Duties of Midwives in Antiquity

1. Assigning in the process of childbearing and helping the doctor with regard to any medical problems relating to women any time such help was needed.
2. Calling a doctor and a couple of assistants or more to be on-call with her whenever the need arises for a more difficult procedure during an abnormal delivery.

Midwives and physicians believed then that a normal delivery was more easily obtainable when a woman sat upright. The childbearing process can therefore be itemized as follows:

1. During parturition, the midwife would sit the woman on labour on a stool at the place where the delivery was to take place in the home of the delivery woman.
2. The stool or seat had a crescent-shaped hole through which the baby would be delivered.
3. The stool or chair had armrests for the mother to grasp to aid her in enduring the pains of delivery.
4. Most of such seats or stools had backs the child bearing woman could press against in the process of delivery (physician Soranus suggested in his writings that in some cases, the chairs were backless and an assistant had to stand behind the delivery woman to render support to her.
5. The midwife would then face the delivering woman, gently dilating and pulling the fetus forward, instructing her on proper breathing and how to push downwards during a contraction.
6. The assistants helped by pushing downwards on the patient’s abdomen.
7. The midwife would finally receive the infant, place it in the pieces of cloth provided for the purpose, immediately after which she would cut the umbilical cord and cleanse it.
8. The midwife or any of the assistants working with her would, on the permission of the midwife, sprinkle the infant with fine and powdery salt, or natron or aphronitre to soak up the birth residue. She would then rinse the infant, then powder and rinse it again.
9. The midwife would then clear the muscus from the infant’s nose, mouth, ears or anus. Soranus encouraged midwives to put olive oil in the baby’s eyes to cleanse away any birth residue, and to place a piece of wool soaked in olive oil over the umbilical cord.
10. With the delivery process concluded, the midwife would pronounce the chances of survival of the newborn child and whether it was health and fit to rear or not. She would inspect the infant for congenital deformities and test its cry to hear whether or not it was health, hale and hearty.

A second-century terracotta relief from the Ostian tomb of Scribonia Attice, wife of physician-surgeon, M. Ulpius Amerimnus, as presented by available literature, portrays the scene of childbirth. Scribonia was a midwife and the relief shows her in the midst of a delivery.

A patient sits in the birthing chair, gripping the handles and the midwife’s assistant stands behind her providing support. Scribonia sits on a low stool in front of the woman, modestly looking away while also assisting the delivery by dilating and massaging the cervix, as encouraged by Soranus.

A more elegantly carved ivory relief from Pompeii depicts a similar scene. There are four women present: the parturient in the birthing chair; an attendant standing behind the chair providing support; the midwife seated on a low stool in front of the mother; and a fourthly woman standing behind the midwife, waiting to take the infant or possible offer a blessing. This little portrait confirms the descriptions of childbirth presented in the work of Pliny and Soranus.

In Grece-Roman times, the socio-economic status of the family largely determined the quality of the midwife attending to the gynaecological needs and conducting the childbirth of the woman in the family. Although the services of the midwife is said to be quite affordable to the general public, women of poor families who could not afford the services of professional midwives depended on female relatives with some rudimentary skills to help them conduct childbirth and provide some bare maternity care, while numerate families employed their own midwives for such purpose. That was the scenario with the families at the two extreme ends of the social-economic ladder.

Majority of women, however, received their gynecological and maternity care from hired midwives who could be either vastly skilled or having elementary skills of obstetrics. Many families had the option of hiring midwives, practicing traditional medicine or the newer methods of professional parturition.