The birth of biopower in eighteenth-century Germany

In April 2009, Sir David Attenborough, the respected face and voice of British natural history programmes for more than fifty years, became the patron of a new charity, the Optimum Population Trust (OPT), an organisation campaigning to limit the world's population. His reason for accepting the honour, he confessed to The Times, was that he was terribly worried about the dramatic increase of the world's population and the effect it was having on the quality of human life throughout the world:

There are three times as many people in the world as when I started making television programmes only a mere fifty-six years ago. It is frightening. We can't go on as we have been. We are seeing the consequences in terms of ecology, atmospheric pollution and in terms of the space and food production.

[Obstetric aid seen in relation to the Nissen-family in Hillerup and on Spøttrup from about 1771 to 1835]

The very rich owner of the medieval castle Spøttrup in Sailing, Jutland died without any descendents. A lot has been written about the Nissen-family, but the circumstances by the deliveries of their children are not explained before. In the local churchbook six of seven deliveries from 1825 to 1835 are described as it was demanded to document and explain birth of dead children to control the skills of the midwives. Only one child survived the birth, and he died in the age of eight month. In the other six cases several ways of attempts to resuscitate the babies are described. One baby had its head crushed by the forceps, and at the last delivery the midwife did not show up, as she assisted at another place. The doctor then had to assist without help. The education of midwives in Denmark took place in Copenhagen, but in lack of a sufficient number, alternative education was given by local doctors ('stiftsfysicus') in Ribe and in Viborg, both in Jutland. The bishop of Viborg, Tetens, tried to help the local 'stiftsfysicus' to establish a school for midwives in Viborg in about 1783, but without success. A grandson of the bishop was the doctor, who unsuccessfully handled the forceps at a delivery at Spøttrup and who also had the honor to assist at the last delivery without the help from a midwife.

From conception to birth: ancient library sources of embryology and women anatomy kept in the Biblioteca Biomedica of the Università degli Studi di Firenze (Biomedical Library of Florence University)

The Biomedical Library of the University of Florence boasts a prestigious group of books collected at first in 1679 at the hospital "Santa Maria Nuova" and then continuously enriched in the course of time up today. The "Antique Collection" consists of 13 incunabola, hundreds of 16th-century books, more than one thousand books on medical subject from the 1600's, about six thousand 18th-century volumes and several large, valuable anatomical atlases. In this paper the most important, curious and fascinating books dealing with human ontogeny (from embryo generation to birth) and with female anatomy (mostly concerning pregnancy and childbirth) are reported in chronological order starting from the work of Hippocrates. Among the ancient sources useful for the reconstruction of the opinions about obstetrics there are also outstanding handbooks specifically edited for midwives. Many of these antique books are especially precious because they embed a great number of didactic pictures, some of which may compete against any modern book of anatomy, embryology and obstetric. Selected images from these books are shown.

Scotland's "wooden operator" William Smellie (1697-1763) and his counterpart in France André Levret (1703-1780): two great obstetricians and anatomists

During the eighteenth century two great physicians, William Smellie and André Levret, instated maternity as a medical procedure. Although they had to face the negative criticism from women midwives of their time, nonetheless, through their work, they were recognized by the medical community as prominent obstetricians. With the expertise they gained they improved the forceps, while they thoroughly studied the anatomy of the pelvis. They passed their skills to their students who became the successors of their toil. Starting from two different countries and schools they both managed to shine within their science and leave behind a rich path.

The campaigns for men to become midwives in the 1970s

The oral testimony of forty men entering nursing (1950-2000) and twenty men entering midwifery (1970-2000) in Australia is littered with descriptions of gender discrimination. Men identify many of the barriers they encountered entering a female dominated profession. The Nurses' Registration Act in the States of Victoria (1958) and Tasmania (1952) explicitly stated no male could be registered as a midwife and this paper focuses on the personal accounts of three men (1974-1976) to change this legal impediment. In twenty-first century Australia the percentage of male midwives, like many countries around the world, remains very small, and depending on the state or territory of Australia is between 1 to 2.7 percent.

The midwife and the church: ecclesiastical regulation of midwives in Brie, 1499-1504

At the turn of the sixteenth century in Paris, midwifery was an emergent profession regulated by the church. This article analyzes fourteen entries in the Registre de causes from the archdeaconry of Brie, 1499-1504, within the context of midwives' relationship with the church. It suggests that midwives were important appendages of the ecclesiastical bureaucracy. Midwife regulation was one aspect of the French church's attempts to maintain its autonomy against secular powers. Regulation by the ecclesiastical bureaucracy provided midwives with professional advantages and disadvantages. The ecclesiastical bureaucracy played a vital role in creating and sustaining midwifery as a profession, but also circumscribed midwives' practices. Overall, however, bureaucratic control was unsystematically applied, and midwives were often left to negotiate their own professional and social positions.

Who were his peers? The social and professional milieu of the provincial surgeon-apothecary in the late-eighteenth century

The social standing of the surgeon-apothecary cannot be determined by reference to professional life alone, yet few such men left social documents. The lower middling sort was typically reticent about evaluations of their own social position in any source genre. This article uses a unique archive, and the concept of community connectedness, to investigate the status of Thomas Higgins, surgeon-apothecary and man-midwife of north Shropshire. Higgins embodied the traditional practitioner who relied on local knowledge and his 'friends' for advancement, in contrast to alternative modes of rising professionalism. He was demonstrably a trusted man at the heart of his home town, but his reliance on the 'partiality' of his neighbors brought him into conflict with his colleagues.

Framing the new midwifery: media narratives in Ontario and Quebec during the 1980s and 1990s

After long periods of activism and policy debate, Ontario and Quebec were the first two provinces to integrate midwifery into their health-care services. Despite its success and growing popularity in the post-legislative era, midwifery was a highly contentious policy issue, with debates emerging at every level of policy development. In this essay, the authors explore how these debates played out in media. Specifically, the authors suggest that the frames produced by newspapers during this period served to align midwifery with broader provincial socio-political discourses, which in turn legitimized state intervention in the area of reproductive health. At the same time, however, the authors demonstrate that where Ontario media representations muted differences between midwives and physicians, representations in Quebec emphasized them. Thus, the authors show that in very different ways, media representations of midwifery in Ontario and Quebec both established a discursive context in which the state had to "act on" midwifery and midwives, and also challenged the potential of midwifery to transform women's birth experiences.

The History and Evolution of the Core Competencies for Basic Midwifery Practice

The Core Competencies in Nurse-Midwifery were first published in 1978 to provide a standard approach to nurse-midwifery education and now serve as the template for curriculum in nurse-midwifery/midwifery education. This article is an expansion of an earlier publication documenting the development of the Core Competencies document and describes its history and use in midwifery education and professional practice. The development and continued revision of this document are a significant part of ACNM and midwifery history in the United States. It defines the competencies essential to basic practice and can be used to define the scope of midwifery practice in both professional and policy arenas.

Presidential Priorities: 50 Years of Wisdom as the Basis of an Action Agenda for the Next Half-Century

Each of the living presidents of the American College of Nurse-Midwives (ACNM), past and current, was asked to select one or more issues that were of particular importance during her term(s) in office. Some of the issues identified by the presidents were amenable to review using existing quantitative data; this article presents those findings. The substantial increase in growth of ACNM membership in the 1980s and 1990s as well as the plateau that occurred at the beginning of the 21st century is documented. The relationship between ACNM and the professions of nursing, medicine, and other public health providers is illustrated. The increase in the number of Certified Nurse-Midwife/Certified Midwife (CNM/CM) education programs and the evolution and current profile of curriculum models are discussed. Finally, expansion of the scope of midwifery practice and the growing number of opportunities for entrepreneurial practice are presented in terms of current practice profiles, practice sites and settings, various employer-employee relationships, and the variety of financial reimbursement streams. This article is intended to complement the broader body of information about ACNM's history, and particularly, to supplement the richness of information derived from the qualitative and historical research inquiries conducted by others.

Midwifery Care of Poor and Vulnerable Women, 1925-2003

A systematic literature review of research on midwifery care of poor and vulnerable women from 1925 to 2003, which included topics studied, research methods used, and special issues and implications for future research, was performed; 44 studies published between 1955 and 2003 were identified. The majority were retrospective, descriptive studies. Outcomes examined included prenatal care visits, vaginal versus operative births, labor interventions, maternal and neonatal mortality and morbidity, birth weight, and cost-effectiveness. Studies showed that midwives predominantly serve vulnerable women who are young, poor, immigrants, or members of racial and ethnic minorities. Preterm birth prevention is emerging as a midwifery research focus. Health system changes are making it more difficult to provide effective care and counseling to disadvantaged women, especially in managed care settings. Extensive evidence documents excellent outcomes of midwifery care for the poor in urban and rural settings over the past three quarters of a century. Future research should include more intervention studies and use both qualitative and quantitative methods to investigate midwifery processes of care and the process-outcome connection. The research focus should broaden beyond childbirth to include gynecology, family planning, and primary care issues. Health disparities, cultural studies, obstetric interventions, and poor women's experiences of childbirth and midwifery care are important topics for future research.

History of Midwifery in New Mexico: Partnership Between Curandera-parteras and the New Mexico Department of Health

Curandera-parteras (traditional Hispanic midwives) have been in northern New Mexico since before its statehood. In the 1930s, the New Mexico Department of Health began a valuable relationship with the curandera-parteras through the Midwife Consultant Program. This article describes the relationship between the curandera-parteras and the New Mexico Department of Health originating in the 1920s. The amenable and effective working relationship achieved between curandera-parteras and public health during this time period helped create the positive support for midwifery that is apparent in New Mexico today.

The American College of Nurse-Midwives and Its Antecedents: A Historic Time Line

In celebration of the 50th anniversary of the American College of Nurse-Midwives, this time line presents a chronologic history of the development of nurse-midwifery in the United States. It places the introduction of nurse-midwifery in American health care into its historic context and follows the evolution of the profession through early attempts at forming a national organization, the eventual formation of the American College of Nurse-Midwifery, and the subsequent merger with the American Association of Nurse-Midwives, to create the American College of Nurse-Midwives. The work of the College between 1955 and the turn of the 21st century is highlighted.

Doubling Back Over Roads Once Traveled: Creating a National Organization for Nurse-Midwifery

The quest for a new national organization began in 1940 and concluded in November 1955 in Kansas City, Missouri, with the founding meeting of the American College of Nurse-Midwifery. This article looks at the conflicts with organized nursing about the place and role of nurse-midwives in the newly reorganized American Nurses Association and the National League for Nursing. Discussions and disagreements within nurse-midwifery over the need for a nonexclusive national organization that would set professional standards are examined.