1—
From Private Practice to Public Service

A Parisian Midwife

4—
Hanging Her Shingle:
Paris, 22 February 1740

A clerk inscribes in the register of the Châtelet police court today that Marguerite Le Boursier, mature maiden, is officially received "mistress matron midwife of the city and fauxbourgs of Paris."^[1] She is twenty-five years old. Five months ago she completed her three-year apprenticeship with Anne Bairsin, dame Philibert Mangin, and passed her qualifying examinations at the College of Surgery. This was a major expense—169 livres and 26 sous—and involved a hair-raising test administered by a panel composed of the king's first surgeon or his lieutenant, a number of Paris surgeons, various deans of the medical faculty and royal surgical school, the four sworn midwives of Paris attached to the Châtelet, and receivers, provosts, class masters, and council members.^[2] An intimidating ordeal, an awesome rite of passage, but she survived it. She had then submitted letters of capacity and mastery of her art with a request to be formally accepted by the city's court.

Before approving her they must get character references as is customary, but they do not hurry. It has taken this long for police officials to organize interviews with her parish priest and various other neighbors and acquaintances. Those questioned might have been shoemakers, goldbeaters, innkeepers, or tailors who lived nearby, or professors of surgery or doctors regent of the medical faculty with whom she had contact. Whoever they were—the records identifying them are not preserved in her case—they responded affirmatively to the rather formulaic questions asked. Just last week, on the seventeenth and nineteenth of February, they gave sworn depositions that Le Boursier upholds the Catholic, apostolic, and Roman religion, lives an upstanding life, and demonstrates fidelity in the service of the king and of the public.^[3] Now that a favorable report has come in, she simply needs to "take the oath required in these

cases" to be legally admitted to the ranks of Paris midwives, swearing never to administer an abortive remedy and always to call masters of the art to help in difficult cases.^[4] And she must pledge to honor one further obligation.

On the first Monday of every month, if it is not a holiday, all sworn midwives are expected to attend holy services at the church of St. Côme and, afterward, pay "pious and charitable visits" to indigent women still inconvenienced by present or past pregnancies.^[5] The church, dedicated to the martyrs Côme and Damien, patron saints of surgery, sits on the corner of rue de la Harpe and rue des Cordeliers on the Left Bank, halfway between the river and the Luxembourg Gardens. Next to the church is a cemetery surrounded by charnel houses, and beyond the cemetery is the school of surgery, familiarly known also as St. Côme. For centuries the sick have flocked here on the first Monday of each month to be tended for free. It is a scene at once morbid and heartening. The cemetery keeps its ditch open until it has received its full complement of corpses; the dead who cannot be accommodated there are buried in the church or surrounding walls. Often the bodies and bones are used in surgical demonstrations. Since 1664 surgeons have been giving lessons to midwives in the charnel house on the western border of the cemetery, which abuts the church, although seven years ago the courses were moved to the college's amphitheater. Over the cemetery's south wall there is a granary and storehouse, where the poor find provisions. They are comforted, once a month, to be in the helping hands of healers.^[6]

Le Boursier will become part of this world now. Perhaps she knows it well already, and even as an apprentice has attended courses there with her teacher. What sort of relationship do they have? She never once mentions Anne Bairsin in her textbook or letters. Yet Delacoux reported that her packet of private papers contained several memoirs on extraordinary deliveries and cesarean sections written, "with precision and exactitude," by Bairsin, "which show her to have been a practitioner both able and learned [instruit ]."^[7] So Le Boursier held on to these writings by her teacher all her life, valuing them enough to keep them (and keep track of them) throughout all her travels. They may have guided her hand in certain circumstances, or served some more sentimental purpose. Might she have collected other manuscripts or case studies by female colleagues, and saved them too over the years? Such unacknowledged debts are probably nu-

merous, for she begins to hone her skills now as an official member of the group of Paris midwives, busy women with vast experience, sources of much shared wisdom and lore.

Louis Sébastien Mercier, the famous chronicler of Paris, estimates that each of the two hundred or so midwives of the capital delivers about one hundred babies each year.^[8] Such an average is misleading; some of these women are surely much more in demand than others. But there is no doubt that, for one with a good reputation, this is a strenuous and full life. Mercier describes the tavaïolle , a large muslin and lace cloth the midwife wraps every baby in, rich or poor, for the trip to church, a kind of "spiritual frock coat that attends all baptisms, the principal and most conspicuous garment of a midwife. If this cloth is not sanctified, then none in the world can be, because this one gets blessed sometimes as often as four times a day." The midwife also uses it to carry the many candies and sugar-coated almonds [dragées ] she receives as tokens of thanks from mothers, fathers, godparents, and guests at each birth, perhaps two to three pounds of these goodies at a time. "The armoire of such a midwife rivals the boutique of a confectioner on the rue des Lombards."^[9]

Because he always has an eye for the sensational and scandalous, Mercier stresses another important role that city midwives play. They do not just officiate at family births; many of them help conceal unwed girls in their apartments, and they are as skilled in diplomacy as in delivery. As a result, hardly anyone seeks an abortion. A girl who finds herself pregnant, though she may concoct a story that she's leaving for the country, need only go around the corner or across the street to the local midwife to hide until she gives birth. Total secrecy is maintained in these apartments, which no one can enter without superior orders. They are divided into many discretely curtained partitions. For two or three months the inhabitants of these cells might converse, but they might never see or know one another. In the capital these wayward girls have privacy; while confined they can look out onto the roofs of their unsuspecting parents' home. In country towns, however, there is no such anonymity, and often a great scandal instead. The city midwife takes care of everything, has the baby baptized, gives it to a wet nurse or to the foundling hospital depending on the fortunes and desires of the parents. Midwives charge a lot to provide these services for fugitive

girls (Mercier calls it usury because his sympathies lie with the young lovers, "victims of their sweet weakness"), often as much as twelve livres a day for the room, board, delivery itself, and of course the confidentiality. Justifying the high cost, they remind everyone that their discretion preserves reputations and saves many from utter ruin. The priest, however, knows that if a midwife unaccompanied by a parent presents a baby for baptism, it is a love child born out of wedlock. He is not particularly happy to see her coming alone; bastards deprive him of the customary fee paid for his services by proud mothers and fathers. Anyone who wants to hear anecdotes about the ruses and the courage love inspires (in which the true identities of the adventurers are, of course, never revealed)—such a person need only get to know four or five midwives. They can tell tales for all classes: women of the people, bourgeoises , courtesans, grandes dames .

The truly poor, those with no resources to pay for a private midwife, deliver at the general hospital, the Hôtel Dieu, infamous for its high death rate and its cramming of five or six to a bed in the main wards. But this hospital's separate maternity clinic, the salle des accouchées , is superbly administered; the critical Mercier even goes so far as to say it is "beyond reproach." Thanks to this establishment, and to the public orphanages, the once rampant crime of infanticide is almost unheard of in the capital these days. Delivering in secret and giving the baby to the foundling hospital, however, has become a widespread practice, and the law has looked the other way. Probably only one in a hundred girls who give birth clandestinely even knows that an edict of King Henry II, now fallen into desuetude, once made their action punishable by death.^[10]

Le Boursier and her colleagues have numerous other functions besides assisting married women at births and harboring unwed girls during their pregnancies. Juries of midwives are consulted on capital crimes. They are frequently used as expert witnesses in legal battles, sometimes called upon to ascertain whether a woman is a virgin. (Here Le Boursier points out that occasionally the hymen is still intact even if the person in question has "endured [souffert ] the approaches of the male," and is thus "not an absolute proof of her purity," but that in general its presence allows the midwife to "presume advantageously" for the girl.)^[11] They are often asked by parties in a legal dispute to establish whether a pregnancy is true or false and make, if necessary, a déclaration de grossesse to a doctor,

surgeon, or directly to police authorities.^[12] And their presence is usually requested to determine whether a dead baby expired in the womb or was killed after birth. The famous lung test is used to establish a mother's veracity when accused of infanticide. A baby in the womb does not breathe air, but of course it does once it is born. If a piece of the baby's lung sinks when thrown into water, so the theory goes, it proves that the child never experienced respiration, that it was stillborn. If the piece of lung floats, however, it is because air has gotten into it. "This circumstance would condemn the mother," Le Boursier explains, no matter how much she insists that her child was born dead, being a proof that air penetrated its lung, consequently that it was once, however briefly, alive.^[13] The judgments rendered by midwives are regarded as essential, and sometimes even shape the evolving legal system.^[14] They are called in on cases of suspected rape, contraceptive use, or abortion. They question seduced and abandoned women during labor, urging them to identify the child's father, thus ensuring the filiation of bastards. Their word is considered sworn testimony. In a very profound sense, then, the law recognizes them and trusts their verdicts. A doctor writing on medical jurisprudence calls their profession "one of the most important in society."^[15] Men, in short, often need and depend on their expertise.

Yet for all their importance—indeed, because of it—relations between midwives and authorities, whether religious or secular, have been strained throughout history. These women are powerful; they have special skills, and knowledge of hidden and forbidden mysteries involving conception, blood, death, and passion. Some have practiced illegally and given their profession a bad name, infamous abortionists like Lepère, la Voisin, and Manon, who toward the end of the 1600s were tortured and either burned alive or strangled for their iniquities.^[16] This trade is still rife with risks and dangers. Occasionally midwives are blamed for causing the monstrous defects of deformed babies that spew forth into their hands, blamed for somehow conjuring the creatures they merely catch. Even now rumors of sorcery and witchcraft hover around any one of them who behaves bizarrely. Their petty thefts are punished especially severely, as if they, of all people, custodians of the newly born, should know better. One such, "just a poor midwife," accused of stealing copper candlesticks from a wine shop, is whipped and sent for three years

to the prison of the Châtelet, then for longer to the Conciergerie, where she now languishes in chains. Protesting this unduly harsh treatment, she says she is afraid she will die.^[17]

Originally the church supervised and controlled midwives, since their work involves them in baptism, in the saving of lives, or at least of souls. An ordinance declared that Protestant women could never exercise this art because they could not be trusted to ondoyer the child, to assure its eternal life if it was dying too fast to get to the priest.^[18] Gradually, the secular state has been taking over surveillance of this group, monitoring it closely. Royal edicts in 1664 and 1678, advertised on huge posters, and numerous parlementary injunctions against particular midwives are evidence of the government's seriousness. In 1717 the art of midwifery was declared of the highest value, and dire sentences were announced for those practicing illegally, "read and publicized in loud and intelligible voice with trumpet fanfare" by the king's official criers "in all usual and accustomed places" so no one could claim ignorance of the law.^[19] Midwives, then, obviously get a great deal of attention, both good and bad. "The policing of childbirth," says a contemporary, "is an object of the greatest importance in the administration. It interests humanity; upon it depends the health and life of citizens. Abuses that slip in [to this field] are not private misdemeanors; they are public crimes."^[20]

Yet Le Boursier and her colleagues, despite efforts to oversee them, continue to function outside the sphere of male control. They gather a loyal clientele without any external help, simply by word of mouth among their female acquaintances. They select apprentices on their own. They are privy to more secrets about lineage and legitimacy than anyone else. It always seems to the authorities that in spite of their overt cooperation, midwives are first and foremost deeply loyal to the women they serve. For this reason midwives have constantly been denied the right to form a guild, to organize themselves into an autonomous corporation. No official bonding is permitted among these masterless women; they already seem conspiratorial enough. Doctors and surgeons are relieved that midwives have no recognized channels for grouping together, asserting themselves, seeking legal redress, or voicing grievances.

Independently, however, these women play powerful roles in the greatest drama of life.

5—
A Birth:
Paris, January 1744

This baby is finally coming, ready now to make its dive into the world—with the help of an accoucheuse , of course.^[1] For months Le Boursier, a robust woman of twenty-nine, has been looking in on the mother-to-be, providing oils and liniments to keep the growing breasts and belly elastic: white pomades of melted pork fat purified with rose water, others of calves' foot marrow, the caul of a baby goat, goose grease, linseed oil, almond paste, and marsh mallow. She counseled the use of supporting bandages recently as the stomach really began to sag, and suggested the woman sleep on one side so that the opening of her womb, a bit off kilter, would be pulled by gravity into alignment with the vagina.^[2] To keep the bowels moving and avoid constipation, which only exacerbates the inevitable hemorrhoids, enemas have been administered regularly—mixtures of bran, oil, butter, and river water.^[3] There was a false alarm in the seventh month when the baby, who had been sitting up, suddenly turned a somersault and reinstalled itself upside down. The woman had feared she was in labor, but the midwife, upon examination, knew better.^[4]

Bloodlettings have been performed at least once a month throughout the pregnancy—whenever the woman felt short of breath or nauseous, got dizzy, bled from the nose, or presented varicose veins in the legs—to relieve tension in the organs and prevent premature delivery. Once before this woman had been pregnant, but lost the baby because another midwife had not known to bleed her.^[5] At least she has not needed purgings of manna, rhubarb, cassia, and senna, because she has been spared the bad breath, livid skin tone, and bilious vomiting that many others suffer and for which such remedies would be indicated.^[6] The midwife has cautioned her to avoid excessive passions and to coif herself with care, combing and styling to get rid of vermin and to keep herself decent and presentable despite her fatigue. She may powder her hair—nothing with a strong fragrance, though—and put on a bonnet so she won't need to fuss with it for twelve to fifteen days and so her head will stay warm.^[7] Walking is recommended, to keep the sinews strong and resilient. Cleanliness is not mentioned—only women of pleasure wash and bathe frequently—but clothing is to be loose and comfortable, the

bed firm and dry, the diet moderate. No ragouts, sauces, fatty meats, or aliments de fantaisie .^[8]

Now a few female friends, neighbors, and relatives have gathered, responding to the baby's quickening. They will help the midwife, as their familiar faces afford comfort; but if anyone's presence upsets or inhibits the mother, that person is quickly removed. The room is fresh and airy; it must not be allowed to get too hot.^[9] The patient (la malade ), as the birthing mother is called, has been put to bed and will stay there through the delivery. She has only light covers over her. Incontinent these last few days from her great womb pressing on her bladder, she is now, instead, retaining her urine, because the baby has moved down, squeezing the neck of the bladder almost shut. By introducing a hollow tube, an algalie , up into the urinary passage, the midwife quickly relieves that discomfort and watches the bright yellow fluid gush out.^[10] This obstruction cleared, the labor pains come more often now. The midwife's greased fingers skirt around the neck of the womb, normally the size of a fish snout or the muzzle of a small dog, and feel the opening growing larger. When it has dilated to the size of a large coin, an ecu de six livres , the serious ministrations begin. On a strong contraction the midwife breaks the waters, piercing the mother's taut membranes with a large grain of salt; and to ease the breathing, lessen engorgement, and soften the cervix so it will stretch and open more easily, she bleeds her from the arm.^[11]

The mother strains now, rolling and rocking. A more comfortable position will work better, head and chest raised, legs spread, heels planted against her buttocks, knees held apart by a helper. She is a slight woman with a narrow pelvis, and it is a big baby, a boy from the way the frame feels, although the midwife cannot be sure. Hours have gone by; the cervix is quite open, and still the head has not crowned. A malpresentation certainly, but just how bad is it? If any part other than the head presents, the delivery will have to be breech. The midwife checks the extent of dilation, speaking in comforting, affectionate terms to the mother, encouraging her, assuring her that she is not in danger, telling her honestly that things will still take a long time, for unrealistic expectations and impatience could make her tense, worsening the pain.^[12] There is no point in trying to rush nature; the birth will progress in due course.

All along, under the bed linens, the midwife is continuing her tactile exam with fingers and full hand. Mucous, blood, and the waters provide natural lubrication. She hardly needs to look, and it would only offend the mother's modesty. A less experienced midwife could make a terrible mistake right about now. Desperate to hurry things along, she might put a finger into the mother's rectum to push the baby down, but this can ulcerate the anus and destroy the separation between the bowel opening and the vagina, rendering the woman "very disgusting."^[13] Too much vaginal meddling is bad too: it can inflame the bladder. The best thing is to wait patiently, alert to all cues. The mother pushes a little, blows into her hand, and the midwife gently rubs her stomach, speaking in soothing tones.

Changes now. The baby is coming faster. She feels a bulge, not hard enough to be the head, too big and round for an elbow or a knee or a foot. It is almost surely the baby's bottom. She feels the crack between the soft buttocks, and up higher the fold of his thigh. Refraining from probing any further, for fear of releasing the black, tarlike meconium from the baby's rectum, she must move quickly before he engages too low.^[14] Inserting a well-greased hand and following the rear, thigh, knee, and lower leg, she takes a foot down into the birth passage, then goes back in for the other one so the knee doesn't get caught. To do this between the womb's powerful contractions the midwife's arms must be very strong. Slowly, with the mother's help as she pants and pushes, she pulls the two feet together, evenly, steadily, out through the vagina. She wraps them in a soft, dry cloth so they won't slip out of her hands. Once the knees are out she must flip the baby, because he is coming with his chin facing up toward his mother's navel, and in this position his jaw will catch and get stuck on the pubic bone. She continues pulling gently on the little legs as she turns the baby around so his nose is now facing down toward his mother's backside. Straightening and bringing down the arms doesn't deliver the head as it usually does, so Le Boursier asks one of the women to hold up the half-born child, thus freeing both her hands. Deep inside the mother now, she seizes the baby's lower jaw and slides the index finger of her left hand into his mouth, while her right hand pushes down on the back of the baby's head to release it. With both hands she tucks

and pulls the head out and up toward her while another assistant, at the same moment, coaxes out the big shoulders. None too soon, for the ordeal has left the mother completely exhausted.^[15]

The newborn baby boy's cord is tied in two places and cut between the ligatures with a blunt scissors. He seems rather weak; there are faint sounds but no robust wailing. The women wrap cloths soaked in strong wine or eau-de-vie around the cord stump and over his head, chest, and stomach. Some liquor in his mouth, some crushed onions near his nostrils, bring him around dramatically. He lies briefly against his mother's private parts, nesting and squirming. After a few minutes, since he is out of danger, the women take him and wash him in lukewarm wine and fresh butter to remove the muck. Soft worn cloths soaked in oil envelop the cut cord, and a bandage around his middle holds this compress in place to prevent umbilical hernia when he cries, which he is doing a lot now. They bundle him up in toasty linen.^[16]

The midwife turns back to the mother, who is relieved and spent, but her work is not finished yet. She must push another time or two to help the placenta out. When some gentle coaxing on the cord still doesn't deliver the afterbirth, Le Boursier goes in with her whole hand to explore, but it is stubbornly adhering. She injects into the womb some mallow, pellitory, linseed, and fresh butter, gives the mother a drink of lukewarm cinnamon water, syrup of artemisia and almond oil, tries an infusion of couch grass with syrup of sour lime, adds orange juice to the bouillon. None of this is working and too much time has gone by, so the method of last resort comes into play. The woman stands up in a tall vat of hot water. She pushes while the midwife rubs vigorously downward on her thighs until finally, all intact, the "secondine" is expelled. Once the attendant women have examined it and determined that it is complete, the mother lies down again, covered and protected from cold. Finally she can rest.^[17]

Attention turns now once again to the baby, who has been slumbering on his side. He gets another wash in warm water and fresh wine, and then he is swaddled again, this time with his legs free to kick. This is far better, the midwife boasts, than the tight wrapping and binding that prevail in some other countries; few French babies are bandy-legged as a result.^[18] Once he seems to be comfortable, the mother becomes the focus again. She is helped with her toilette and

the bed is prepared so that she can sleep. Luckily there are no signs of unusual lethargy or convulsions, or a doctor would need to be called in.^[19]

Le Boursier will watch the mother closely over the next days, to make sure all is well. As soon as she is strong enough, a trip will be made to church for the baby's baptism. The midwife will make all the necessary arrangements with the curé , or parish priest. She, rather than someone else, must present the baby because her word is trusted to certify its sex. If a domestic were to present the baby, he would need to be undressed and examined for visual verification, and this is considered indecent in church.^[20] The midwife has also lined up a wet nurse (nourrice ). For the first twenty-four hours of his life, while he is getting rid of phlegm, the baby drinks warm wine with sugar, syrup of chicory with rhubarb, or boiled and strained honey water to get his digestion going. At first it had seemed a surgeon might need to be called to open a membrane across the baby's anus, but now the bowels are moving freely.^[21] Tomorrow he will begin to suckle at the breast of his nourrice . May she not roll over and crush him in her sleep!^[22]

Because this mother is of a "delicate complexion" and will not nurse her own baby, a regimen is prescribed to prevent milk fever. Breast milk is believed to be nothing other than menstrual flow that rises in the body, fades in color, and is transformed. The garde , hired to stay with the mother, will bring her bouillon every three hours; it mustn't be made from veal, which causes diarrhea. If she is terribly hungry, she may have a soup of soaked white bread cut thin and small, easy to digest. She should also drink infusions of couch grass, or lukewarm water with a little wine, or syrup of maidenhair fern. In five or six days she will be allowed some poultry in the morning, but not in the evening until she is walking and exercising. The garde must check the mother's chauffoir , a kind of diaper, for blood clots and a flow that is bright red and normal. If it stops or becomes pale, it means too much milk is still going up to the breast. Then a bouillon of chervil will be called for, with arcanum duplicatum or Glauber's salt dissolved in it, and the breasts, kept covered and warm, will need to be treated with an unguent of marsh marigold or olive oil with tow of flax, or honey, to prevent engorgement.^[23]

The new mother is suffering because her parts are somewhat torn. Embarrassed, she reluctantly confesses this to the midwife,

who tells her she must help along the healing by bathing herself in a soothing lotion of milk and herbs. A mixture of water and vinegar and some hot wine alleviate the itching. Her diarrhea can be calmed with an enema of milk, egg yolk, and sugar, changing after a few days to a potion of equisetum and pomegranate peel with an egg yolk twice a day.^[24] The diet of good bouillon must continue, and she can eat some jelly. Because she is still bleeding, cloths soaked in oxycrate, a mix of water and vinegar, are wrapped around her thighs and placed under her back. Some powdered Spanish wax, about a hazelnut's worth, dissolved in six spoonfuls of water, should be swallowed, followed by a second dose. A brew of wild chicory, orange blossoms, syrup of diacode , and capillaire will help too. She must sniff cloth soaked in Queen-of-Hungary water, which will strengthen her heart, as will drinks made from comfrey root and rice, and sap of purslane. And she continues to be bled from her arm.^[25]

Soon the midwife will give some vaginal injections and fit the mother with a pessary made of cork and layers of wax to hold her womb where it belongs. Its ligaments have been loosened by the strains of childbirth, and it might prolapse completely without support. If the pessary gets dislodged, it needs to be dipped in wax again, and again, until the added hardened layers enlarge it sufficiently to stay in place. A hole in the center allows the woman to conceive.^[26]

And so the whole cycle will begin anew.

6—
The Petition:
Paris, 17 May 1745

For many, it is a day like any other in the tumultuous capital, with its unique mix of luxury and filth, of magnificence and obscenity, its changing cacophony of sounds. Heavy spring showers have for weeks now sent rainwater gushing from the roofs of the many-storied buildings, making rivers of mud in the narrow, packed streets below, where people jostle, shove, and splash one another. Enterprising Auvergnats run about with planks to improvise bridges whenever they spot well-dressed pedestrians who might be willing to pay to keep their feet dry. Huge shop signs made of wood or heavy iron depicting the various trades—cobblers, glovemakers, perfumers, butchers—protrude high above the storefronts, creaking omi-

nously in the wind. Midwives' signs usually show a cradle or a child leading a pregnant woman and carrying a candle. Scents of wet stone, ashes, wax, leather, soap, bread, sage, wine, grease, damp straw, fish, rotting apples, feces, and blood from the slaughterhouse near the Châtelet permeate the air. Shrill voices resound—merchants hawking their wares, town criers bellowing out royal edicts—filled in by the background shouts of bargemen floating west on the brown-gold Seine, the din of the blacksmiths' hammers, the clatter of carriage wheels and horses' hooves, and the tintinnabulating bells of a hundred churches. Sturdy women plant themselves on the corners, rain or shine, carrying on their backs large tin canisters of café au lait, which they serve, with little or no sugar, in earthenware cups for two sous.

A habitual sequence of events unfolds in Paris. At 7 A.M. gardeners with empty baskets on decrepit horses return to their little plots having sold their goods wholesale to the market during the dawn hours. At nine wigmakers scurry to coif and powder their clients, while young horsemen followed by their lackeys go for a practice gallop on the boulevards and make fools of themselves falling off. At ten there is a parade of black-robed justices going to the courts with plaintiffs running after them. Noon brings the money men to the Bourse, and solicitors of all stripes to the quartier St. Honoré, where financiers and men of rank have their dwellings. By 2 P.M. the carriages are in great demand as everyone scrambles to find a ride; passengers often come to blows, and police have to intervene. Three ushers in a peaceful spell; few are in the streets, for everyone is eating. Quarter past five, on the other hand, is truly infernal. There are crowds everywhere—on the way to the theater or to the promenades—and the cafés are overflowing. By seven it is calm again, although as night falls criminals come out of hiding and honest citizens must watch their step more carefully. Now carpenters and stonecutters head back to the outskirts of the city, whitening the streets with sawdust and plaster from their feet. As these laborers turn in after a long, hard workday, the marquises and countesses are just rousing themselves to begin their toilette! Nine is noisy. Theaters let out, many make their way to dinner engagements, prostitutes solicit potential clients. By eleven supper is finished, cafés disgorge. At one in the morning six thousand peasants arrive at Les Halles on their exhausted mounts, bringing vegetables, fruits, and flowers from the surrounding countryside. After

these produce deliverers come the fishmongers, then the wholesale egg merchants with their precariously balanced pyramids of baskets. A similar scene takes place on the quai de la Mégisserie, but here instead of salmon and herring there are straw cages full of hares and pigeons. The rest of the city sleeps through most of this. At 4 A.M. only brigands and poets are awake. At six the bread gets delivered from the boulangeries of Gonesse; laborers rise from their straw pallets, gather their tools, and go to their workshops, stopping on the way for café au lait, their breakfast of choice. Libertines stumble out pale and rumpled from the whorehouses, gamblers emerge into the brutal light of day, many hitting themselves in the head and stomach, looking heavenward in desperation. And then everything starts over again.^[1]

Babies, however, are born any hour of the day and night, so Le Boursier is on call around the clock. There are no set rhythms or patterns to her schedule, although its very unpredictability in a sense becomes routine.

For her, though, today is special. She is one of forty midwives who have just signed a petition urging the Faculty of Medicine of the University of Paris to provide them with instruction. Her name appears near top center of the signatures (fig. 3), immediately after those of the four official sworn midwives of the city, jurées whose job—bought and usually passed down within a family—is to oversee the craft, make known infringements, collect fines, and expel offenders. If Le Boursier has not spearheaded this rally among sister practitioners, she was at least one of the first to approve it.^[2] A few of her cosigners demonstrate a fluid, easy hand; many more make quirky scrawls and seem to find writing awkward, as though they rarely have occasion or need to join letters together, and one who cannot write at all marks the document with an X. Le Boursier's manner of signing, though not flamboyant, seems sure and practiced among the clumsy ones. She has been a midwife in the capital for many years and is no stranger to writing her name.^[3]

Organizing for this petition was not easy. Midwives are deliberately kept as subordinate members of the guild of surgeons, "to whose policing they must submit," and have historically been deprived of a separate, recognized voice. There is "absolutely no community among them," gloats the surgeon Louis in the Encyclopédie with obvious relief, reassuring himself and his readers, as if an independent consorority of these women would be a nightmare.^[4]

Figure 3.
A rare look at the handwriting of forty midwives on a protest
petition. One cannot sign, some obviously sign rarely and with difficulty,
some have a fluid, confident signature. Le Boursier (as Mme du Coudray
was known in Paris) puts her name near the top.

Lacking a corporation of their own, they have no meeting house, no built-in avenues for sociability, no established network of communication. They are excluded from academies, ignored by the press, never eulogized after death as are male practitioners. Even annuals like the Almanach royal in these years leave them out of the lists of health officials. So solidarity and camaraderie among them are not fostered, do not come naturally.

There are, however, some old rules that encourage a kind of interdependency. Midwives cannot be approved for their licenses until authorities learn about their lifestyles, so they are sometimes asked questions about their colleagues.^[5] Do they live wholesome lives, eschew profanity, practice discretion? As far back as 1580 statutes and regulations forbade midwives to use any dissolute words

or gestures or to speak ill of each other, unless it was to expose anyone among them who conspired to help women "kill their fruit."^[6] Back then, in the late sixteenth century, Paris had only sixty midwives, and it may have been easier for them to know one another, whether personally or by reputation. But ever since then there has been enormous migration to the capital, and the expanding population has naturally swelled the demand for midwives. These days there are about two hundred of them scattered around and out into the burgeoning faubourgs .^[7] Presumably they see each other monthly at the first-Monday services at the church of St. Côme, although it is not clear how rigorously they attend.

Yet something has occurred recently to pull forty of the most enterprising among them together. Disenfranchised though they may be, they have a shared grievance now, and they have mustered the stoutness of heart to initiate a protest. Since 1733 midwives have been admitted to classes at the school of surgery on the rue des Cordeliers. César Verdier was the demonstrator for anatomy, Sauveur-François Morand for dissections and surgical operations.^[8] Recently, however, these lessons were closed to them, and the women are now turning to medical doctors, the surgeons' age-old rivals, for help. Doctors, with their Latin, their robes and bonnets, and their university schooling, have always fancied themselves greatly superior to surgeons, whose roots lie in the more practical artisanal tradition, so the women request their intervention. Exactly how many midwives have actually been attending these lectures is not known, but the forty who assemble today to complain about their recent exclusion obviously feel debarred from what had become, at least for them, an accustomed right.

Not only are the midwives intellectually deprived; they fear that their very profession is in jeopardy. The petitioners complain that for the past two years the normal testing and reception of aspiring midwives by Paris surgeons has also been suspended. The "dangerous consequences of such a cessation" are now rampant. Many women, finding the credentialing examination at St. Côme unavailable, have simply been setting up shop without it. The city's sworn, official midwives have forced such illegal practitioners to "take down their shingle," but these are put right back up again, the defiant matrons claiming that they have studied and therefore deserve to profit from their vocation, and that it is not their fault if surgeons refuse to test them. These women, though they have broken the rules, at least

boast some training. But others—their names are provided in the petition—upon hearing there are no more formal receptions, have begun to practice without any background experience whatsoever. Expectant mothers seeking help from these unscrupulous characters court, according to the signers, the gravest peril.

The petitioners go on to demand instruction in reproductive anatomy, which will replace the classes now suspended by the surgeons. Understanding the "parts used in generation," far from being "vain curiosity," allows them to serve their clients better than the purely empirical training they have received as apprentices. In particular, they feel unsure about when to call for help; some are too secure, nearly foolhardy, others overanxious and lacking in confidence. The group now formally asks that doctors provide regular demonstrations for them and admit them and their students to all dissections of female corpses.

In response to this pressure the members of the medical faculty, unaware that the situation had gotten so out of control, move very quickly. They promise to prepare and distribute a yearly list of officially approved midwives, which should put an end to the anarchy and help regulate the profession. They assign one professor, Exapère Bertin, to teach bone structure, and another, Jean Astruc, to teach delivery, both for free and in an accessible form—in French, not Latin—in their school amphitheater on rue de la Bûcherie. The classes are to start immediately. They even try to get some cadavers from the hospital administrators, despite the fact that between 1 May and 1 September, because of putrefaction in hot weather, autopsies are not allowed. In an effort to persuade, the doctors boast about their latest facility, a beautiful rotunda with a dome built just last year, magnificent and modern: "Our amphitheater is new and cool. The demonstrator will prepare the [cadaver] parts with spirits of wine and aromatic essences and take all precautions so that his work will cause no foul smells . . . in neighboring houses." Despite this plea, a response to the medical dean from the chief of police denies the request for bodies because of the season; the lecturers continue anyway, doing the best they can using skeletons. Twenty-three lessons are given, to which "the midwives most in demand [les plus employées ]" and their apprentices flock in large numbers.^[9]

Why are the doctors so eager to help out? And why since 1743 have surgeons turned their backs on their teaching and licensing duties? Perhaps because on 23 April of that year the king gave a

great boost to the status and prestige of surgeons, separating them squarely from any demeaning past association with barbers and wig-makers, putting them now on the same lofty footing with doctors, their historic enemies. The year 1743 was the beginning of the personal reign of Louis XV, who was very much under the influence of his first surgeon, La Peyronie.^[10] The chronicler Barbier predicted then that, because the science of doctors was merely conjectural, surgeons with their combined practical experience and book learning would soon be the only experts needed.^[11] Do the newly favored surgeons, imbued suddenly with a fresh sense of importance, simply believe the approval of midwives to be beneath their dignity? Or do they wish to squeeze out female practitioners completely, thus eliminating any competitive and menacing alternative to the male surgeon accoucheurs already fashionable in high social circles?

The midwives suspect the latter. They feel cheated because the "masters of their community" who owe them instruction are withholding it. They soon complain again to the medical faculty, that "the more carefully they watch the conduct of master surgeons toward them the more they are persuaded that they wish to destroy them in the [eyes of the] public even though they are part of the same community." They thank the doctors for responding to their request for instruction with such "clarity and precision." Surgeons have apparently complained that Paris has too many midwives already. The petitioners protest vociferously. There are fewer than two hundred they say, some of whom are far too elderly to practice. New ones take a long time to train, as private apprenticeship lasts three years. And now the Hôtel Dieu, which forms midwives much more quickly in several months of intense clinical training, is distributing most of its graduates outside of the capital into the provinces.^[12] As a result, only six or seven new Parisian midwives present themselves each year, while at least that many retire. "Such a small number in a city as extended and as populated as the city of Paris shows that, far from being overabundant, [the supply] is not even sufficient." The timely reception of new, legitimate midwives must be reinstituted. Surgeons, the petitioners now claim unequivocally, "are trying to deprive midwives, against order and the public good, of the fruits of a profession." The group urges doctors, magistrates, and the lieutenant of police to force surgeons to recognize their error and resume their duties as instructors and examiners.

The doctors seem ready to do anything to embarrass their professional rivals, including the forging of this temporary alliance with the midwives. And the women do not hesitate to exploit the traditional animosity between the two groups of male practitioners, whose polemics have been at fever pitch for the last two years, if it means achieving their aim of better training and regulation. The surgeons, however, despite their scorn for their female underlings, seem unready to relinquish control of them, and vow to put a stop to the doctors' encroachment. The midwives must not fancy that they can go over to the other camp permanently. "You will never escape from our corps , whatever entreaties you make. Alert your companions, because no matter what you try you will only be the dupes."^[13] And indeed, the doctors' lessons soon cease.

Being caught in this crossfire, pawns in this game, is humiliating for the midwives. Surgeons are busy making a display of their new professional and academic status; doctors are busy doing anything and everything to protect their traditional prestige. Both groups are far more concerned with their personal interests and privileges than with helping the midwives. They give hollow, false promises at best. The petitioners seem overworked, insecure, forsaken. That they band together and demand more thorough education shows they possess at least some sense of a shared work identity. But what is driving them is not chiefly female pride. A large part of the grievance here is against female quacks practicing blind, murderous routines. "It is to the mercy or rather the rashness of such women that the life of other women and children is surrendered." These petitioners do not experience—or at least do not express—the indignities they suffer at the hands of surgeons as affronts to their sex, but rather as professional usurpations. Job-related alliances like this petition doubtless offer some consolation, but there is little sense of sisterhood under such circumstances. The issues here are not framed in terms of women defending themselves against men.^[14]

Le Boursier signs the petition beside one Heuzé, with whom she will exchange an apprentice several years from now. Perhaps they are friends who afford each other mutual support. For now, though, they are only two of many midwives whose collective work is not properly appreciated, not receiving adequate recognition. They are lost in the crowd, their reputation suffering because charlatans masquerade as colleagues. To observers commenting on the group, the

superior practitioners are indistinguishable from the others. One doctor, musing on the fact that midwives were once highly esteemed in Greece and Rome, laments: "To see the low opinion of midwives in Paris, one is tempted to say 'past honors are only a dream.' But we must focus on individuals who practice this profession and not on the profession itself. . . . There are many who should be excepted, even singled out with high praise; but we have often seen crime obscure the virtue that walks beside it."^[15] Is the future of Paris midwifery imperiled, even for this enterprising group of petitioners who crave learning in addition to technique? Could Le Boursier already be thinking she must break away if she is ever to shine?

Whatever her thoughts may be at this point in her career, she is making the best of it in Paris. She and Heuzé may even have been designated or have assumed the role of unofficial leaders of Parisian midwives, for their signatures are the first after the pro forma list of jurées , women who have inherited the title but are not necessarily good at rallying the group. That Le Boursier denounces as abusive the threat posed by surgeons and quacks to her livelihood, that she organizes or joins others who regard it also in that light, is perhaps an early indication of her strong sense of self. It is impossible, naturally, to do your best work when such obstacles are thrown in your path. There are things about the Paris scene that are irksome, even mortifying. If the surgeons think she will be cowed by their snub, waiting submissively for the affair to blow over, her activism for the petition shows otherwise. What satisfaction there would be in turning the tables on them some day!

And there is all this new talk, especially at the Hôtel Dieu, about well-trained midwives being so sorely needed in the provinces right now. Might this be when the idea of leaving and setting out on her own first takes root in Le Boursier's mind? Whether it is or not, for a while still she will stay here in Paris, biding her time.

7—
Apprentices and Associates:
Paris, 22 January 1751

Today Le Boursier takes on a new apprentice. It would have made no sense to have one these last six years because all that time the surgeons stayed on strike, refusing to resume their duties.^[1] It finally

took royal intervention to halt the conflict, and only lately have things begun to pick up again, so there is quite a backlog. The petitioners had estimated that six or seven apprentices usually finish each year. Now, to make up for the lost time, twenty-five women sign up to begin three years of training with mistress midwives throughout the city. The ranks must be replenished.

Angélique Marguerite Le Boursier seems still to be unmarried, for the notary who draws up the arrangement, scrupulously thorough about such details, mentions only the marital status of her apprentice. Madeleine Françoise Templier, widow of the baker Fourcy, has for the last four months been apprenticed to Marie Anne Heuzé, but quite recently she moved to rue St. Croix de la Bretonnerie, where Le Boursier lives. She no doubt finds it more convenient to have a near neighbor for a teacher. In any case, she now makes a new contract reflecting the change. Three hundred livres will be paid to Le Boursier for three years of training, during which the midwife will "show and teach [her apprentice] all that her profession involves." The student will live in her own home and dress and eat at her own expense, but she will come to Le Boursier's residence, or accompany her on rounds elsewhere, whenever needed.^[2]

This is a very advantageous contract for Le Boursier. Such a student is an important source of income, and indeed, Heuzé loses no time finding another for herself, just six days later, negotiating similar terms.^[3] These two women drive a hard bargain. Most midwives charge their apprentices considerably less, give them considerably more, and spell out precisely just what the conditions will be. Le Boursier's contract, however, is sketched in abbreviated terms, as if working with a midwife of such distinction and reputation is enough in itself.

Usually, contracts made by Le Boursier's colleagues are elaborate, and mutual obligations intense. One midwife pledges "to show her whole art . . . without hiding or disguising anything, and to alert and call" her student to come with her everywhere. The aspirant, for her part, will "learn with all possible attention the art of delivery, agree to all that can contribute to her instruction, do for mothers and for children all that a midwife should, and generally listen to and practice all" that she is shown, "day or night."^[4] Most midwives promise to "feed, sleep, lodge, warm, and light" their students, even wash their laundry—towels, sheets and clothes—in addition to teaching them, thus taking on a maternal role. Most

students stipulate that they will "enhance the profits" and "prevent the damage" of their teacher, that is, warn and protect her against injury to her reputation. They also swear "never to leave or work elsewhere during the three years" and, in case of flight, to submit to finishing out their obligations after being hunted down by the searchers dispatched to find them.^[5] Some midwives commit themselves to teach about medicines and remedies, bandages, fomentations and fumigations, as well as about childbirth itself. Some students specify that they will follow the midwife faithfully as long as she is trustworthy, "obey her in all she asks that is honest," "reasonable," and "licit."^[6] The reciprocal agreement is for the exchange of ethical attitudes as well as skills. Whereas most preprinted apprenticeship contracts, kept handy by the notaries with blanks to be filled in, talk of learning a "trade" (métier ), midwife contracts are worded differently. They call this line of work an "art."^[7]

Arrangements vary considerably. One woman from Meudon puts her sister into apprenticeship for only three months, because she will practice in the countryside where regulations are quite lax, in some regions nonexistent.^[8] Another provincial, from Champagne, the wife of a master founder, is determined to take the full three-year course. She pays 250 livres for this apprenticeship.^[9] It is curious that she is willing to spend long years away from her hometown, but perhaps she has been urged to do so, even subsidized, by the authorities of her region, who are zealous about securing thoroughly trained practitioners.^[10] Most provincials study for a much shorter time, although such truncated training limits their marketability, obliging them to keep their practice outside the capital forever.^[11]

A few contracts involve family members. Two sisters-in-law have an arrangement in which one instructs the other "without a single sou being exchanged."^[12] But even within families some considerable sums are paid for instruction, with all manner of guarantees and collateral stipulated to make the obligation binding. The wording can be dramatic. The husband of one apprentice pledges "solidly" to pay the necessary fees, or lose all his earthly goods.^[13]

A midwife might agree to teach a next-door neighbor for free, simply taking her around to watch and help during a three-year period. In one such case on the rue des Fossés de Monsieur le Prince, the apprentice is single, the midwife married to a master perfumer.

Perhaps his income is sufficient for his wife not to be preoccupied by gain.^[14] Others may simply enjoy the company and assistance. Usually neighbors do exchange money, 100 livres, 200 livres.^[15] Le Boursier's 300 livres for such an arrangement, however, where no hospitality is offered, no responsibility assumed for the apprentice short of the instruction itself, is very high. She must already consider her teaching of sufficient quality and value to command a superior price without providing any fringe benefits for her pupil. And she is apparently uninterested in having a boarder, companion, or surrogate daughter as do so many of her colleagues. Life can sometimes get rough for apprentices; they can be a burden. One midwife will take an apprentice from the provinces who, when seduced and abandoned by an old doctor promising to help her advance in her career, exposes him and creates a public scandal. Though the apprentice wins a good financial settlement, her reputation is ruined and the whole affair is most unpleasant.^[16] Le Boursier avoids these sorts of entanglements.

Apprentices frequently present themselves alone, of their own volition; others are brought before the notary by husbands, older sisters, or parents who wish to prepare them for a secure profession. One seventeen-year-old orphan is presented by the guardians who have cared for her since age four.^[17] Midwifery continues to be regarded as a valuable, worthy female trade, despite the dire scenario foreseen six years ago by the petitioners, in which they would be irreparably sabotaged by the surgeons. Dancing masters, financial administrators, clerks, cobblers, prisonkeepers, printers, pastry chefs, caterers, locksmiths, and journeymen all willingly pay large sums for women in their family to acquire expertise in the art of delivery.^[18]

One midwife, dame Bresse, requires an all-around helper, a woman to serve as domestic and personal secretary. So her twenty-year-old apprentice pays her no money for the three years of training but agrees in exchange to see to the "needs" and "personal affairs" of her teacher, to be generally "at her service."^[19] Quite a number of midwives have responsibilities managing the household accounts and so seek clerical help.^[20] One brings to her marriage a dowry of several thousand livres.^[21] Another has been part owner of some property in Fontenay.^[22] Another brings only 500 livres but marries a man with nearly 10,000 and many investments.^[23] One midwife, widowed after twenty-eight years of marriage and the mother of seven

children, decides to apprise her eldest son, a soldier, of their estate. The current value of everything after the ebb and flow of life for nearly three decades—itemized down to the gold buttons on some sleeves—is now 4,213 livres, 2 sous, 3 deniers. When all is said and done, each of the seven children will get a rather paltry inheritance, but it must be accurately calculated nonetheless.^[24] Severe economic reversals can occur quite suddenly with widowhood. One midwife whose surgeon-husband dies abruptly needs to sell all her belongings to pay three months' back rent for the apartment she sublets. The inventory of this sale shows she occupies several rooms cluttered, indeed overflowing, with possessions—numerous feather beds, straw mattresses, cots, serge curtains, wall hangings, and armoires.^[25] Almost surely the many furnishings and tapestries have been used in the private partitions described by Mercier. What will she do, even with her back rent paid, in this suddenly empty apartment, once the scene of much activity, the temporary refuge of numerous pregnant clients over the years, now stripped and bare?

Le Boursier's colleagues are scattered all over the city, although some very populous quarters seem to have more midwives than others. According to records from the 1770s (no lists for earlier periods have been found), several of the Right Bank neighborhoods, teeming with inhabitants, have as many as twenty-three, sometimes even a few clustered on the same street. Le Boursier's quarter, St. Avoie, near the graceful recreational boulevards and full of grand homes and gardens, has only two.^[26] Has she expressly chosen to be a big fish in a smaller pool? Does this put her in greater demand and ensure her a healthy, wealthy practice and singular reputation even before she enters public service? Or is it that her presence discourages others with lesser reputations from establishing themselves there? The Marais, where she lives, once an aristocratic bastion, still has many nobles, magistrates, and others of distinction. Rue St. Croix de la Bretonnerie, her street, is itself the home of several provincial intendants, royal ministers, and bankers.^[27] It is quite likely that Le Boursier has gotten to know during these years some prominent and powerful neighbors, whose financial support and political assistance will soon become important to her.

She also frequents and befriends colleagues in the medical field. She has been acquainted with the surgeons Morand and Verdier since their lectures at the anatomy courses for midwives at St. Côme.

Old-timers who have been practicing since 1724, they were probably on her jury when she completed her apprenticeship and took her qualifying examination. They seem not to hold a grudge from the petition days of accusation and recrimination, and will facilitate things for Le Boursier later on. Morand will do this in his capacity as royal censor. He seems to take particular interest in sponsoring talented women, and has given special encouragement also to a Mademoiselle Bihéron, who fashions precise anatomical models out of a secret lifelike wax substance. A former midwife who now devotes herself entirely to this "artificial anatomy," she holds weekly visiting hours in her home cabinet , where these pieces are on exhibit, so realistic, it is said, that only the smell is missing. She is presently preparing a collection of models commissioned by Catherine of Russia to be sent to hospitals and displayed in the museums of St. Petersburg, and Morand is lending her his patronage. Le Boursier, typically, never mentions Bihéron, but these wax models of pregnant women might well have been the inspiration for her own later mannequin made of cloth. Verdier, a peerless lecturer and close friend of Morand, will later pen some obstetrical "observations" to be published alongside Le Boursier's textbook.^[28] She is also acquainted with the Sües, a veritable dynasty of influential medical men, three of whom, a father, a son, and a first cousin, will come to the midwife's aid in a variety of ways.

But Le Boursier's most important contact from the Paris years is the maverick lithotomist Jean Baseilhac, known internationally by his nickname Frère Côme, for this celebrated surgeon is a monk. He is a fascinating character in his own right, as his swashbuckling portrait seems to bear out (fig. 4); a native of Tarbes in the south of France, he has recently discovered and perfected new techniques for cutting out stones, and for curing cataracts. Special instruments of his own devising are made for him by a favorite cutler on the rue Galande, and he tries them out on patients at the Hôpital de la Charité. He also experiments on corpses. Though a great humanitarian, so intense is he in his research, so enthusiastic about his findings, that he is said to have lamented the recovery of a person whose cadaver he was particularly curious to dissect! An expansive and generous man, he is devoted to healing the poor, for whom he has set up a number of free medical clinics, but constantly sought out by the rich and famous, especially many in the king's immediate

Figure 4.
Frère Côme, the famous medical monk, assisted Mme du
Coudray and managed her mission in various ways behind the scenes.
Photograph courtesy of the Académie Nationale de Médecine, Paris.

entourage. In the mid-1740s his virtuosity came to the attention of the king's first surgeon, La Peyronie, and ever since he has been a darling at Versailles. Superior orders forced the Paris surgical community to accept him into their fold, but his unorthodox methods and the favoritism shown him at court have made most of the members of the Academy of Surgery too resentful to welcome him.

He has a deep, genuine commitment to the destitute, an enormous talent, a colorful personality, and an entirely unique and very powerful position in the medical landscape, won by skill, of course, but also furthered by people in high places. Le Boursier will develop along these same lines, and perhaps he foresees this potential in the gifted, ambitious midwife. He probably teaches her how to exploit good connections, how to use letter writing to her own ends, how to generate a network of supporters and gather their written testimonials, how to create and enjoy special idiosyncratic freedoms. He has perfected and used these methods for years, and she is much influenced by his example. He will later claim to have groomed her for her great task.^[29]

In any case, Frère Côme is to become her principal fan and impresario. His unflagging support for her, which will last until his death in 1781, is a mixed blessing. That she has a strong, influential man working behind the scenes to sustain her during three decades is not bad. That he is a flamboyant personality who gets distracted by his own exciting projects and makes as many enemies as friends is not good. The famous Rouen surgeon Le Cat, for example, hates Frère Côme and calls him Frère Coupe-Chou because he lacks the usual university credentials and behaves in such an earthy manner. Another medical colleague, the eye specialist Daviel, who peddles a rival cataract procedure, refers to his own method as Davielique and to Frère Côme's as Comique in an unsuccessful attempt to reduce the monk to a laughing stock. There are also far more insidious attacks on his reputation, and even physical assaults on some of his disciples. He survives all this, his energy undiminished, and remains steadfastly loyal to the midwife, raving about her wherever he goes. And he travels widely. He does enough for Le Boursier's reputation through his solicitations that doctors and surgeons both at court and far beyond know well who she is and marvel at her abilities.^[30]

Frère Côme realizes as well as anyone the desperate need for good midwives in the provinces. An enquête back in 1729 revealed the woeful state of rural delivery practices, one panicky priest near Laon estimating that more than 200,000 country babies were dying each year.^[31] The monarchy responded, and since 1735 the Hôtel Dieu has been training provincial midwives almost exclusively.^[32] This hospital's maternity ward, an alternative route for apprentices who have

neither the time nor the money to study privately with the likes of Le Boursier and her mistress colleagues, used to train women from all over Europe—Sardinia, Denmark, Spain—and of course Parisians, but they are now being turned away in favor of those from the French countryside. This training is of the highest quality. It is an exhausting, intensive, round-the-clock three-month session, presided over by one midwife who devotes herself entirely to this responsibility, living like a nun, dressing modestly, eating with her apprentices—no meat—spending all her nights at the hospital, accepting no tips for deliveries and baptisms, receiving no guests in her room, earning a mere 400 livres a year. The teacher committed to this "assiduous and sedentary" engagement demands that same kind of devotion from her apprentices, of whom she takes only four at a time.^[33] These students get extraordinary clinical practice: each year 1,400 to 1,600 women give birth at the Hôtel Dieu, and some nights as many as a dozen deliveries take place.^[34] Not only is this education superb and efficient, but it is also a bargain. It costs only 180 livres, and includes the fee for the qualifying examination and certification when the three-month session ends. City apprentices, by contrast, in addition to their lessons, which can cost several hundred livres, must bear the further expense of the grueling qualifying exam.^[35] Le Boursier and her Paris colleagues endured the private apprenticeship, but provincial women opt, understandably, for the cheaper, shorter training at the Hôtel Dieu.

There is a problem, however. Even the three-month session in Paris is stressful for many who do not want to be away from home so long. Although provincial wigmakers, valets, coachmen, sculptors, shoemakers, notaries, surgeons, masons, millers, sheriff's officers, and wine merchants from all over France respond to the Hôtel Dieu recruitment program and hasten to sign up their wives, the women themselves are often reluctant. They comply at first with their husbands' bidding but, once inscribed, prove to be unready for the commitment. It is too rigorous and fatiguing. The registers of the hospital's maternity ward make note of these ambivalent pupils: "paid but has not shown up to enroll"; "paid and we have accepted her but she no longer wishes to come"; "paid—we have searched for her—nobody knows where she is"; "does not wish to learn, does not want to come." Some women try to get refunds of their deposit after changing their mind.^[36] Obviously this system of

enlistment is not really working. There is more and more talk in high circles of better, alternative ways to train midwives for the provinces. Recently a few regions have employed an experienced Parisian woman to come teach the locals, but the fledgling efforts have been sporadic and there are very few trainees.

Soon a wealthy philanthropic seigneur from Auvergne comes to Paris looking for someone to instruct the peasant women on his estates in the art of childbirth. He may be considering sending one or two of them to study at the Hôtel Dieu, for he feels the situation is urgent. He and his wife make inquiries. Frère Côme seems to know that Le Boursier is restless, that she would gladly reassign her new apprentice to someone else and break free, that she is just waiting for an opening. The quickening pace of intrusion by surgeons into the professional space of midwives has displeased her for some time, but there is apparently more. She wants to leave now . Maybe some private drama has taken place in her life, to which Frère Côme is privy, though we cannot be because all correspondence between him and the midwife is lost. In any case, the monk dissuades the seigneur from looking any further. Once the man hears of Le Boursier in such glowing terms, he will stop at nothing to lure her south to his terres .^[37]

Teaching in Auvergne:
The Depopulation Issue

8—
Break to the Provinces:
Thiers-en-Auvergne, 1 October 1751

So eager to make her breakaway, the midwife has left precipitously, arriving in Thiers far ahead of schedule. Nothing is ready. She will have to be put up at the inn for a few days while her residence is prepared.^[1] What has made Le Boursier quit Paris in such a hurry, has made her rush to accept this call? Some sudden trauma? A need, building slowly but abruptly felt, to escape from the relentless ritual of city birthing? The wish to test herself? One can cut oneself adrift, take refuge in a journey. It is evidently not hard for her to leave things behind when she has been singled out and summoned for a purpose out of the ordinary. She seems to have lost interest in what is within easy reach; it is as if she has been waiting to spring loose, to be given a challenge, a change, a chance. Indeed, she craves adventure, if her early appearance here is any indication.

The voyage from Paris has taken her along a route that follows the great river valleys, where it can, but that passes through the forests of Fontainebleau and Montargis with their assorted dangers, and bumps along elsewhere over brush-covered, scrubby bogs and rocky hills with an occasional dappled goat. A contemporary guidebook of France classifies only the last part of the trip, south of Moulins, as offering "good roads." This has no doubt been a long, hard journey, the carriage creaking and lurching on these broken routes, but the autumn climate is bracing and the destination lovely and we hear no complaints. Thiers, full of steps and narrow zigzag streets, is situated on a jog of the rollicking Durolle River, which laps at its walls. It is a densely populated commercial center where boats come and go, cleaving the water beside the paper mills and the tilt-hammers where knife blades are forged.^[2]

Le Boursier's apprentice back in Paris, having given her teacher 200 livres already, was supposed to pay the balance of her fee, another 100 livres, at Easter of next year, but the midwife has collected it instead on 17 September,^[3] and with this early payment has embarked on her travels. She seems to have dutifully made some private arrangement with another midwife to continue teaching the apprentice, perhaps for free; her student does finish her contracted training on schedule and does become a full-fledged Parisian sage-femme in 1753.^[4] Meanwhile, Le Boursier turns her back on the capital without apparent remorse, and although she will make numerous trips to this center of power and influence, it will never again be her home. She has walked away from one life to begin another. She has broken free.

Auvergne's intendant, La Michodière, is especially progressive and has for some time been concerned about the perceived depopulation crisis. He is therefore keen to provide his region with good obstetrical care, even corresponding with Voltaire on the matter.^[5] As early as 1746 he recruited a Paris midwife, a Madame Berne trained at the Hôtel Dieu, who settled in Riom just north of Clermont, was paid a salary of 500 livres, worked hard, and sang Italian cantatas. The husband of this "gracious lady," however, could not find a satisfactory job, so in short order the family returned to the capital. Next came a Madame Bailly; she lasted five years at her job, but grew to feel she was inadequately recompensed to sustain her ever-growing family, and left at her husband's urging. At the moment of Le Boursier's arrival in Thiers, in nearby Brioude a male surgeon is doing all the deliveries because of the difficulties in keeping Paris-trained midwives in that town. The last one, discouraged, had returned home to her husband, "to the bosom of her family where she could find comfort."^[6] For these reasons the Auvergne authorities might be pleased to find that the newest Parisian midwife in their midst is unattached, that she has no husband pulling her away.

Right now Le Boursier is here on a private arrangement. Although the intendant knows of her, she has been invited to Thiers by the local seigneur and philanthropist, Monsieur de Thiers himself. He is vacationing in Tignes, but has alerted his men to her coming. Le Boursier's premature arrival, however, has thrown everything off balance. A Monsieur Merville, judge and journalist in the town, is

trying desperately to smooth the path for her. Almost immediately a conspiracy of surgeons and local matrons forms and vows to undermine the efforts of the new recruit, to treat her as if she came unbidden, to turn the townswomen against her and ensure her ostracism. They experience her presence among them as an invasion, a violation. Merville laments a few days later that already a mother and child have died unnecessarily for stubbornly refusing her services. The new midwife "feels all this, although she doesn't know the extent of it," explains Merville, who believes she will be entirely justified if she, too, chooses to leave the region.

Le Boursier, meanwhile, is watching, listening, taking everything in and learning a great deal. This encounter with blatant hostility is a new experience for her. She handles herself with dignity and restraint, telling Merville that despite all this she is glad to be away from the hustle and bustle of Paris. He, unable to contain his distress, pleads with regional authorities to help him muster support for this "poor outsider, whose merit, spirit of charity, and sound judgment are infinitely touching." Merville works himself into a fury trying to sell the virtues of this highly trained Parisian midwife to his "ignorant" and "undeserving" townsfolk. He contacts the intendant himself, apologizing for the futility of his efforts, and goes on dramatically to despair for the whole unenlightened nation. France is "ungrateful. . . . I thought I knew her. I was wrong, and I swear, she is worse than I dared believe."^[7]

If an onlooker is this upset, what is Le Boursier herself thinking? Calm and seemingly unperturbed, she is nonetheless not at all sure she can overcome the obstacles in Thiers. Or that she wants to. But she needs no pity. Shrewdly assessing her chances, she is already sending her papers and recommendations ahead to the much bigger city of Clermont, where the principal mistress midwife has just died. It is a coveted post, and she perseveres. She offers to submit to any new examinations the Clermont surgeons care to give her if her Paris credentials are for any reason insufficient or unacceptable. She volunteers to teach four apprentices.^[8] Le Boursier is, instinctively, designing a strategy that will serve her well. Unfailingly gracious to those, like Merville and de Thiers, who appreciate her, she tries not to be discouraged by the others. Far from making anyone regret that some of their efforts on her behalf fail, she commiserates with them about how difficult it is to change habits, to break from old, familiar ways, to overcome inertia. All the while, though,

this energetic woman is doing what she must on the practical front for herself, so that her talents will not go to waste in some obscure backwater of Auvergne. She has not left Paris to molder and fade into oblivion here. A strong sense of self-preservation propels her forward. If supporters, however obliging, are too few or timorous or ineffectual, she will go elsewhere, press on, not squander time reproaching them. She is cut out for nobler ventures. Let other midwives summoned to the provinces retreat to Paris, licking their wounds, seeking tranquillity. No amount of possible peril will deter her; for her there will be no turning back.

Why would she want to go back anyway? The atmosphere in the capital grows increasingly unwelcoming to midwives. The much-anticipated first volume of the Encyclopédie has appeared, and it is the talk of the town. Its article "Accoucheuse" is nothing short of defamatory, quoting the philosopher La Mettrie as saying, "It would be better for women . . . if there were no midwives. I advise . . . to repress these reckless accoucheuses ." The author of the article, a doctor named Pierre Tarin, claims to have gone out of curiosity to watch a sage-femme do a delivery. "I saw there examples of inhumanity," he reports, "that would be almost unbelievable among barbarians. . . . I therefore invite those in charge of watching over disorders in society to keep an eye on this one." The preceding article, "Accoucheur," sums up the prevailing view: "A surgeon delivers better than a midwife." The article "Accouchement," all about childbirth itself, does not even mention midwives at all, and has only men presiding.^[9] Demoralizing to be sure for Le Boursier's former colleagues. She is less inclined than ever to look back with nostalgia. Her aim is to move ahead.

Soon she receives a license from the community of master surgeons in Clermont and moves on to that city.^[10] She will remain there for the next decade, fashioning and slowly implementing a brave and mighty plan.

9—
"The Stories They Told Me":
Clermont, 9 May 1755

Today at the St. Pierre parish church is the baptism of "Marguerite Guillaumanche, legitimate daughter of François and Aimable Parcou his wife, inhabitants of Talende, born the 4th of this month in

our parish and presented by Helène Desson, midwife, godfather Jean Crouseix, godmother Marguerite Crouseix, inhabitants of this city, who did not sign."^[1] Talende is a little town about twenty kilometers due south of Clermont. The parents of this baby were visiting the big city when she was born, but had they come expressly to give birth here or were they taken by surprise? The little girl may well have been premature, for five days have elapsed between birth and baptism, suggesting that the baby was too weak or sickly to be taken to the church until now. The parents, godparents, and midwife are evidently all illiterate, for they cannot put their signatures to the baptismal act.

Le Boursier is nowhere in the picture, evidently not involved in this birth in any way, neither as family member, nor as godparent, nor as presiding midwife, although she has been living, teaching, and practicing in Clermont for four years already. Her surnames bear no resemblance to those of the principals here. She might not even be aware of this event when it occurs. Yet this newborn girl, by some quirk of fate, will become her "niece," will be raised by her, taught by her, and declared her sole heir. Orphaned early, Marguerite Guillaumanche will become the itinerant midwife's only known "family," in one of several acts of self-styling by which, it seems, the midwife finds or invents for herself what life itself has not provided.

But while she appears right now to have no connection with this particular peasant family, Le Boursier has gotten to know many others just like them. Living and teaching in Clermont these past years has gradually transformed her. Ladies of the local nobility place their confidence in her, as did her elite clients in the capital, but there is something different now. She finds herself increasingly drawn to the indigent women of the countryside and moved deeply by their stories. They have become the real focus of her attention.

Auvergne is a rough, isolated part of France where winters are harsh, the snow blanketing the volcanic massifs and reluctant soil during many months of the year. Summers are heavy and hot, cultivation and plowing thankless, poverty rife. The rural women from the surrounding villages whom the midwife befriends have been toughened by the realities of life in huge, hungry families so poor that husbands go out on the road for up to nine months out of

twelve seeking work as seasonal migrants. These traveling Auvergnats rarely make enough to send or bring home more than a few pocketfuls of seed, but at least they "eat away from home" and so do not need to be reckoned in for food.^[2] When they return, the pregnancies that result are often unwelcome; every new mouth to feed is something of a calamity.

Worse yet, birthing leaves many of these women permanently impaired, or so the midwife reports. They complain to her of constant disabling pain, uterine prolapse, private parts hideously mangled by village practitioners who don't know what they are doing. Not only that, but many of their babies, if they survive at all, suffer injuries that last a lifetime, a fate worse even than death. Misshapen heads squeezed, then clumsily remolded by some desperate matron (the number of village idiots is very high); useless shrunken limbs; broken backs; eyes rendered sightless by a jagged dirty nail during delivery—such tales, told repeatedly, touch the midwife's soul.^[3] Since coming here she has encountered for the first time the climate of terror and dread that hangs over childbirth in the countryside, the constant menace of pain and death.

How does she hear and understand the stories? These rustic matriarchs have qualities that quickly win her respect, though with their rough ways and crude talk they could as easily arouse aversion as liking. The more shocking she finds their revelations, the more frightful and strange their experiences sound, the more determined she is to help. In Paris she had been safely insulated from all this, had never been exposed to the blood, gore, and butchery these women report, or to their world of supernatural signs and symbols, powers and threats. She interviews them tirelessly. But then an interesting process takes place as she transforms their tales into terms she can comprehend, filters out much of their color and drama in an effort to gain some control. Their narratives of ghosts, spirits, all manner of unseen forces and dangers, are recast by her into rational medical language. The result of this superimposition, of her reductive laundering of their magical popular stories, is the depiction of childbirth as a mechanical problem to be solved.^[4] That is what she offers to these women, who are both patients and pupils. She heals them and gives them free advice and free lessons. Then she begins to formulate, especially for them, a new pedagogy, a special teaching aid to relieve their suffering.

The Parlement of Paris has just this year ruled that midwives are not authorized to use obstetrical forceps. The encroaching surgeons rave about this innovative technology as a new conquering tool that can and will change the medical landscape and make midwives obsolete. Watching her female colleagues belittled and diminished in this way gives Le Boursier pause, then resolve. She would pioneer as a special kind of teacher, so as not to be bound by such rules and constraints. Inspired by this contemplated freedom, she begins to reconfigure her own sphere of competence. This is yet another opportunity for her ingenuity, and she takes full advantage of it. She will create a device of her own, one that women can use and that will help them immeasurably: not an instrument for extracting babies like the forceps, but one that will make forceps unnecessary. It is her way of fighting back, staking a claim, securing a piece of the action. There will be something in it for her women, and there will be something in it for her.

10—
The "Machine":
Paris, 13 May 1756

After learning in the capital the art that I profess, and having practiced for sixteen years, destiny led me to the provinces. To earn the marks of esteem shown me by those who called me there, I announced that I would gladly give my advice to poor women who needed it. I cannot say the number who opened up to me about their sad situation, most of whom were afflicted with a loosening of the womb. I made them go into detail about their deliveries, and by the accounts they gave me I could not doubt that they attributed their infirmities to the ignorance of the women to whom they had recourse, or to that of some inexperienced village surgeons. My zeal therefore determined me to offer to give free lessons to these women. I made this proposition to the subdelegate, who, charmed to procure such a great benefit, accepted my offer. The only obstacle I found to my project was the difficulty of making myself understood by minds unaccustomed to grasping things except through the senses. I took the tack of making my lessons palpable by having them maneuver in front of me on a machine I constructed for this purpose, and which represented the pelvis of a woman, the womb, its opening, its ligaments, the conduit called the vagina, the bladder and rectum intestine . I added a model of a child of natural size, whose joints I made flexible enough to be able to put it in different positions; a placenta with its membranes and the demonstration of waters that they contain; the umbil-

ical cord composed of its two arteries and of the vein, leaving one half withered up, the other inflated, to imitate somewhat the cord of a dead child and that of a live child in which one feels the beating of the vessels that compose it.

I added the model of the head of a child separated from the trunk, in which the cranial bones are caved in on each other. I thought that with a demonstration this tangible, if I could not make these women very skilled, I would at least make them feel the necessity of asking for help soon enough to save the mother and child, help that cities do not lack, but that would be very necessary in the countryside, where the skill of a surgeon called too late is often useless, and he can only be the spectator of two expiring victims for whom his art and his zeal are by then fruitless. Thus my project was to have these women recognize the diverse dangers to which their incapacity exposes the mother and child.^[1]

Large groups. Collective teaching. Students whose mental universe is quite distant. Here is the new challenge, very different from training a single apprentice whom you know well. So a palpable, concrete technique must be designed, one that features hands-on experience and practice, not theory and principles. Dealing with this new audience of rustics whose thoughts and worries are so alien, the midwife realizes that "it is to their eyes and their hands that [I] needed to speak."^[2]

This, then, is the origin of the midwife's famous anatomical model, her upholstered "machine" with its womb and extractable baby doll (fig. 5). Upon this mannequin her students can practice, practice, and practice. The skin and soft organs are made of flesh-colored linen and pliant leather—some parts are redder and some paler—stuffed with padding, and the pelvic basin and various bones are at this point made of real skeletons, although later wood and wicker frames will be used. The different parts of the machine are numbered, and an accompanying table identifies all the anatomical names. Besides the main mannequin, as the midwife explains, there are many detached pieces, exhibits that allow a closer look at, for example, "the membranes showing the void filled with water in the middle of which the child swims."^[3] The model is meant mostly for maneuvers that, as others confirm, allow her students to gain confidence, be "encouraged, and succeed perfectly."^[4] Delivering babies from every conceivable position and presentation will prepare her students for all eventualities. But other auxiliary exhibits are meant also to warn and alarm, hence the flattened, shriveled umbilical

Figure 5.
The only known extant example of Mme du Coudray's obstetrical
"machine," made of wicker, fabric, leather, stuffing, and sponges. She
produced hundreds of these, but the others must have disintegrated with
use. This one is preserved in the Musée Flaubert, Rouen.

cord of a lifeless baby and the severed head with crushed cranium. This machine, as the midwife's followers will continue to testify, makes an "impression that can never be erased," "an advantage all the more essential because this class of surgeons and these women [of the countryside] do not have the resource of reading . . . [so] these daily continual maneuvers . . . [must be] vividly impressed on their senses."^[5]

Today in Paris two distinguished surgeons, the midwife's old acquaintance Verdier and his colleague André Levret, "named by the Royal Academy of Surgery to examine a machine invented by la Dame du Coudray, Maîtresse Sage-Femme licensed in Paris, established in Clermont in Auvergne, to demonstrate the practice of delivery," approve it in a "very advantageous report."^[6] She journeyed to the capital in April to show it to La Martinière, La Peyronie's successor as the king's first surgeon, whom she no doubt knows from her last years practicing in Paris, and he suggested she show it to the academy. It is an age when such innovations are recognized and prized; they sometimes even reap financial rewards in the form of royal pensions, and she has been led to believe she might be entitled to one of these. Officials in Auvergne tell Versailles about the good works she has done in their region which make her deserving of recompense, stressing especially her "spirit of charity that leads her to seek out the poor."^[7]

But what is happening to this "spirit of charity"? The midwife has been motivated, she explains, to develop this device out of pitié .^[8] This sentiment, however, is not simply sympathy or compassion. It is, as the books of the day and the Encyclopédie explain, a generous natural feeling brought out in the relatively prosperous by the sight of those who suffer or live in misery.^[9] There is, in other words, a latent condescension embedded in the concept. Somehow, the midwife's genuine calling to help these country women has reinforced her sense of superiority. The city-trained, modernizing midwife responds to the flocks of women who divulge to her their secret distress, and she gains their trust. But she then imposes on them a sophisticated diagnosis. As she sees it, ignorance is the culprit, and she with her mechanistic explanations of anatomy will serve as a vector of science, of progress. She seems increasingly shaped by the spirit if not the letter of the Encyclopédie , five volumes of which have now appeared. This influential work, so scathingly critical of midwifery as "superstitiously" practiced, may be inspiring her to create

a very new and different image of her trade, one that is not folkloric but simple and free of danger, not secretive but transparent, not haphazard but professional. To promote her craft and win over its critics, she is reframing it using their conventions and language. She is always evolving new strategies.

That she refers to her obstetrical mannequin as a "machine" is telling. This is not an idiom that would naturally occur to her students, "mes femmes," as she calls them. They do not have, until they work with her, a mechanical view of birthing. The midwife is speaking here the language of enlightenment and reform, one well understood by the men she seeks to impress, but altogether foreign to her female pupils. Although she is grateful to the women for opening her eyes to a problem, for giving her a raison d'être, her own motives and agenda are shifting. Requesting unabashedly the reward she believes is her due for this invention, voyaging to Paris to defend her interests and make known her own new technology, the midwife puts a new spin on things. Her original altruistic devotion and a newer entrepreneurial zeal are conflating now. Thus far in her career her allegiance has been to the women, the mothers who seek her help and expertise, share confidences, bond with her. That was true in Paris, and has continued in her Clermont practice so far.

But with the introduction of the machine, by which she hopes to profit, some separating has necessarily begun. She is working on a different plane here, generalizing about bodies in the most impersonal terms. Since Descartes, writers in France have assumed that lack of freedom is inherent in all mechanical devices. He equated the animal body with an automaton, but to explain human free will he depended on his theory of the soul.^[10] Where, then, is the soul in the midwife's mechanical teaching? What kind of message is communicated by the objectified pelvis she now deploys on such a grand scale? The animate individual, the person in the patient, the organic whole could start to fade from view if she is not careful. Does she realize any of this as, armed with the male establishment's official approval of her machine, she heads back to Auvergne?

11—
Early Lessons:
Clermont, July 1757

The midwife's lessons, developed in Auvergne over the last many years, are assuming an order and form that she will preserve, with

only minor variations, throughout the decades of her teaching career, because she is finding that this method works. She reaches her students, makes herself understood, builds their confidence, and believes that by the end of her course she has imparted to them knowledge and techniques of real value. Her lofty self-assessment is shared by the subdelegate, who has eagerly accepted her offer to teach for free and is, as she puts it, "charmed to procure such a great good." There are about forty lessons. Each takes a day, so with weekends off the course lasts approximately two months.^[1]

She begins, always, with a discussion of the qualities necessary in those women who mean to practice the art of delivery. Christianity is familiar terrain for her rustic students; she therefore starts out sounding more like their parish priest than the worldly Parisian expert that she is. There is a back-and-forth, give-and-take rhythm comfortably reminiscent of a catechism. Speaking in the inclusive nous , she talks as one of them, a member of their group, joined with them in a career of devotion and service. This immediate identification, this bonding in a common cause, at once relaxes them and makes them proud. "Penetrated by our Religion . . . we must do good works . . . care for the poor women who need our help . . . satisfy the commandment of loving God in his members."^[2] The destitute, who fill the countryside, should never be abandoned for wealthier clients, should never be made to pay, should never be treated with bad grace or coldness. They must know that charity will keep their midwife by their side however long the labor might take. "Let us calm their fears, sympathize with their situation; it is the only way to console them. Let us endure a thousand inconveniences and all the disgust we encounter in their thatched huts; the recompense that God grants should give us the force and the courage to withstand all of it."^[3]

These words might shock and even insult many of her students, who are themselves from humble hovels, but they have distinguished themselves by coming forth to complain about traditional rural delivery practices, by opening up to her, so the midwife has already elevated them into a select group deserving of her help. Yet that does not spare them further admonition. On the contrary, it allows her to be particularly hard on them, to speak plainly, and to spell out very firmly the high standards of conduct to which they will now be held. She warns once more against being seduced by the rich or rushing a birth for which there will be no payment just

to get it over with. These, she says, are "hideous crimes," for negligence and haste often kill both mother and child. "Do we not know that these two victims were dear in the eyes of God, useful to their family, necessary to the State? They were a deposit entrusted to us. Can we, in sacrificing them to vile interest, not tremble at the exact reckoning we will need to give one day to [the creator] who gave them being?"^[4] Another "crime" matrons sometimes commit ("that they try vainly to justify with virtuous-sounding sophisms") is refusing aid to a girl who gets pregnant out of wedlock. "We abandon her, and reduce her to despair; we force her, deprived of confidence and consolation, to kill an innocent whose mother's crime does not render unworthy of our attention." But it is not their place to be judgmental. Such self-righteousness, which would "leave nothing to divine vengeance," is unacceptable among midwives, who must instead "scorn prejudices so contrary to religion and humanity" and help these unfortunate girls and their illegitimate babies as much as possible.^[5] The teacher will not tolerate intolerance. Even the misbegotten are precious.

God is featured rather centrally in this opening discussion, but the midwife sees her task as a secular one, and the tone of the lessons becomes now less pious and more practical. She moves on to the next pressing issue. "It should not be necessary to advise women never to become overly fond of wine, but midwives must be even more careful about this than others, as they can be called at all hours and must have a clear head so as not to expose the mother or the child to any danger."^[6]Bonnes moeurs^[*] (high morals) are essential to win and to deserve the confidence of those who will need their services. With sober seriousness would-be midwives must undertake the conscientious learning of "things essential for the profession": the parts of the human body—at least those involved in delivery—and knowledge of the practice of the art. Such learning can be acquired four ways: by the thoughtful reading of good books containing all the precepts; by watching able people practice; by practicing oneself; and finally, by attending, as often as possible, anatomical dissections.^[7] Here the teacher betrays her distance from these unlettered students, most of whom will never realistically have the opportunity to do either the first or last recommended step; she means, however, to impress them with the gravity of their chosen course. If they cannot read, or study anatomy in city classes, they are at a disadvantage and must be aware of their inadequacies and limita-

tions. Nevertheless, she adds encouragingly, with the benefit of her lessons they can progress enormously, and be of great service.

This introduction to professional ethics behind her, the teacher now turns to the body itself. Here she alters her voice and tone; she is lecturing to them as an expert to novices. The next lessons concern basic anatomy, for which she uses large posters with pictures. One day is devoted to the womb, its muscular, membranous makeup and its situation in the pelvis between the bladder and the large intestine (this she also gives the common name, gros-boyau , by which her students know it). All the bones are named and discussed—some of them spread apart a bit during birth, some do not—as are ligaments and the endpoints to which they attach.^[8] The womb must be demystified, understood, respected, treated gently; it is an anatomical organ, not a curse. Ignorant village matrons call it the "mother" and see it as the root of all evil, but that, says the teacher, is nonsense. Next the fleshy vagina is described, its length measured in thumbs. Students learn about the intact hymen and what it looks like after rupture. The lips, the clitoris, the fourchette (the area between the vagina and anus), and the perineum become familiar terms, as do the fallopian tubes and ovaries.^[9]

There follows a brief and difficult lesson on theories of generation, in which the teacher introduces several technical terms and puts forth her view that the whole baby is preformed in miniature in the mother's egg and that with fertilization it begins to grow to a size and strength at which it can be born.^[10] Although the midwife does not dwell on this notion because it has little practical import, she has, however unobtrusively, introduced an idea of considerable ideological significance. By placing herself squarely in the ovist camp, she has taken sides in a controversy over generation that is currently raging. The more popular position among her male contemporaries is the spermatist or animalculist view, which gives all the credit for reproduction to the male sperm swimming about in semen, discovered in the 1600s by Leeuwenhoek with the aid of his microscope. Misogynists tend to think of women as nothing more than a receptacle, whereas the midwife's ovist position, by privileging the egg, casts women as the life-producing force. We should not make too much of this, because she doesn't, but it is worth noting that her statement here is unequivocal and that if her students reflect upon this matter at all, they could feel a certain pride.

Discussion of the fetus, placenta, and umbilical cord come next,

of circulation through arteries and veins, of systole and diastole, of amniotic membranes, of animal spirit in the nerves. All of this information on anatomical structure and physiological function is completely new to these students.^[11] How to distinguish real from false pregnancy is the next lesson, followed by a very important one on the technique called "touching," "the touch," or palpation, with hands and fingers under the sheets, by which an aspiring midwife must learn to do most of her vaginal exploration and diagnosis. Indeed, a good midwife should be able to do an entire examination and birth blindfolded.^[12] The need to bleed the pregnant woman is the next subject. Here the teacher goes along with the view, popular in obstetrics since the Renaissance, that bloodletting from the leg, arm, and neck at regular intervals is salubrious, relieving an excess of this humor.^[13] The need for systematic bleeding, purging, and dosing to get rid of other surpluses in the body, and an introduction to the midwife's arsenal of herbal remedies, take up the next lesson. There are numerous cures, brews, poultices, potions, enemas, bouillons, and compresses that her students must learn how to administer. The last two classes on this introductory material concern tumors or other kinds of uterine growths—"a chaos with no mark of a child"^[14] —that detach and get automatically expelled during the first three months, and miscarriages (called "abortions"), often caused by the failure to administer bleedings, or by straining at stool, violent coughing, anger, dancing, falls, blows, carrying heavy loads, riding in bouncing carriages, exercising too vigorously. There is, of course, no discussion at all of women willfully aborting their babies. In the case of a stillbirth, all attention is focused on checking for blood clots and making sure all parts of the dead child including the placenta are out so that the mother, at least, can survive.

Now the students are prepared to move on from foundations to the actual techniques of delivery. The teacher devotes the remainder of the course to developing the skill and dexterity of her students on the machine. Proceeding almost as if they were children, she patiently explains, repeats, then shows, and shows again, helping them to feel and visualize everything so that they will have the moves indelibly etched in their memories. First they spend several days on the normal presentation and easy delivery of the baby, with its head down and facing toward the mother's back. "Although great science is not necessary in natural delivery . . . there are still

plenty of precautions to take during labor to ensure that favorable beginnings do not end badly."^[15] Techniques for facilitating the baby's slippery exit from its "prison" are explained,^[16] as are others for tying the cord. Lots of anecdotes keep the students interested, mostly concerning feats and rescues performed by famous Parisian accoucheurs .^[17] After explaining the delivery of the placenta, the teacher focuses the students' attention briefly on the newborn child, the kind of care it requires, then back to the new mother, whose diet, hygiene, and toilette are all important for her speedy return to normal life.

Lest this process become entirely mechanical, the students are reminded now and then that they will be dealing with human beings, not cloth mannequins. "You must console [the woman] as affectionately as possible: her distressing state obliges you to; but you must do it with an air of gaiety that gives her no fear of danger. Avoid all whisperings [in the ears of others], which can only make her nervous and make her worry about bad things. You must speak to her of God, and engage her in thanking him for putting her out of peril. Avoid letting her do anything that will depress her. If she has recourse to relics, persuade her that they are just as effective on the bed beside her as on her body, where they might constrict her."^[18]

The last half of the course is devoted to l'accouchement contre nature , malformations of the mother and malpresentations of the baby, whose unusual positions can result in tragedy if the practitioner does not know some basic anatomy and design her maneuvers accordingly. By now, the midwife's students have a good understanding of the pelvic basin, both its bony and soft components, so they know that extracting babies from many positions is physically, mechanically impossible. The child must therefore be moved around so that it can be delivered safely. Numerous lessons teach the students how to turn the baby, through a combination of external and internal pressures after detecting by means of touch that it is presenting abnormally—a shoulder, elbow, stomach, chest, heel, hand, knee, or chin. Nearly all of these presentations require podalic version and footling breech delivery. With the proper manipulations and positioning, a baby can almost always be safely extracted. And it is in that positive, activist spirit that the students work away at the machine, engineering the right lifts, twists, and turns.

But what about twins? Here one must be particularly careful.

Any time a student feels a left foot and a right foot presenting, before pulling them out she must check that they both belong to one baby. If instead she is holding one foot of each twin, it would be futile and fatal to pull. She will need to push them back in and search around until she is confident that she has found two feet of the same child.^[19] Nothing can be assumed, everything must be verified. She also learns what to do if the cord comes out first, if the womb comes out, if the placenta detaches too early.^[20] All of these reduce to clever, dexterous, speedy, confident maneuvers. The teacher reminds her students that in the villages from which they come, matrons and surgeons who lack this experience watch many children perish and "need to separate the head, or use hooks and ladles to go in and get the rest of the body out in pieces."^[21]

The lessons end, as they began, on a sober, even pious note, away from the mechanics of birthing and back to issues of conduct, professional ethics, and morality. There are certain, very grave conditions that can follow a birth, such as lethargy ("a weakening of the whole animal economy"), convulsions, fevers, and hemorrhage, for which an able surgeon or doctor must be called in, to help the midwife or to take over completely. She should never fancy that she can handle such emergencies alone. Instead she prepares a full report of events leading up to the crisis and passes it on to the summoned expert. The teacher assures her students that with this deferential attitude they will win the cooperation of male practitioners. "I have found myself many times in . . . cases where, having called habiles gens [skilled men], I could ensure that no woman died [of the complications] and even that I often delivered their children alive."^[22] As the lessons come to a close, the students are told that their final obligation is to secure a good wet nurse if they cannot persuade the mother to feed her own baby, which is best for all concerned. The nurse's character traits will almost surely be passed on to the baby she suckles, so she needs to be upstanding and without vice. "We should neglect nothing in informing ourselves about all these circumstances," and above all must refuse to accept bribes to influence the choice, which would be a "very great crime." All sorts of inquiries should be made in the little villages wet nurses come from, where gossips will gladly provide information about them. Every precaution must be taken so that, at the critical juncture when the midwife surrenders responsibility for the baby, she will have nothing to reproach herself.^[23]

This, then, is what the teacher passes on to her numerous disciples. The course has a clear shape, a symmetry, beginning with the serious duties a midwife must assume, moving through the skills and techniques, and finishing with the rigorous, careful choice of a nourrice to whom the new life will be entrusted. Whether they can read or not, the students receive written copies of these lessons so that they or a literate person of their acquaintance can review them whenever necessary.^[24] Throughout the course the word accoucher has been used, a transitive verb meaning "to deliver." Students have been taught, in other words, that they need to intervene and do things to the mother, deliver her safely with the aid of the art rather than assist her in delivering herself.

Yet, as the much more commonly used reflexive verb s'accoucher connotes, self-delivery is the deeply ingrained habit of the women these students will now go home to serve. They return to their villages armed with two months' worth of new theory and practice; but are they prepared to face the inevitable clash with centuries of country tradition? Do they or their teacher honestly imagine that they will be welcomed with open arms either by the matrons who, as part of a convivial team of mutually aiding friends and confidants, assist birthing mothers, or by those very mothers themselves, who take pride in controlling their own deliverance from nine months of bondage?

12—
A Future Hero:
Chavaniac, 7 September 1757

Yesterday a baby was born here in the great chateau on the slope with its long flat front two stories high and its circular towers at either end. They say the birth took place in a chamber of the western turret that commands the valley and faces the violet rim of mountains on the horizon. The child's name is Marie Joseph Paul Yves Roche Gilbert du Motier. He is held at the baptismal font today by Paul de Murat, grand vicar of Sens, almoner of the dauphine, abbé of nearby Mauriac.^[1] But it seems the midwife who delivered him yesterday was none other than du Coudray. She is a celebrity in Auvergne and must have been summoned all the way from Clermont, fifteen leagues northwest of here, because of her great reputation. Despite complications, she brought the child safely into the

world. She has not stayed to preside at the baptism; no doubt the pressing business of her teaching called her back to the big city. But her niece will one day declare that du Coudray saved this baby's life. Had she not done so, he would not have grown up to become the marquis de Lafayette.^[2]

13—
Textbook As Patriotism:
Clermont, January 1759

Le Boursier du Coudray's textbook, the Abrégé de l'art des accouchements , has just been printed in the capital. It is published on the rue St. Jacques by the widow Delaguette, official printer/bookdealer of the Royal Academy of Surgery, with royal approbation and privilege, and sells for 50 sous, or two and one-half livres. This is a momentous occasion; plans for the book have been in the works for years. Some ambivalence about the audience for the volume is evident in its full title (fig. 6): Abridgment of the Art of Deliver, in which we give the necessary precepts to put it successfully into practice. We have joined to it several interesting Observations concerning singular cases. A work very useful to young Midwives, and generally to all Students of this Art who wish to become skilled in it . The work is supposedly for women, but it is also for men; it is an abridged, practical manual, but it has added to it some stories of curiosities and freaks. For whom is this book intended? Why has the midwife chosen to write a book at all, when the vast majority of her country pupils cannot read?^[1] Why has it suddenly appeared now, a year and a half after permission was first granted to print it?

An interesting series of events has led up to the midwife's decision to go public, to bother publishing, to become an author. Her successes in Auvergne have gradually emboldened her: the support of the intendant, the favorable reception of her machine in Paris, the popularity of her innovative lessons and demonstrations, her broadening fame. Yet her repeated requests for a pension, despite professed appreciation for her teaching and her invention in Versailles, have gone unheeded. Since France's 1756 entry into war with England the midwife has envisioned a larger role for herself, a grander kind of recognition. She has employed more and more the language of political significance to describe her work, has come to

Figure 6.
Title page for the first edition of Mme du Coudray's textbook-
(1759). This one had no illustrations and was published in
the 12° format to be inexpensive. There would be five
subsequent editions.
Photograph courtesy of Special
Collections, University of Maryland Libraries.

see it as her patriotic duty to make her expertise more widely available. Saving future soldiers and cultivators of the earth for France is now crucial. Gradually she has reframed birthing as a matter of state.

In mid-1757 the midwife, who had already been writing up her lessons for some of her students, assembled them into a textbook and took them to Paris. She saw a new opportunity for her work. This was a difficult moment for the crown. Since the beginning of the war the Parlement had been resisting the new taxes necessary to finance it. The resulting disorder in the royal treasury had led to near chaos, and Damien's attempt to kill the king on 5 January 1757 only added to the sense that the monarchy's authority was disintegrating.^[2] The midwife's book could perhaps make a small contribution to shoring it up. Presenting it in this light shortly after the regicide threat, she obtained approval to print the manuscript from the royal censor Morand, one of her former anatomy professors, on 2 July. That same month she wrote to the controller general reiterating her interest in a pension, this time placing her machine and now her book in the rhetorical context of patriotism and the war effort.

Apparently her timing was good, for suddenly things began to move. On 26 July Versailles informed the intendant of Auvergne that, although the financial demands of war made a regular pension for the midwife impossible, a handsome gratification would be forthcoming.^[3] A month later, in connection with the imminent publication of the book, a gift of 400 livres was promised.^[4] Although the actual appearance of the Abrégé has been held up this last year and a half—during which time her other old teacher, Verdier, added a set of notes and observations to her text, without attribution—the censor and accoucheur Süe has just last month given his enthusiastic approval to this longer version of the book.^[5] And a flurry of correspondence has begun that will soon see the gratuity for the new author raised to 700 livres.^[6] At the end of this year she will be charged by the king to launch a nationwide teaching tour. And as we already have seen, the bold "mission statement" letter she then writes to the intendants features the Abrégé centrally; in it she announces her authorship of a book on birthing before even explaining what the monarch expects her to accomplish on her travels.^[7]

The Abrégé , then, is pivotal in the fashioning of the midwife's

special part in the obstetrical mobilization of the country. She and the authorities in Versailles agree that the book is a passport granting her agency, absolutely necessary if she is to function in a more public capacity and figure not just locally but nationally in the modernization and medicalization of France. Participation in literate culture seems a sine qua non; it will enhance the professional status of her art. "It is to be hoped that la dame Du Coudray will send her book to the intendants as she promised me," reads one ministerial directive. As if to confirm the special validating impact of her text, one intendant, upon receiving it, will claim to his subdelegates that it is "imbued with all the authenticity necessary for meriting complete confidence in the lessons she gives."^[8] There is no question that the book makes possible her navigation in the public sphere.

The midwife's transformation through authorship from a humanitarian into a political actor can be seen immediately in the book's opening dedication to the intendant of Auvergne, Ballainvilliers:

A little work of this nature will doubtless seem very strange and inappropriate for the important affairs you administer to so much praise. Nonetheless, I do not hesitate at all in offering it to you; everything that has some utility earns an author the right to your goodness and protection. You understood in an instant, Monseigneur, the advantages of the machine that I invented to facilitate the Art that I treat. Your love for the bien public encouraged my zeal, and I perfected an invention that pity made me imagine. The students you gave me occasion to train already prove in the countryside the usefulness of my machine . . . [and] many subjects worship the protector of the art who saved them from falling victims to ignorance. Your name, Monseigneur, at the head of this book will never tarnish the brilliance of eulogies posterity will owe you. It is no less glorious to watch over the conservation of His Majesty's subjects in the bosom of his realm, than to chase from his frontiers and destroy the enemies of his State.^[9]

Thus support for the midwife's work is as significant as victory in battle. She is up there in loyalty and importance with military generals, sustaining and defending her country. They kill foes, while she repairs, restores, preserves life. They do warfare, she does welfare. In the "Avant Propos" she continues the same argument: "I have put together these lessons and am venturing to publish them today less out of presumption, which twenty years of experience might have inspired in me, than out of the desire to make myself

more useful to my Patrie in this manner."^[10] She claims, in a seeming contradiction, that "compassion alone made me an author," that empathy and identification with other females inspired her,^[11] but she tries to reconcile that with her newer purpose. What began in Auvergne as genuine sympathy for the "pauvres malheureuses" (poor unfortunate women) has evolved into an understanding that the safe delivery of their offspring, of healthy future citizens, is of immense value to the nation.^[12] France must be abundant and prosperous; children are an investment in that renewal. By the time the Abrégé appears in print, the midwife's focus has shifted significantly from mother to baby, her tone from sentimental to soldierly.

Some rather patronizing passages were added as the midwife assembled the book. In the lessons themselves she speaks as one with her students, but the printed Abrégé has numerous sections in which she speaks about them. "My whole object is to include in a few words the true principles of this Art and to present them from a point of view comprehensible to women of little intelligence. How many of these there are, who, without foreseeing any problem, meddle in childbirth, and how many unfortunates become the victims of this ignorance. . . . Since I do not write for the enlightened, I cannot err in expressing myself simply."^[13] She consequently begs her readers not to pay attention to faults they might notice in her "diction," implying that her foremost desire is to convey useful information to these deprived rustics.^[14] At the same time, she knows the book may be picked up by "more intelligent people likely to be interested in more extended instruction." For them she has added particular remarks (and the editor has added erudite footnotes) so the book can be read with "more satisfaction" and "more fruit."^[15] After all, she is the bearer of city wisdom, of the latest obstetrical knowledge, which she will spread to petits endroits (small localities) but also way beyond.^[16]

The midwife is trying to please many publics at once, including doctors, surgeons, and apothecaries. Seeking harmony with male practitioners, she acquiesces willingly to them, most of the time pointing the finger of blame at inexperienced or incompetent bonnes femmes .^[17] The Abrégé is activist, interventionist, bold, but for all her confidence the midwife admits several times in the book to mistakes she nearly made, and praises the triumphs of great men in her field.^[18] She has no airs, alienates no one, creates no sense of danger. Quite the contrary. She writes:

I ask the grace that I not be accused of passing myself off as a Doctor. I speak here only from a pure zeal for unfortunates deprived of all aid, either because the distance of the villages does not permit a doctor or able surgeon getting there in time, or because the poverty of these women prevents them from paying the suitable fees. It is in these pressing cases that I hope country midwives will be capable of giving the necessary help to women in danger. I cannot exhort them too strongly never to overestimate their supposed knowledge, and to be docile to the wise advice of experienced persons.^[19]

Thus the author artfully constructs the image of midwives obedient to male medical authorities whom they will never challenge or compete with.

The Church must be placated too, of course. One of the first lessons her students learn is "the necessity of procuring baptism as soon as possible for those [babies] who seem ready to die."^[20] She provides elaborate instructions for baptizing the child by syringe if getting it out alive seems impossible. "Child, if you are living, I baptize you in the name of the Father, the Son, and the Holy Ghost." Baptism must be given preventively to any child in abnormal presentation. "The time it will take to do this delivery could deprive the child of eternal happiness. We would reproach ourselves greatly if we neglected to do this." If all goes well and the baby survives to be taken to church, the priest must be informed that the private baptism (ondoiement ) has already taken place.^[21] Thus any ecclesiastical authorities looking over the Abrégé should be sufficiently convinced of the midwife's piety.

Most of all, she strives to write a book that bridges from group to group. She is female, but not antagonistic to men; Parisian, but adaptable to the provinces. She is superior, but never scornful of her students, conveying to them her conviction that they can learn to do what needs to be done to save numerous babies from the jaws of death. She is schooled, but not so urbane that she cannot appreciate the robust earthiness of peasants. She can use the common terms for body organs as fluently as the learned ones, and does. She can use units of measure from town or country, describing cervical dilation by the size of a coin here, the size of a fish's open mouth there. The midwife's book, as she says on the first page, is not an obstetrical treatise. Of these there have been many, full of theory, Latin terminology, and ponderous references to authorities from antiquity. The Abrégé is an abridgment, a different, new genre, a

practical how-to manual, possibly the first of its kind in France. In fact, this text will generate a fad: short, clear, accessible childbirth booklets, often in question-and-answer catechism form, proliferate during the rest of the century.^[22]

Journalists recognize immediately the usefulness of such a volume, reviewing it in the papers of the day. They sense the incongruity of the footnotes and the "Observations," which, written in a scholarly idiom and offering a titillating bit of the grotesque—dead babies that allegedly stayed in the unsuspecting mother several years, fetal bones found in a woman's excrement—really do not seem to fit with the practical text. (The editor of the Abrégé must have realized this himself, because after placing recondite notes in chapters 4, 9, and 10 he abandoned the idea completely.) The Année littéraire says the Abrégé contains nothing new for the learned but is helpful for those incapable of profound thought, and therefore it is good for humanity. It also recognizes how essential the publishing of a book is for the midwife if she aspires to practice her art nationwide.^[23] The Mercure de France and the Journal de médecine herald the Abrégé 's appearance,^[24] and Grimm's Correspondance littéraire remarks, "Here is the title of a useful work."^[25] The Censeur hebdomadaire thinks it is wonderful, written with great precision. The tone is pleasing; the author writes "with a modesty that is the constant companion of true understanding, stripped of any vain parade of erudition." The work will surely help France, for midwifery is an "important function on which depends the hope, the strength, and the support of states."^[26] The most enthusiastic review is in the Annales typographiques , a journal edited by three doctors. It explains in detail the great things du Coudray has been doing in Auvergne, including her ingenious machines. Prophetically, the reviewer hopes her "establishment" will spread everywhere and have many imitators. The book, a précis of her lessons, is "clear and methodical" and "contains all that is essentially useful in the art of delivery." The "Observations," on the other hand, which he recognizes instantly to be by a different writer, are "too erudite for the people for whom the Abrégé is intended."^[27]

The Abrégé , then, has certainly attracted attention. In a time when women writers are mostly ignored and denied the courtesy of a reply, male reviewers at least do the midwife the honor of critiquing her. Hers is a fresh voice—something of a curiosity, but worthwhile.

Later, when she is on her mission and famous, when the novelty has worn off, newspapers will be far less charitable. Many will enter the lists against her.

The Abrégé is to become a key player in du Coudray's odyssey, a central character whose carefully timed appearances, in the form of five new editions over the next twenty-six years, will signal important developments in her life. This little volume serves its readers, but it definitely serves its author as well, now by establishing her reputation and catalyzing her mission, eventually also as a source of considerable revenue. She writes so as never to be dismissed as an empiric. Rather, she is an authority worthy of publicity and posterity, enhancing the ability of her readers, be they women or men, high or low.^[28] Parts of it may appear to wildly flatter and overestimate her peasant audience, but she is aiming also at other publics, and she is being widely heard.

Of course, not everyone likes what they hear.

14—
Protest from a Village Matron:
Plauzat, 12 June 1759

The matron of this village near Clermont, one Brunet, has a mounted policeman banging at her door, a cavalier of the maréchaussée , serving her with an official warning from the intendant.^[1] A spectacle of public embarrassment! What next?

About a month ago the king's man told the curé that only du Coudray's trainee should be allowed to practice in this town.^[2] Ridiculous! says Brunet. That woman cranks out students from her classes in the big city; after a mere two months and some lessons on a cloth doll, they think they know everything! Jeanne Cureyas, handpicked by the curé Biron, attended the course in Clermont to profit from the new-fangled instruction and has just returned with a special diploma. Together the priest and the girl are trying to rob Brunet of her loyal following, she who has been helping mothers deliver themselves of babies in this parish for more years than she can even count. Because she won't bow down to a certificate, a stupid piece of paper, they call her a "rebel" and say she has ganged up on Cureyas, organized a "faction . . . cultivated in these parts by surreptitious practices and by secret calumnies."^[3] Such fancy words!

A surgeon friend of Brunet's told her of these accusations. He understands, of course, that the parish women know and trust her, and he is not so fond of du Coudray himself; after all, her students get away without the exams and approval normally given to midwives by village surgeons. So he has written out a license of his own for Brunet allowing her to claim she is the one practicing legally, to turn the tables and make the young trainee look like the impostor.^[4]

Oh, how Brunet resents that Cureyas woman. She had no business seeking out the class in the first place, complaining about village ways as crude and empirical, betraying her peasant stock. She has polluted the air, made sour feelings. And now she's always carrying around a book by her teacher. Probably she's just pretending she can read it. Or maybe, even worse, she really does read, and knows forbidden things. Maybe it's full of spells. After all, Cureyas managed a few tricky births when she first got back from her classes; it seemed almost like magic what she could do! Brunet wouldn't be surprised if she was a witch, with her nose in that book all the time, and plenty of other folks around here think so too. So now nobody's asking her for help anymore. To Biron the priest, who's completely on the girl's side, it seems unfair that she has no business. He pities and protects the pathetic creature. He blames her, Brunet, for turning everybody against Cureyas, reports to his higher-ups that the poor thing is "terribly afflicted," "leaves her house no more than a recluse," and is reduced to misery.^[5] To Brunet's mind it's the girl's own fault. What did she and her big-shot teacher from Paris expect? What does that du Coudray woman know of our country ways anyhow? She carries on about the "ignorance" of us femmes de campagne , but we have traditions that date back ages and routines that work just fine much of the time without any help, thank you.

Brunet is not alone. Almost every parish in France has at least one matron (or preneuse [taker], attrapeuse [catcher], or ramasseuse [picker upper]), a trusted and familiar figure, secret keeper, sometime matchmaker, who helps mothers deliver the local children—or as they put it, "make new feet"—often with success. After all, these matrons have had numerous babies of their own, have experienced in their own flesh these labors. Sometimes they are paid by the village, like the shepherd. Usually they practice for a period of thirty to thirty-five years.^[6] When the baby presents abnormally, or

the woman's pelvis is too narrow, mother or child or both will die, but there is widespread resignation about death as a part of the birth process. The matron helps with that too, if need be, laying out the corpse, easing the eyes shut, dressing and preparing the body for burial. Among peasants there is an acceptance of things others might call tragic. More often than not, though, the birth works out all right. In spite of the hardships and dangers, most women want to get pregnant and have children. Everyone in the parish expects this, watches, waits, celebrates. Having babies is a normal life-cycle event, not a medical procedure. Of course there are anxieties and fears, but nobody here thinks of calling the expectant mother la malade (the patient), as du Coudray and her students do. From beginning to end, country pregnancies are marked by rituals and rhythms that evolved over hundreds of years and that feel comfortable, natural, right.

A clove of garlic slipped into the vagina tells a woman if she is with child or not. The next morning, if her breath smells of garlic, she believes she is not pregnant: a fetus would have blocked the diffusion of the characteristic odor. Sweet breath means there must be an obstruction and that she has conceived. Another woman consults a uromancer , a seer of waters, another listens for particular bird songs, another checks phases of the moon. Many wear amulets to prevent their baby from plunging into the world prematurely, and they try to avoid intense maternal desires and yearnings, which can scar the unborn. Envie , after all, is a common word for birthmark. To avoid the untimely birth of an "unripe fruit" or "dough not cooked long enough in its oven" women stay away from funerals, make sure their feet touch the floor when sitting, and refrain from working on the baby's layette. Prayers and vows to the Virgin safeguard the pregnancy, and pilgrimages are made to the shrines of Saint Margaret—they are numerous and scattered throughout France—where women walk around the baptismal fountain, press their naked navels to the statue, then continue to wear a cord or piece of clothing that has touched the holy relic. Some just soak a symbolic garment in a spring that is thought to be blessed. Many town churches have fertility stones that wishful mothers rub. The one outside Le Mans cathedral is especially famous, its hollowed pits worn by myriad fingers over the ages.^[7]

During pregnancy peasant women take other precautions as well.

Most cannot afford cosmetic pomades to avoid stretch marks, but they slather themselves with animal-fat concoctions of their own devising. They continue to wear their usual clothes and wooden sabots (if they even have shoes) but try to get as comfortable as possible. To keep the bowels moving they prefer diet to enemas, eating combinations of leeks, spinach, honey, and prunes. Intercourse during pregnancy is thought to be the father's way of molding and imprinting the child, giving his stamp to the otherwise shapeless mass. Women long for a pink, hale, blond, curly-haired child with good complexion and bright eyes. They want sons, mostly, and it is amusing sport for friends and neighbors to divine if the baby is male or female. Is the mother rosy and merry, carrying high, with red, hard, raised nipples and her right breast firmer than the other? Then she will have a boy. If she is pensive, of dry and hot temperament, with paler, drooping nipples oozing dilute milk, then she must, alas, be about to give birth to a daughter.

Many country women work in the fields to the end and, surprised by the onset of labor, give birth unassisted right then and there. Others prepare more gradually and arrange to deliver at home. When the hour approaches, the communal room of the low-ceilinged dwelling (often the only room) is darkened and closed up tight against cold and evil spells. The birth takes place usually in front of the hearth. Bright flames from the fire scare away the night, when the souls of dead ancestors, attracted by the newborn's cries, beckon the baby to join them. Straw scattered before the fireplace absorbs excretions. It can be burned afterward, and if there is excessive blood, ashes conveniently soak it up. Numerous female relatives, neighbors, and friends surround the laboring mother in the warm, moist room, chattering, advising, exchanging recipes, drawing and heating water, supporting the woman, washing, sponging, drying linen. Later they will be there to hold and care for the baby, to sing it lullabies and ward off demons, to prepare cordials and broth. Each of these women has her own stories to tell: most are mothers themselves, and they try to calm their agitated friend as she labors. Unmarried girls are rarely allowed in; decency and custom dictate that virgins stay away. Only very exceptionally is the husband admitted to this collective drama, and if he is it is usually a bad sign, for these are cases where his extra strength is required, to push or pull more than is necessary in a smooth, normal birth. In extreme cir-

cumstances he may even mount his laboring wife to lubricate and open passages, to "shake the baby out" if it just won't come. Husbands, though generally excluded from the scene, have their own moods and sometimes do the couvade , going to bed themselves for attention, getting fussed over and waited on.^[8]

The mother keeps an armory of comforts and puts her favorite talismans nearby or actually on her abdomen or thigh. The eagle stone shaped like a pigeon egg, which contains other smaller stones rattling safely inside it, symbolizes when worn high on the neck or arm a secure pregnancy and the certainty that the baby has been held in and carried to term. When pains start it is moved lower, to the thigh or foot, so its magnetic effect can now coax the baby down and out. A snakeskin belt is sometimes tied high up about the left leg, or a snakeskin broth might be sipped; since the snake sheds its skin with ease, it is hoped that this birth too will be easy. When labor begins the mother's hair must be styled; village women are convinced that the outcome of delivery is greatly influenced by how carefully they are coiffed.^[9] The woman opens her mouth wide to let out the pain, to scream, grunt, cry, if it relieves her fears or makes her more comfortable. The father's hat, turned inside out, is placed upside down on the woman's stomach or vulva. The inversion signifies a reversal of the process whereby the man put the baby into the mother months earlier. She may clutch a mysterious, unopenable "birthing bag," containing saints' lives and prayers, secret, sacred, and safe like the womb itself. A dried Rose of Jericho placed in water near her swells and unfolds as it gets wet—a sort of vegetable vagina. This will, it is hoped, cause the cervix to dilate.

Various positions are assumed as the contractions intensify: sitting, crouching, kneeling upright or on all fours, standing, leaning forward with elbows on a table, reclining in a chair. Vertical positions are the most natural, the most instinctive; gravity seems to aid and hasten the birth. Squatting on her haunches or standing gives her an awareness of her body's pulses and changes, a way of watching the process, of helping the baby come down, even of welcoming the child as it emerges between her taut, sweating legs. She sees what's going on, and she can actively deliver herself. Lying high up on a bed is far less natural. Hardly practiced at all in the countryside, it removes the happening from the mother's control, restricts her freedom of motion; besides that, it fouls a set of bedclothes. Some

women half sit, half lie on a straw mattress in front of the fire on the floor, supported under the armpits by a sister or friend, but this is rare because it is so awkward and uncomfortable for the birthing attendants. Mostly, such horizontal positions distance country mothers from the event in which they desire to have a major role.^[10] They far prefer to be upright, and are often encouraged to climb stairs, walk around a table, even bounce, so that the baby will "fall into the world" like fruit from a tree.

The mother does not want to be captive any more to this pregnancy. The circle of women speak now of the baby as a parasite to which the mother has devoted more than enough time and energy. Her moment has come for relief, for freedom. If anything goes wrong with this birth, it is the baby who's guilty. The mother deserves now to help in her own liberation. With her long, hard pushing she makes a steady rhythm of rolling, heaving, guttural sounds. To hasten this last spreading of the flesh and bones, she is given drinks of wild herbs and roots. The matron works the parts, trying to subdue the womb, keep it from its wanderings, seduce it into place with perfumes, or egg yolks on the navel, or sweat from the husband's testicles rubbed into the vulva.

Finally everything gives, and the head appears, hairy, wet, long, lopsided, and shiny. One more push and the rest slides out, covered with its silvery, slippery, sweet-smelling film. Even once the baby is out, attention continues to focus on the mother. The placenta is actually called "the delivery," or "deliverance"; experience has shown that only with its complete expulsion is the woman out of danger. Peasants believe the fate of the placenta must never be left to chance. Animals generally eat their own afterbirth, and while few country women go that far, they certainly keep close track of it. Some bury it in the garden to ensure future fertility of the family and of the crops. Some save it, dry it, grind it into powder, and use it for medicine.^[11] In many huts it seems to be fussed over more than the newborn!

And what of the baby? If it is born with the amniotic membrane, or "divine skin," draped over its head, there is wild rejoicing. The umbilical cord of a child so blessed must be saved, for it will bring its bearer every conceivable kind of luck. The ordinary child, not so lucky, is considered still unformed, its head, nose, hands, limbs malleable, adjustable. So it is pushed, stretched, flattened, and molded

aggressively. If it is a girl, its nipples are pulled, pinched, and twisted, and its cheeks are pressed and poked where dimples should go. If it is a boy, its umbilical cord is left longer to encourage the penis to grow "to good measure." The baby is swaddled tightly and left for days at a time in the same wrap, still caked with its white, cheesy coating. This covering, combined with sweat, urine, and excrement, is naturally protective, it is thought, and creates a warmth that prevents crying.^[12]

Village women practice this kind of mutual assistance or communal aid, helping one another in a constant exchange and criss-crossing network of favors. Usually the matron is presiding, though she is just one member of the group, a familiar, sturdy person with little or no formal training but lots of children of her own and thus plentiful firsthand experience. For her service she is paid, if at all, some eggs or cakes, a bread, a capon, some soup, fruit, or lard, some firewood or faggots, and of course hospitality and food as long as the confinement lasts. She comes whatever the hour or weather to tell reassuring stories. However robust, she is known for her nimble, supple, graceful hands. These matrons believe a birth should go quickly. If it's too slow, the mother will get exhausted and complications will ensue.^[13] So they manipulate and stretch her parts, patting her vulva, massaging and pressing on her abdomen, rolling her from side to side, having her walk or even jump to dislodge the baby, keeping her active and involved so that she can deliver herself of her burden. Vomiting and diarrhea are induced to speed things along, to bring the woman through safely and fast. Loyalty is always to the mother. If a choice needs to be made between her and the child in a complicated birth, almost always the baby is sacrificed. Either it is born mutilated or dead, or it gets stuck in the birth canal and needs to be gone in after with spoons, knives, and hooks to be removed piecemeal. But this is almost never considered the matron's fault. The child was somehow just not meant to be.

Matrons like Brunet know what they know because they have watched and learned by doing, over the years. They might lack savoir but they have ample savoir faire ; without any lectures or demonstrations on a model, they have figured things out for themselves. Situations, not theories, dictate their behavior. They have imitated and matched maneuvers their elders performed, at first helping in little ways, then, and most important, continuing to absorb and

understand more fully as they grew up. Delivering babies is less a job than a way of life for them. Gradually they assumed new responsibilities, took over bigger parts of the workload from the older women, who showed them the way. They didn't have to ask a lot of questions because they were learning all the time, driven simply by what needed to be done. As years go by they become competent in longer stretches of the process, more central, complex jobs. Their elders have guided their hands, so that they feel the baby somersaulting in the abdomen, feel the head crowning, feel the life flowing from the mother through the pulsating cord. No need to be praised or blamed; they know how they measure up.

There is much talk, always, but these women offer stories, not lectures. At difficult births they relate similar cases they've seen or experienced themselves, pooling suggestions, deciding collectively what's best to try next. Stories bind this community of women together, but they also serve to identify and legitimize the matron, move her out of the shadows toward recognition in her own right as the wisest one. She must inspire confidence; it cannot be imposed. Then, even though mothers mean to do the big work of birthing themselves, they want her to be there.^[14]

Brunet has earned her following in just this way. But now along comes du Coudray with her students to turn the matron's world upside down. Have these girls learned as they grew up, do they work out of connectedness with the women of the village? Of course not. They've had a government training course, that's all. And they have picked up some pretty crazy ideas, calling the mother the "sick one," making her lie down passively and surrender to her deliverer, caring far more about the survival of the child than the woman! They pretend to know all about anatomy and mean to charge for their services. But really they have just memorized a bunch of rules, manipulated a rag doll, gotten a piece of paper, and that's the sum total of their experience. Cureyas is one of them. She is young, has done nothing to win the trust of the village women. She has never heard their lamentations, welcomed their offspring, escorted them to the baptism at church, advised them about teething or how to wean the baby when the time comes. She has no knowledge of any of these repeated rituals and life passages. Yet for this upstart Brunet is supposed to step aside.

The king's man and the priest threaten her with "various pen-

alties" for just going about her business, doing what she is and always has been expected to do.^[15] It sounded pretty vague to her at first, and she doesn't take it seriously—until today, when she is told by the horseman at her door that if she persists in delivering babies she will have to pay a fine of twenty livres. And it gets still worse. If she temporarily complies, and then tries to start working again when the whole fuss blows over, they will throw her in jail for "recidivism"! They'll know, of course, that she has resumed her activities if she shows up at a baptism, for who else presents a child at church but the one who catches it?^[16] So she's trapped for the moment, hands tied (almost literally), and furious at du Coudray for ever coming to Auvergne.