Abstract
This article focuses on the determinants of the economic cost of at-home childbirth in Flanders in the nineteenth century. Literature on the remuneration of medical professionals in the nineteenth century is sparse. Yet the few existing studies show that fixed rates per delivery did not exist during the nineteenth century. Before that time, pricing was influenced by factors such as the professional experience of the midwife, the distance between the residence of the midwife and the client, the social status of the client and the specific circumstances of the client’s condition. I analyse these factors with regard to home births that were assisted by a certified midwife, using the casebook of a rural Flemish midwife for the period 1831-1892.
Highlights
Midwifery in historical literature Since the 1990s, eighteenth- and nineteenth-century midwifery has receivedalotof internationalattention.1Yetmostpublicationshavefocused on the training of midwives and on legislation and regulations aboutTSEG their duties and tasks
Before that time, pricing was influenced by factors such as the professional experience of the midwife, the distance between the residence of the midwife and the client, the social status of the client and the specific circumstances of the client’s condition
The historian Hilary Marland and the nurse Anne Marie Rafferty conclude that: ‘despite the many challenges she faced, the midwife was still firmly stationed as the main provider of obstetric care at the close of the nineteenth century in most countries’
Summary
Midwifery in historical literature Since the 1990s, eighteenth- and nineteenth-century midwifery has receivedalotof internationalattention.1Yetmostpublicationshavefocused on the training of midwives and on legislation and regulations about. The medical historians Defoort and Thiery, for example, claimed that in nineteenth-century Belgium the dominant image of midwifes was a negative one of incompetence and that anyone who could afford it would consult a physician-obstetrician instead.[5] According to them, working class women were unable to pay the fees of a trained midwife and preferred to hire an illegal handywoman. These are undue generalisations based on sources created by medical men and ignore the fact that the majority of lower and middle class women, especially in the countryside, underwent home births with the help of a midwife.[6] Because there were fewer doctors in the countryside, elite women living in such areas may have had less access to obstetricians. Loudon, ‘Midwives and the quality of maternal care’, in: Marland and Rafferty (eds.), Midwives, society and childbirth, 180-200. 7 Marland and Rafferty, ‘Introduction’, 7; Towler and Bramall came to similar conclusions for London: Towler and Bramall, Midwives in history and society, 160
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