A midwife presents St Anne, naked except for a white cap, with the baby Mary. Ranworth Antiphoner, fol 257.
A midwife presents St Anne, naked except for a white cap, with the baby Mary. Ranworth Antiphoner, fol 257.

I’m excited to introduce a new feature to my blog: interviews! I hope to periodically showcase the work of academics who share some of my interests in the broad areas of gender, culture and family, both in the middle ages and outside of that. My first interviewee is Dr Alaya Swann, who teaches at Blinn College in Texas. I’ve known Alaya since 2006, when we were both studying at the Centre for Medieval Studies. I have lots of fond memories of Alaya from our rehearsals for the medieval drama society, the Lords of Misrule, which I was lucky enough to chair for a couple of years.

Alaya and I managed to catch up in person a couple of years ago, and she told me a bit about her work on her PhD thesis at ASU, titled “Childbirth and Midwifery in the Religious Rhetoric of England, 1300-1450.”  It sounded fantastic, and I found myself thinking of her work this year, as I negotiate the strange state of being a pregnant woman in academia. So I was delighted when Alaya found space in her busy schedule to have a chat with me about her work.

R: Alaya, let’s talk about how you ended up writing a thesis on childbirth and midwifery in the later middle ages. What was your background in this area?

A: I am one of those medievalists who came to the field via fantasy; an undergraduate course at Williams College on Tolkien inspired a curiosity about the Middle Ages, and the beautiful sound of Middle English being read aloud on the first day of my Chaucer class was the point of no return for me. I was incredibly fortunate to study for my MA in Medieval English Literatures at the University of York – a city many times older than any I’d ever lived in. My MA thesis actually focused on representations of Eve as a template for women in the works of Christine de Pizan; I was already interested in women’s bodies in literary texts.

I focused more narrowly on childbirth and midwifery, especially in literary and religious contexts, during my doctoral research. Part of a chapter of my dissertation is an article titled “‘By expresse experiment’: The Doubting Midwife Salome in Late Medieval England” in the most recent issue of The Bulletin of the History of Medicine.

R: I definitely need to check that out! What led you from women’s bodies generally to midwifery and childbirth more specifically? 

A: I’ve been fascinated with birth since I was 13 and held my mother’s hand while she was in labor with my little brother. In the US, women generally have ob/gyns deliver their babies in hospitals; midwives, birthing centers, and home births are still rather rare, though their popularity has been growing in recent decades. My mother had a midwife and wanted a natural birth in a birthing center, but she eventually needed to go to the hospital for a caesarean, due to the small width of her pelvis. At the time, the confusion of the transition from birthing center to hospital seemed of a piece with the rest of that terrifying, exhilarating day, but in retrospect, I think my curiosity about birth, including distinctions between midwives and physicians, originates with that experience.

My interest in medieval childbirth was first sparked when I was taking Chris Baswell’s wonderful course called “English Antiquities: The Disaster of Origin” during my master’s program. We were reading “Kyng Alisaunder,” an English romance from the late 13th or early 14th century, and I found the scene of Alisaunder’s birth bizarrely intriguing. His mother Olympias goes into labor, but his father, a powerful astrologer named Neptanabus, reads the heavens and determines that if the child is born a few days later, he will be far more powerful. Neptanabus instructs Olympias to delay the birth for several days – which she does! I found myself wondering whether the author of the text was ignorant of women’s actual capacities, delighted to exceed the boundaries of real life, or simply dedicated to following literary conventions of extraordinary birth stories. Although the story didn’t make it into my dissertation, it inspired me to examine how stories – including moral tales, plays, and saints’ lives – might tell us more about medieval birth.

R: I love that you explicitly link your interest in childbirth to your mother’s visceral experiences of childbirth, to which you served as a witness. The role of other women in supporting labouring women is so significant in the middle ages, after all! And I think you’re tapping into a real contemporary interest in making birth once again a female-centred experience focused on the labouring woman. A lot of contemporary research on modern birth indicates that midwife-led birth for routine labour can lead to a much more successful labouring experience for women. But tell us about medieval midwives – who were they? Was it in any sense a profession, did those women have formal training? 

A: There’s a lot we don’t know about medieval midwifery; unfortunately, late medieval midwives and birth attendants did not themselves produce a body of literature defining their roles in their societies. There’s no real indication of widespread formal training or apprenticeship, and it’s not even clear that midwifery was necessarily a defined profession, which is why I try to use ‘birth attendant’ in any case where a text does not explicitly use the word ‘midwife’. Midwives were not regulated by licensing laws until the mid-fifteenth century – the early sixteenth century in England – and even when regulations and licenses did start becoming common, they focused more on the moral character and duties of the midwife than on her medical expertise and knowledge.

R: This is a perennial problem when investigating premodern work that was primarily done by women: lack of written material! But what kind of sources do let us build up a picture of the medieval midwife?

A: I have found it surprisingly fruitful to focus on vernacular religious texts – collections of moral tales and saints’ lives, visionary texts, cycle plays, and handbooks written for moral education. The references to birth and midwifery are passing, but they can provide details about contemporary perceptions of midwives and birth attendants. For example, John Mirk’s Instructions for Parish Priests (c. 1400) details exactly how a midwife ought to use her hands to reach into the birth canal during delivery if she fears the infant’s life is in danger and wants to baptize it before it dies. Representations of Salome, the apocryphal midwife at the birth of Christ, implicitly illustrate late medieval understandings about the physical signs of virginity, pregnancy, labor, and breastfeeding through their descriptions of the Virgin Mary’s extraordinary body and the midwife’s startled responses.

R: This sounds fascinating. Ever since Caroline Walker Bynum’s Holy Feast and Holy Fast (1987), scholars have been deeply engaged with the role of the (female) body in late medieval spirituality – but I’ve rarely seen that turned around the other way, to  use medieval spirituality to access real, every day physical experiences for women. You write in your dissertation that midwifery “straddled the boundaries between domestic, medical, and spiritual practices”; were there any tensions or contradictions in the roles the medieval midwife had to play?

A: The absence of texts written the practising women themselves requires me to speculate, but the emphasis on correct baptism in the later Middle Ages surely caused some tension for birth attendants. They were not supposed to baptise unless the infant was in immediate danger of dying, but if the baby did die, the correct recitation of the formula before the moment of death was vital for the salvation of the baby’s soul. Robert Mannyng of Brunne’s Handlyng Synne (1303) even contains a cautionary story about a midwife whose ignorance of the baptismal formula meant the loss of the infant’s soul. I can easily imagine that a birth attendant who failed to baptise an infant quickly enough before its death, or forgot a word or phrase of the formula, would be tempted to lie in order to allow the infant to be buried in sanctified ground or reassure the parents that the child’s soul was not lost.

R: Absolutely; the gap between what was technically supposed to happen and what real experience (and human feeling!) resulted in must be difficult to assess. Which leads me to ask about the role of doctors and scholars. You write in your thesis that “Theoretical knowledge [about birth] proliferated among university-trained scholars, while experiential knowledge remained generally in the realm of female practitioners”; do you find any conflict between these male scholars and female midwives in their attitudes toward/advice on birthing practices?

This is a surprisingly difficult question to answer, as we have very little knowledge of what female midwives and birth attendants actually thought or did. The late Middle Ages were a strange point in time for the field – female practitioners were no longer sole authorities of obstetrical and gynaecological medicine, but male practitioners were not yet widely established or accepted. Texts by learned physicians and philosophers often denigrate the techniques of female practitioners as the errors of foolish old women. However, as a number of historians of medicine have examined in recent years, the texts often incorporate or praise those same techniques, or at least admit that the experiential knowledge gained by female practitioners was invaluable for diagnosis and treatment.

Birth attendants also needed to navigate the boundaries between prayer and magic. Women in childbirth and those who assisted them often used specific charms and prayers, and the associated rituals ran the risk of being seen as superstitious. The prayers and charms that survive sometimes combine Latin with nonsense words; the prayers needed to be said a specified number of times, written on parchment and bound to the labouring woman, or even inscribed on fruit and ingested. Texts by male scholars often condemn these prayers and charms, even as they admit that some remedies used by female practitioners were indeed effective.

R: There must have been some tension between what men-as-scholars would have needed to condemn in their role as theological and medical authorities, and what they needed to accept as pragmatic reality as human beings within a community… But we’re not here today to talk about men, so I won’t get sidetracked! Can your sources give us any insights into the experiences of labouring mothers?

A: I am grateful that one prevalent aspects of medieval birth – the fear of death for mother or infant – no longer resonates so strongly due to advances in obstetrical medicine. Yet I do think that studying medieval childbirth provides an important point of comparison. The texts I study paint a picture of birth as an event interwoven into everyday life, if also tinged with fear and pain. Medieval birth took place in a birthing room at home, where the pregnant, laboring, and post-delivery woman was surrounded with female family members and neighbors giving assistance and advice. To me, at least, the perception of the process of birth as integrally connected to family, spirituality, and community instead of merely a medical procedure is deeply appealing. Similarly, the communal care of pre- and postpartum women for several weeks or months before and after birth implicitly acknowledges the challenges pregnant women and mothers faced – and still face – outside the singular event of birth.

Much of my work has also focused on what birth and midwife imagery can illuminate about other aspects of medieval and modern life. There’s a really lovely passage in Birgitta of Sweden’s Revelations, in which the Virgin Mary speaks about spiritually assisting Birgitta’s son at the moment of death. She says, “I acted like a woman standing by another woman who is giving birth, in order that she might help the infant, lest it die in the flow of blood or suffocate in that narrow place through which an infant exits .… [I] helped him in that narrow space, that is, at his soul’s exit from his body” (Birgitta of Sweden, Revelaciones. VII.13, trans. Bridget Morris). Spiritual rebirth imagery is common today, but it is usually imagined as an individual, internal process; the Virgin of Birgitta’s vision paints the picture of members of a larger community helping one another in times of danger and fear.

R: That’s a very positive note to end on. So what’s next for your research? 


I’m currently working on an article on the attempted pregnancy of Emperor Nero and its late medieval English versions, a version of which I’ll present at this year’s International Congress on Medieval Studies at Kalamazoo. It’s a marvellous story – Nero insists that his physicians make him pregnant so that he can understand the pain his mother experienced during his birth. They secretly give him a potion containing a tadpole and then feed him drinks that will nourish the tadpole for some time. When Nero inevitably experiences pain and bloating, insisting that it is time for him to deliver, the physicians induce vomiting and Nero ‘gives birth’ to a hideous toad. Depending on the version, he either loves it just as all mothers love their children, questions its hideous appearance and is lectured on the dangers of aborting one’s fetus before its proper time, or walls it up so that it will be forever protected (or entombed?).

I’m also working on a project tying some of my observations on medieval midwifery to twenty-first-century rhetoric about natural birth, birthing centers, and holistic medicine. I hope, in the next few years, to work more extensively on representations of female bodies and medicine in late medieval exempla and moral tales. I am fascinated by the brief, odd stories contained in An Alphabet of Tales, an early fifteenth-century anonymous English translation of the Alphabetum Narrationum by Arnold of Liège (1308); John Mirk’s Festial (c. 1380s); and other similar collections. The intersections of medicine, religion, and literature are an underexplored and potentially valuable trove of information on medieval cultures.

R: I for one can’t wait to hear more about Nero’s experiences with pregnancy and his toad-child! Thank you so much for your time; you’ve given me (and hopefully my readers) lots to think about.