Avner Giladi, in Muslim Midwives: The Craft of Birthing in the Premodern Middle East, presents a history of the midwives of the premodern Islamic period (seventh–fifteenth centuries). The midwives are foregrounded within a broader timeframe that extends through the Ottoman period and includes developments in midwifery in the nineteenth and twentieth centuries.
Giladi sifted an impressive range of Arabic–Islamic legal, medical, biographical and religious sources in search of early midwives and, with recourse to modern ethnographic data, identified relics of past cultural practices associated with traditional midwifery in parts of the modern Islamic world.
Giladi's main argument is that, contrary to the tenor of the male-authored Arabic medical literature that frequently but, it is important to note, not exclusively, assigns the midwife a subordinate role to the male physician, or omits her altogether, the practical expertise of female midwives in obstetrics and gynaecology was probably more advanced than that of the male physicians, who intervened in births only in exceptional cases.
The accelerated urbanization of Muslim societies is linked by Giladi to a stricter enforcement of gender separation, a situation which, in his words, “worked in favor of midwives, who in most cases remained the sole authorities in the birthing room” (p. 162). The main strength of the book is the detail with which Giladi probes the socio-cultural history of the midwife in Islamic societies, highlighting the subtle ways in which he navigates the male and female domain.
The book contributes a useful Islamic perspective to existing scholarship on early modern midwifery and obstetrics (see, e.g., Hilary Marland, The Art of Midwifery: Early Modern Midwives in Europe, London, 1993; Helen King (ed.), Midwifery, Obstetrics and the Rise of Gynaecology: The Uses of a Sixteenth-Century Compendium, Aldershot and Vermont, 2007). It also engages with recent scholarly debates on women and motherhood in medieval Islamic discourse (see Kathryn Kueny, Conceiving Identities: Maternity in Medieval Muslim Discourse and Practice, New York, 2013). The book will appeal to Islamic historians, social historians of medicine and to scholars interested in the history of women and gender in the Middle East.
The book comprises an introduction, six chapters, an epilogue and concluding remarks. By way of introduction, Giladi reveals an ambivalence in medieval Islamic culture towards midwives, reflected in two fourteenth-century authors: Ibn Khaldūn, in his Muqaddima, Introduction to History, accords midwives great respect, while the Cairene jurist Ibn al-Ḥājj al-ʿAbdarī (b. 1336), in his Introduction to Religious (šarʿī) Law, al-Madḫal, is fiercely dismissive of them.
In chapter 1 Giladi convincingly posits that the complex historic male attitudes towards birth and motherhood are key to understanding the ambiguous attitudes extended by male Muslims towards midwives. On the craft of midwifery (chapter 2), he presents the terminology used to refer to the different titles of midwives in the Arabic sources, of which qābila and muwallida are the most frequent (p. 57).
Interesting, with respect to gender relations, is Giladi's examination of the disputed division of labour between the female midwives and male physicians (chapter 3). Scholars, Giladi included, dispute the gap between the theory that is integral to the normative male-authored medical literature and the realities of medical practice. In the context of Muslim midwifery, the issue is further exacerbated by the lack of Arabic female-authored accounts of events inside the birthing room, coupled with the cultural improprieties generally attached to male treatment of women, exceptions notwithstanding. To be sure, a central (not exclusive) role for female midwives, as opposed to male physicians, in Islamic childbirth, is posited in existing scholarship (see Peter E. Pormann and Emilie Savage-Smith, Medieval Islamic Medicine, Edinburgh, 2007, p. 107). Giladi's assertion of the midwives' sustained and prolonged superior command of obstetrics and gynaecology, relative to that of the male physicians, has much to commend it.
The human midwife is largely superseded by supernatural agency extending succour to parturient women in hagiographic accounts of birth (chapter 4). The biographies and diaries are observed by Giladi to be similarly reticent in terms of the midwife, bar a rare mention of midwives in the personal diary of Ibn Ṭawq (1430–1509).
Muslim jurists (chapter 5) conferred necessary privileges on midwives as witnesses in cases implicating women's bodies, with important exceptions. Midwives performed tasks in addition to delivering babies (chapter 6): offering advice to women on infertility, contraception, abortion and, on occasion, performing female circumcision, to cite a few examples. The nuanced argument is that the midwives acted as agents of patriarchy, monitoring women's behaviour and sexuality.
The epilogue focuses on the transition from traditional to modern midwifery in the Middle East.
In the concluding remarks, Giladi usefully summarizes the arguments, succinctly stating the wide role assumed by midwives in historical Islamic societies, with appropriate caveats.
Giladi contrasts the Andalusian physicians al-Qurṭubī (d. c. 980) and al-Zahrāwī (Albucasis d. 1013), who “write appreciatively” of the midwife, with “authors of medical encyclopedias and gynaecological-obstetric treatises in the eastern parts of the Muslim Mediterranean world” (p. 77). In this regard, perhaps a footnote to the Christian (not Muslim) Syrian physician, Ibn al-Quff's (d. 1286) work On Preventive Medicine and the Preservation of Health, Ǧāmiʿ al-ġaraḍ fī ḥifẓ al-ṣiḥḥa wa dafʿ al-maraḍ (ed. Sami Khalaf Hamarneh, Amman, 1989), in which a respected role is assigned to the midwife (qābila), during and after the birth, might have been useful: (see “On preserving the health of the pregnant woman” (fī ḥifẓ ṣiḥḥat al-ḥublā), Arabic text pp. 145–50 (embryotomy, 150) and, “On treating the newborn child, or on preserving the health of the infant” (fī tadbīr al-ṭifl ḥīna yūladu aw fī ḥifẓ ṣiḥḥat al-ṭifl), pp. 151–4).
To sum up, in reconstructing the Muslim midwives of premodern Islamic societies, Giladi has crafted a fitting monument to their remarkable role in the history of Islamic civilization.
