What's in a name? - Dr Sara Wickham

Mid-wife (mid-wîf): From Middle English “mid”+”wif”, meaning “with woman”; one who assists other women in childbirth.

We often use the fact that the English word midwife means ‘with woman’ to illustrate that this, for many midwives, is the cornerstone of midwifery practice. And this often needs illustrating. While there have always been social and political pressures on midwives, they have probably never been quite so diverse and conflicting as they are today. We are practising in a time where it can be extraordinarily difficult to be with the woman, because midwives are busy balancing the need to be with the fetal heart monitor, the notes, the multidisciplinary team, the local guidelines, the evidence and the professional rules. It’s just as well that, as the French sage-femme and the German weise frau suggest, midwives are wise.

Thinking about midwives being termed wise women led me to wonder what male midwives are called in French – I suspected the suggestion that they be called sages-hommes might be as problematic as the idea of calling male English midwives midhusbands. It turns out that maieuticien (the official term for male midwife according to the deliberations of l’Académie Française) is rarely – if ever – used, with the most popular everyday term being un sage-femme-homme.

Whatever their gender, the idea of midwives being with woman is certainly widespread, if not universal. There are direct parallels between the English word midwife, the Spanish comadre or comadrona and the Latin cummater. Yet there also seems to be something about the birth of the baby from the earth itself which is an essential part of the etymology of the word in several languages. The Danish jordemoder may be directly translated as ‘earth mother’ but it also refers to the child being lifted from the earth. As do the German terms hebamme, the Italian levatrice – the one who raises, or pulls out – and the Inuit nutaratitsijij. In Hebrew, meyeledet means literally, ‘one who delivers a baby’, while according to Mitchell and Oakley (1976), the original English word meant ‘she who pulls the baby out’.

Discovering that the Hungarian term bába translates as meaning ‘with baby’ made me wonder whether this reflected a different focus. Western culture seems somewhat confused about the different rights and status of women and babies, and whose needs should take priority should there be a conflict. If the English concept ‘with woman’ links with the English law which protects her rights, does a culture whose midwives are ‘with baby’ place different emphasis on the woman’s place at the centre of care?

Yet it is the rare woman who wants to choose something which she feels would be dangerous for her baby. The notions of danger and conflict often arise where the woman and a professional disagree about whether a particular course of action is dangerous, and is a tension which has more to do with differing philosophies than about any kind of objective truth about risk and safety. From an admittedly limited understanding of the area, I would suggest the fact that some midwives are linguistically with women and some with the baby says less about this modern and artificially-created tension than it does about the ancient knowledge that mother and baby are inextricably linked; a dyad. Indeed, Italian midwives talk about the esogestazione; the first nine months after birth, where the mother and baby are together with the baby outside the mothers body. This is considered to be a continuation of pregnancy, or endogestazione, and some mothers and midwives celebrate the day on which the baby becomes nine months old as the point where the baby becomes a separate person.

The Italian terms for midwife are also an example of how changes in culture impact what midwives are called, and how what midwives are called reflects the culture in which they practice. The term levatrice once applied to all midwives, but now describes a non-professional midwife, with the term ostetrica (from the same root as obstetrics; to stay in front of) now being more commonly used. Yet even levatrice is modern construction relative to the mammana, or ‘big mother’, a term which, sadly, is used today to refer negatively to a bad practice, magic or witchcraft.

Language, terminology and nomenclature change fast in the world today, as do the meanings of the words we use to describe ourselves. How interesting that some midwives are called by the same name they have been for thousands of years, while others find their title changing. And how appealing that there are deep-rooted similarities, which may or may not be due to common roots of language, between the terms for midwives around the world. I find it a bit reassuring, when trying to juggle all those other things we are expected to be with as well as the woman, that so many other midwives around the globe are dealing with the same issues.

As you will have gathered from the note above, this article is a good few years old now and terminology is bound to have changed.

References

Mitchell J & Oakley A (Eds) (1976). The Rights and Wrongs of Women. London, Penguin.

Many thanks to Susanne Houd, Michel Odent, Verena Schmidt and Leslie Wolff for their help with translations when I originally wrote this article.