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Basic Information

A midwife is an (almost always female) professional who attends expectant mothers to assist with delivery - and in many cases to support them during pregnancy and in caring for the baby afterwards. Depending on the culture and era this may be a role for a specialist ob-gyn medical practitioner, the default responsibility of some female elder who has seen it all before or part of the local wise woman's portfolio. Although ahistorical, it would also not be completely insane for pre-modern midwives to be at least affiliated to the barber-chirurgeon's guild for reasons explained below. Historically, a male practitioner might have been referred to by the French term accoucheur.

The core of the role is in delivering babies - which can become quite complicated where humans are concerned. Besides coaching and directing the mother (especially in first deliveries) they may also need to physically manipulate the child if it becomes stuck, perform and repair episiotomies and stitch parenteral tears and perform other related minor surgeries. Caesarean deliveries are probably out of scope except in the sort of context where the child is being salvaged from a dead or dying mother. Obstetric hygiene (if practiced) is also likely to be the midwife's responsibility and she may have other cultural roles such as performing religious or other protective rites associated with the birth, inspecting the child and acting as a witness of its maternity1. Following delivery she is likely to coach the mother in breastfeeding and provide other advice and support as required. Additional skills are likely to include culturally appropriate counselling skills and other related medical skills such as herbalism. Ancillary skills such as the administration of enemas, hair dressing and physiotherapy can also be of significant benefit. Some may also work on animals when there are no humans needing their assistance.

In some cultures a midwife may also provide advice on contraception and/or infanticide as a sort of primitive family planning service, conduct coming of age rituals for young women and otherwise act as (and/or be) a female community elder.

Midwifery may be the preserve of wise-women (as noted above), nuns (in the right culture) or priestesses (especially those of goddesses governing motherhood or fertility). In more advanced cultures this is a skilled medical profession - potentially a graduate one - and quite often a speciality of nursing.


1. full source reference

Game and Story Use

  • Accusations of witchcraft are not uncommonly levelled at the wise-woman variety, especially be dissatisfied or deranged clients (for example women suffering from post-partum depression or grieving widowers).
    • Added possibility in cultures that use rye-blight to arrest post-partal bleeding. The active in rye-blight (a species of grain ergot) is ergotamine, a potent vasoconstrictor but also a psychoactive substance similar to LSD.
  • Likely to be a great source of community gossip and background information.
    • And quite possibly know of the odd scandal and/or children born with unusual features such as cauls or teeth (both traditionally significant), let alone things like tails.
  • A midwife may also be implicated in baby switching (possibly swapping out a noble's daughter for a male child that he can pass off as an heir, or replacing a stillborn child with a live one) and/or determining which of a pair of twins is the elder (as in the story of Jacob and Esau). In some societies, she may also be required to inspect a newborn for defects and report (and possibly kill) one deemed unfit (as in Sparta for example).
    • A midwife is probably also a good point of contact for wet-nurses and potential adopters.
    • Tracing a missing child may start with tracking down the midwife that delivered them.
  • With limited surgical skills, she may also be the best hope for treating your wounded in a rural village - and probably quite sarcastic about male pain thresholds.
  • "Traditional Midwives" can be a serious nuisance in modern healthcare programmes in the third world, impeding maternal health projects with unsuitable or harmful traditional methods, engaging in female genital mutilation and scaring mothers away from vaccination programmes.
    • Or, with the right training and a desire to co-operate, can achieve great things with limited resources.
  • Finding one, especially for a complicated job, can be a surprisingly hard task.
    • Terry Pratchett's Nanny Ogg (who actually is a sort of witch, but not as defined here) has a fearsome reputation as a midwife, which lead to her being specifically sought to deliver the Avatar of Time's offspring in Thief of Time. Her friend and colleague Esme Weatherwax, by contrast, is a midwife with a fearsome reputation … which is not same thing at all.
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