Bedside Manners 12: The Beginning

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. 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 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 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 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 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,

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 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, 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

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

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 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 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 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 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, 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 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 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 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 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 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 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 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. 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, 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 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 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. 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 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 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 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 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.

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. 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, 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 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 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 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. 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 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. 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 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 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 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 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 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 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. 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, 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 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 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 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.

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. 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 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 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 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, 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 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 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 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. 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, 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.

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