A Tale of Two Midwives across Four Centuries
Six months ago, certified professional midwife Elizabeth Catlin was arrested on the grounds that she was practicing midwifery without a license. Catlin had long served the Old Order Mennonite community of Yates County in upstate New York. It is common for Old Order Mennonite families to be very large, and for women to give birth at home. Many families live as traditionally as possible, and do not have cars or health insurance. Catlin provided a traditional style of home birth midwifery care, attending women throughout pregnancy, birth, and postpartum recovery for a reasonable fee.
Catlin has a midwifery certification that is recognized in 31 states, but New York is not among them. She had long practiced with tacit approval from authorities. Her lack of legal standing, however, became a liability when she transferred a laboring patient to a nearby hospital and the baby did not survive the birth. A physician at the hospital, blaming Catlin’s home birth methods for the tragedy, reported her to authorities, and suddenly her midwifery practice and her personal freedom were at stake.
While that physician might have disapproved of Catlin’s practice, her clients and their families rushed to her defense. They showed up in droves at her hearings, and passed a hat to raise bail. Many wrote indignant letters to the editor insisting that they knew full well what kind of practitioner they had hired, and that far from being dupes of an unscrupulous practitioner as the prosecutor alleged, they valued her skills and techniques and received exactly the care they sought.
Catlin’s story eerily echoes that of midwife Alice Tilly, who served the women of Boston almost four centuries earlier. In 1649 Tilly was jailed for allegedly causing “the miscarrying of many wimen and children under hir hand.” The women of Boston were dismayed by the imprisonment of their highly-experienced, well-respected midwife, the person they regarded as “the ablest midwife that wee knowe in the land.” They knew that birth sometimes went wrong no matter how skilled the birth attendant, and they trusted Tilly above other local practitioners. Hundreds of women signed petitions in her defense, and presented them to the General Court. The wives of leading citizens led the effort, begging that Tilly be pardoned, not just for their benefit, but for that of their future children.1
While the women of the community were willing to request simply that Tilly be given permission to leave jail periodically to attend births, and Tilly served in this manner for some time, Tilly eventually sought full exoneration. The authorities reacted with anger at what they regarded as Tilly’s “excessive pride.” Tilly continued to live and serve as a midwife in Boston, and the surviving record does not reveal whether she was ever fully exonerated.2
Like her seventeenth-century predecessor Alice Tilly, Catlin stirred the ire of authorities who found her arrogant and recalcitrant. After her first arrest, she continued to practice, because there was no one to take her place: she had been the only currently practicing certified midwife in her area, and when she briefly stopped, several women gave birth without any trained attendant. The district attorney piled on four more felony charges related to the lab work she ordered as part of her clients’ prenatal care, threatening her with consecutive sentences. She was brought to the courthouse in shackles, and the district attorney requested a punitively high bail, disingenuously suggesting that Catlin, whose entire family and work life was deeply embedded in Yates County, was a flight risk.
In her book Founding Mothers and Fathers: Gendered Power and the Forming of American Society, historian Mary Beth Norton characterized controversy over seventeenth-century midwife Tilly’s arrest as a battle along gender lines. At the time, pregnancy and birth were the province of women, and lawmakers were all men. These men seemed to have limited understanding of how pregnancy or birth worked, and in fact, often deputized midwives to investigate cases of alleged infanticide, where physical evidence of pregnancy and birth (or lack thereof) was crucial. After Tilly’s arrest, exasperated women, desperate for safe maternity care, petitioned the clueless all-male assembly to respect their judgment about who could best see them through the dangers of pregnancy and childbirth. The men responded with anger at this midwife who would challenge their judgment, even as they gave in to the women’s demands that she be allowed to practice.3