, she gathered native plants, knowing that through
the alchemy of heat and time, she could turn them
into soothing potions. She loved the sap from sweetgum trees
and the leaves of yellow dock for teas. She learned
these things from her mother and from her grandmother. Carrying
on a long vocation of community care, our granny Woman
and her sisters all carried with them the midwifing traditions

(07:48):
of their enslaved ancestors. During America's enslavement of African people,
The granny woman held a special place in plantation society.
From the perspective of her captors, it was her job
to keep her fellow slaves healthy and to ensure their
fertility in order to make more enslaved bodies for her
fellow captives. She was there to protect them with her

(08:09):
deep held knowledge of both plant medicine and the female body.
The reputation of such women was held in high esteem
in this social order, which allowed her to occupy a
unique liminal space. She might be sought out for medical
care from her white owners, or be allowed to travel
to a birth on a neighboring plantation. She might attend
to blackbirths as well as white ones. With the Emancipation

(08:32):
Proclamation of eighteen sixty three, the formerly enslaved population did
what they could to establish themselves in a hostile land.
These black midwives entered into the free market, free to
practice how and on who they chose. Midwives worked across
the country and importantly held down their posts in poor
and rural areas. They provided crucial gaps in community care.

(08:54):
White physicians, many who had recently come back from training
at European medical schools felt threatened by these midwives. As
medicine began to gel into a professional class, those in
power had a lot of interest in gatekeeping. These newly
minted physicians had their economic security to protect. By the
early twentieth century, the schools would begin to teach obstetrics,

(09:15):
which finds its roots in the modern Latin word which
means quite literally midwife. Perhaps they found this term to
be more academic. In doing so, they were intentionally distancing
themselves from the more informal, long women held tradition of delivery.
It was an attempt to edge out women from their
profession and gain more of the market share that was

(09:36):
women's bodies. But in nineteen ten, a landmark publication arrived.
The Flexner Report was a study of American medical education.
The report revealed a high maternal mortality rate. It situated
midwifery firmly in its crosshairs and recommended that birth should
be treated as a medical event, so hospitalizing every mother

(09:56):
and abolishing midwiffery. This would create a steady streat of
revenue for new hospitals. At this point, about half of
the births in America were attended to by physicians and
the other half by midwives. The following year, an obstetric's
professor in New York was quoted in saying that midwives
are and I quote dark, dirty, ignorant, untrained, incompetent women.

(10:18):
Evil though necessary, evil that must be controlled. We must
save our women. By nineteen fifteen, doctor Joseph de Ley,
the most famous obstetrician of the day, suggested that birth
be viewed as a dangerous pathological process that must be
controlled to the highest degree. He believed that every woman
in labor needed medical intervention, even when the intervention itself

(10:40):
left long lasting damage to the mother and child. He
invited the use of forceps, restraints, episiotomies, and drug cocktails
to knock laboring mothers unconscious. He stripped humanity from childbirth,
and to many it seemed that modernity had finally arrived.
By nineteen seventeen, a national debate and dias desire for
governmental response had been triggered. They needed to do something

(11:03):
about the American midwife problem. In nineteen twenty one, the
Shepherd Tuner Act was passed by Congress, which provided federal
funding for maternity and childcare. The states were required to
match these federal dollars, but without necessary health care infrastructure,
many rural places heartily welcomed midwiffree to fill in the gaps.
States worked towards regulating their practices in the meantime, requiring

(11:27):
training and licenses in order for them to legally work,
but none of this made birth safer. In fact, until
the invention of antibiotics in nineteen twenty eight, maternal and
infant hospital deaths kept rising, as did the incidents of
death from birth injuries. America saw a forty one percent
increase in infant mortality due to injury between nineteen fifteen

(11:48):
and nineteen twenty nine, primarily due to invasive obstetrical interference.
By nineteen thirty five, less than fifteen percent of American
births were attended by midwives. Practitioners were working in the poor,
black and rural South, a place where many white doctors
chose not to go. But it was also around this
time in rural Alabama that a very special baby was born.

(12:19):
Annie Lee Logan came into the world as the fourteenth
child of Martha and Lenn Rodgers. She was born around
nineteen ten near the community of Sweetwater. Her family's land
was beautiful as the name suggested. Her parents owned it,
and even though they were cash poor, they lived in
abundance among their fruit orchards, rice fields, and vegetable gardens.
As Annie got older, she began to experience fainting spells.

(12:42):
These kept her from working her family's fields and gardens,
but they gave her access to another world. She went
off with her mother to deliver local babies. Annie was
curious about everything that she saw and cared for her
baby dolls just as well as her mother cared for
new infants. By the time Annie was about eight years old,
the state legislature began to crack down on non licensed midwives,

(13:04):
which is to say all of them. The state of
Alabama soon established a regulatory board which managed all registration
and training. And while this seems like a sensible chapter
in the March toward progress, the truth was a bit
more complicated. You see, America didn't have a midwife problem
like the American Medical Association claim. Rather, it was the

(13:24):
midwives who had a problem on their hands. The issue
here was one of inclusion. Long ago, Europe had established
midwiffery schools and accepted them as integral parts of the
medical field. But this was not true for America. Instead,
American medical schools refused to accept women into their ranks,
let alone black women. They wanted to replace all midwives

(13:45):
with male doctors, many of whom lacked functional knowledge and
culturally competent care. After her mother died when Annie was
about eighteen years old, she went to work to support
her family. She took up work as a domestic servant.
A few years later, already having had a child of
her own, she began to consider what it might mean
to her to become a midwife. It was when she
received heaping praise while helping a local doctor deliver her

(14:08):
employer's child that she realized that her life's course had
already been charted. She took up work as a granny woman,
just as her mother had been. Annie was working in
rural communities at a time when white doctors refused to
deliver black babies. She was one of thousands who continued
to work across Alabama. Often, the families that Annie and
her fellow midwives worked with were living in deep poverty.

(14:31):
Even still, these birth workers considered their path a calling
and found ways to barter and give their time beyond
delivering children. They provided care for the household. They cooked
and cleaned, and helped prepare for the baby's arrival. They
prayed with scared parents and wiped the laboring mother's brow.
Unlike the medical doctors of her day, who wished to
expedite childbirth by any means necessary, Annie made sure that

(14:54):
she didn't rush it. She would later recall a birth
she attended alongside a supervisor. A mother had gone into
labor with twins. The first child was born, but he
wasn't breathing. Her supervisor set the baby aside, assuming he
was dead, as she assisted the second child from the
birth canal. Annie, having never been trained in mouth to
mouth resuscitation, had a sense that this was the only option.

(15:16):
She worked tirelessly for forty five minutes, and soon the
baby began to cry. In the nineteen forties, she began
taking classes with the Mobile County Board of Health to
secure her license and registration. Pen in hand and paper
on the desk, she sat quietly as teachers conducted their lessons.
They discussed hygiene and pre and postnatal care, the curriculum

(15:37):
that was already familiar to many in the classroom, but
it wasn't the hard and necessary skills that she believed
she was most gifted with, but something more spiritual, something
more ineffable, something that she would call mother wit. Annie
believed that there was this God given wisdom, her common sense,
and she relied heavily on it in her practice. By
nineteen forty nine, she was certified by the state board

(16:00):
and joined the professional ranks of the new medical establishment.
Annie kept working in homes, and public hospital health care
infrastructure kept expanding. Finally, hospitals allowed black mothers inside, leading
to a decrease in the demand for in home midwives.
By nineteen seventy six, the state outlawed midwiffery. Altogether, Annie
and one hundred and fifty of her peers were allowed

(16:22):
to continue their care, but theirs was a dying breed.
She had delivered hundreds of babies in her career and
had only lost four of them, and as a reward,
very quietly, in nineteen eighty four, she received a letter
in the mail. It was from the state of Alabama
telling her that her license and those of all her
fellow midwives were being revoked immediately. At seventy three years

(16:45):
of age, Annie had been the last practicing granny midwife
in Mobile County. As she would later recall, it was
one of the saddest days of her life. Annie Lee
Logan didn't go quietly. Although she never practiced again, She
met a young student, Catherine Clark, in the summer of

(17:06):
nineteen eighty four. Together they created Annie's autobiography, entitled Mother Wit,
an Alabama midwife Story. Doing so helped to capture the
story of Annie's life, as well as an institution and
a community of healers that was all but eradicated. Annie
passed away in nineteen ninety five, and although midwiffery is

(17:26):
still illegal in Alabama, she had lived long enough to
see the tides change. With the social upheaval of the
nineteen sixties and seventies, layman whiffery began to make a comeback.
The fight for bodily autonomy was a hot issue during
the surge of the women's movements, and of course it
made sense that focus landed on pregnant and birthing bodies.

(17:47):
Those who sought to decriminalize midwiffery knew that a sacred,
ancient practice had been sent underground. They wanted choices and
a holistic kind of healthcare that treated them as so
much more than faceless numbers on a hospital chart. Today,
midwiffery is legal to practice in all fifty states, although
home births still remain illegal in seven of them. Even still, today,

(18:08):
more than ninety eight percent of births in the United
States take place in hospitals. But shockingly, a set of
twenty eighteen statistics tell us that the maternal mortality rates
in the US is higher than it was in nineteen ten.
Among forty nine other developed countries across the world, we
come in first place with our death rates. That's a

(18:28):
top spot that comes with no prize, just a whole
lot of justified scorn. Today we are in the throes
of a maternal healthcare crisis, one that continues to disproportionately
affect the same communities of women that Annie had dedicated
her life to serving. My wife and I have a

(18:51):
deep connection to the world of midwiffery. We know from
multiple berths just how important their advice was in preparing
for the big day, as well as their stay hetty
hand and calming spirits in the delivery room. Midwives are
guardian angels, and to learn about the way our society
has treated them is honestly beyond heartbreaking, but in their
stories we can still find hope. And if you stick

(19:14):
around through this brief sponsor break, my teammate Robin Miniter
will tell you one more tale of a healer finding
their place in the world.

Speaker 2 (19:27):
Stenny Slawa Lishtinsky was born May eighth, eighteen ninety six
in Poland. Her family was poor and Catholic, and her
childhood was marked by war. Her father had been drafted
into military service, which left Stennyslava's mother to take care
of the family, the home, and the finances. They moved
around some, spending a few years in Rhodijonio before returning
to their home in the city of Wuch. By nineteen seventeen,

(19:50):
Stony Slawa was married. By nineteen twenty three, she and
her husband, Bronislau, had three children. She spent the next
few years raising their family and finishing her Midwi freequel horses.
Her life was full. Delivering babies brought so much joy
to the families that she worked with, but this happiness
wouldn't last. On September first, nineteen thirty nine, Germany invaded Poland.

(20:12):
Nazi forces spread throughout the country, establishing ghettos for Jews,
the Roma and other designated enemies. On September eighth, the
Nazis arrived, in which they quickly got to work rearranging
the city and everyone who lived there, eventually erecting the
second largest ghetto in all of Nazi occupied Europe. The
neighborhood where Stanny Slava had been born and raised was
turned into a hell on earth. Fences were erected and

(20:34):
barbed wire lined them. Armed Nazi troops patrolled the perimeters.
Sanni Slava watched as her neighbors, patients, and friends were corralled, starved,
and abused. In the bright light of day, she secretly
slipped them food and falsified documents from the outside, risking
her own life. As part of the resistance, The Nazis
continued to close in. Stanislava's family was arrested in nineteen

(20:54):
forty three. Two of her sons were sent to a
concentration camp. She and her daughter, Sylvia, who was as
a medical student, were both sent to Auschwitz Berkanew. Stanny
Slawa Lishtinski became inmate number four, one, three, five five.
She also became the camp's midwife. The Nazis had a
vested interest in the fertility and reproduction of their captives.
They enlisted Stanny Slava to help do their bidding. Day

(21:17):
and night Standy Slava took care of the imprisoned women
in one of the barracks. The thirty bunks nearest to
the stove made up what was known as the maternity ward.
The stove, which was shaped more like a trough, ran
like a line through the building center, but it was
rarely used for warming. Instead, these troughs became places for
laboring women to lay. It was a frigid, horror filled
place that she later wrote about, being infested with bold,

(21:39):
hungry rats, slicked with bodily fluids, and lacking any access
to basic hygiene or comfort that would keep these mothers
and their babies safe. The Nazis sentenced every newborn baby
to death. It was ordered that the baby's umbilical cord
was not even to be cut, but rather immediately thrown
with the placenta into the trash. Later, the babies were
ordered to be drowned. A sign to complete this deed

(22:02):
was a disgraced midwife who had been convicted of infanticide.
While still on the outside, mothers often silently bore witness
to this entire atrocity. Even still, standy Slava did everything
she could to provide these mothers and newborns with comfort,
if only for a short while. She would pray over
each baby, baptizing it with warm water and herbs. She
would swaddle the baby in any extra sheet that could

(22:22):
be traded for, and created diapers from torn strips of fabric.
After mid nineteen forty three, a pivot happened. Non Jewish
newborns were now permitted to live. The ESSSS would later
decide if a baby could pass as Aryan, it would
be rehomed and Germanized. Standy Slava secretly tattooed these babies
and communicated as much to their mothers in the hopes
that they could one day be reunited. In all, standy

(22:45):
Slava delivered more than three thousand infants. Remarkably, she never
lost a single mother or child during birth. Each baby
was born alive and healthy, and despite the world they
were entering into, they were ready to live. According to
her counting, over fifteen hundred of these infants were drowned
at the hands of the SS. Another one thousand died
of cold and starvation. A few hundred were transported for placement.

(23:08):
Only thirty survived everything. When the war ended and Auschwitz
was liberated, Standi Slawer returned home to Wooch. There she
continued to serve as a midwife to her community until
she retired in nineteen fifty eight, and before she died
in nineteen seventy four, she got to once again meet
some of the children whose lives she had saved. Her
surviving son, who later became a doctor, was quoted as saying,

(23:31):
for her, the child was the greatest miracle in the world,
and the act of giving birth was nature's greatest biological exultation.
In the face of unspeakable horrors and the threat of
immediate death, standyslaw Was still found it within her to
fight for life. She never gave up on her mission
to care for those in humanity's darkest hours.

Speaker 1 (23:51):
Grimm and Mild Presents Bedside Manners was executive produced by
Aaron Mankey and narrated by Aaron Manke and Robin Minitter.
For this season was provided by Robin Miniter, with research
by Sam Alberty, Taylor Haggerdorn and Robin Miniter. Production assistants
was provided by Josh Thayin, Jesse Funk, Alex Williams, and

(24:12):
Matt Frederick. You can learn more about this show, the
Grimm and Mild team, and all the other podcasts that
we make over at grimandmild dot com, and, as always,
thanks for listening