The king's midwives: The 1764 midwifery expedition to Saint Domingue and why it failed.

In 1764, the French ministry sent a group of trained and licensed French midwives to Saint Domingue (now known as Haiti), a French colony on the western half of the island of Hispaniola in the Caribbean.1 The French state empowered these women to practice midwifery in Saint Domingue in order to improve the birth rate, but the midwives encountered opposition from colonial medical practitioners. Leading colonial physicians criticized the midwives for their use of birthing practices unsuitable to the climate and people of Saint Domingue. They asserted that the midwives, who had been trained in France, knew nothing of the dangerous diseases of the island environment or the uniqueness of the colonial body. By invoking a distinctive colonial medical identity and emphasizing acceptable professional mores, the medical men of Saint Domingue fought against the 1764 midwifery expedition and doomed it to failure. Midwifery has been a popular topic for historians of gender and of medicine. We know a great deal about the history of midwifery in France as a result of the efforts of scholars like Jacques Gelis and Nina Gelbart. Gelis recounts the characteristics and skills expected of French midwives in early modern Europe and shows how the ritual of birth coincided with the change of the seasons.2 Gelbart focuses her study of French midwifery on a specific individual-Madame du Coudray-and creatively recounts the triumphs and difficulties the 18th century midwife experienced in a 22-year struggle to educate women and men in the proper ways of delivering children. Her nation, its citizens, her students, and her colleagues feted her for her educational techniques, her invention of an obstetrical machine used to demonstrate birthing positions, her book, and her dedication. Yet du Coudray endured numerous setbacks and much criticism. Medical men resented both her skill and her outspokenness. Her strong personality also did not endear her to town leaders with whom she had to deal as she made her way across France. Finally, du Coudray suffered criticism from village women who practiced midwifery without benefit of formal training.3 Thanks to the research of scholars, we also know something about the history of midwifery in other Western nations. Jean Donnison studies the uneasy and competitive relationship between female midwives and male medical practitioners in England from the 18th to the 20th century.4 Jane B. Donegan examines how obstetrics developed in the United States in the 19th century and discusses how male obstetricians aimed to wrest control of childbirth from midwives in the midst of fights over women's proper sphere and the nascent women's rights movement.5 Laurel Thatcher Ulrich employs the diary of Martha Ballard and other primary sources to show how male physicians challenged midwifery in late 18th and early 19th century America by learning from the midwives themselves how to deal with ordinary births.6 Despite the tremendous work undertaken by these historians, however, we still know little about the practice of midwifery in the colonies Western nations held in the 18th and 19th centuries. Who were the women who traveled to colonial outposts to ply their medical trade? How were they trained? What did they accomplish? What difficulties did they experience? My study of the 1764 midwifery expedition to Saint Domingue shows that, despite the need for their services, these women endured professional criticism from male medical superiors who set out to gain control of colonial medicine through the development of a colonial medical ideology. The sources on which the story of the midwives of 1764 is based are rich and varied. 18th-century medical books that analyze the disease environment of Saint Domingue describe the illnesses that colonial residents, both free and enslaved, suffered and the health patterns of white, biracial, and African women. Travel accounts provide information about the customs, climate, and social life. …