Mariel Tishma
Chicago, Illinois, United States

In the mid-1600s, midwife Justine Siegemund was a household name for mothers in Silesia, part of modern-day Poland. She served patients of every class in Legnica, in Berlin, and beyond, and published an obstetric manual which became one of the most popular midwifery books of its time.

Details on her early life are missing. Likely she learned to read and write from her father, a pastor who ensured she could read the Bible in German.¹ She married, but significantly she had no children, which was considered an essential experience for midwives of the time. However, Siegemund had her own early encounter with birth and midwifery. Her exact condition is unknown—perhaps a prolapsed uterus—but at some point, the midwives in her community believed Siegemund was pregnant and treated her aggressively and incompetently.²

Childbirth at the time was extremely dangerous, even lowering the overall life expectancy for women, so at any sign of difficult labor or pregnancy, family members called a midwife to ensure mother and child survived.³ Therefore, the urgency of the midwives who treated Siegemund could be seen as caution. However, Siegemund felt better-educated midwives would have known what had happened to her. She decided to become that educated midwife for others.

Siegemund began her study with the few obstetrics texts already available. She gained most of her experience firsthand in an unofficial apprenticeship, typical for midwife training at that time.⁴ If a woman wanted to be a midwife, she could attend the births of other women to learn the basics and then develop a professional relationship with an already recognized midwife. Many women also became midwives after birthing their own children and learning through that experience.⁵

In 1659 Siegemund would attend a birth in Rohnstock alongside a midwife who recognized her interest and knew she had read texts on childbirth. Siegemund was able to guide the midwife during that difficult birth. She began her career and expanded her practice, first treating poor women, then taking on more affluent clients as her reputation and experience grew. She was made the town midwife of Legnica (also called Lignitz). Eventually, her name reached the doctors of Duchess Luise von Anhalt-Dessau. They called Siegemund to treat the duchess for a gynecological condition, and Siegemund removed a cervical tumor. As a result, she became the official midwife of the duchess’ court.^6,7

However, with her increased fame she became a larger target for opponents, and when the duchess died in 1680 it left Siegemund open to attack. Another court midwife named Elske Baker complained about her practice.⁸

But a more serious allegation came from Martin Kerger, a doctor in Legnica who had supervised Siegemund’s work at one time. He said that she was greedy, misusing herbs and her experience to speed up births so she could attend more of them and make more money. The case was heard in court, dragging on for four years. The judge called witnesses—Siegemund’s patients—and all of them testified in her favor. Male doctors from the medical school in the surrounding area agreed with Siegemund’s testimony and believed she was competent, and so cleared her name.⁹

After this ordeal, Siegemund moved to Berlin, where she continued her work. She caught the attention of Frederick William, the Elector of Brandenburg, who appointed her Court Midwife once again.¹⁰ In this role, she helped the highest classes deliver their children, including the royal family.¹¹ She attended three hundred births in the area,¹² and her services were so in demand that she even traveled to serve noblewomen at other courts.¹³

She then contemplated writing a book. One story suggests that meeting Mary II of England in 1689 was the final push she needed, as the queen apparently encouraged Siegemund to write.¹⁴

Her book, The Court Midwife of the Electorate of Brandenburg, was one of the first German medical texts written by a woman. It was published in 1690 and written in the local German rather than the medical Latin.^15,16 Books on obstetrics and midwifery were primarily written by men, even though women handled most births at this time.¹⁷ Very few women wrote anything at all at this time. They often were not taught to read and write and were not educated on topics that academics thought were important. Women were encouraged to remain silent, as speaking in public was considered immodest.¹⁸

Court Midwife included detailed engravings of the developing embryo by Regnier de Graaf and Govard Bidloo.¹⁹ Siegemund paired these illustrations with her description of anatomy.²⁰ The book was structured in two parts and stylized as a conversation between an experienced midwife named Justina and her apprentice Christina.²¹ The first part contained stories and examples taken from Siegemund’s career and testimonies from her patients.²² The second half focused on the apprentice’s religious education.²³

A large portion of the text is devoted to proving Siegemund’s authority. As a midwife who had never had children, she may have felt that her experience was in question not only from male doctors but also from other midwives and potential patients.²⁴ In response, she wrote that physicians did not need to suffer every disease they treated, so there was no reason that she needed to experience birth in order to care for those who did.²⁵

She included letters from high-ranking officials, medical faculty, pastors, and even Holy Roman Emperor Leopold stating that they approved of her work and that it was under their protection.²⁶ This not only gave credibility to her text but also functioned as a sort of early copyright, asserting that the work was hers and no one else’s.²⁷

At many points, Siegemund writes with compassion towards women, and unlike other texts, she does not describe labor pain as a punishment for original sin. While other medical texts focused on saving the child in instances of life-threatening birth, she always worked to save the mother.²⁸ Mothers were more than the hosts for potential greatness, but rather individuals with value in their own right. She refused to use surgical instruments, including early specula, because she felt they caused too much pain and preferred to use touch.²⁹ She rarely used pharmaceuticals, though she had few that she was authorized to use or prescribe as a midwife.^30,31

Court Midwife contained techniques developed by Siegemund that demonstrate a high level of medical knowledge. This included a two-handed internal rotation to address shoulder presentation, which could be fatal to both child and mother.³² She also described puncturing the amniotic sac to control bleeding.^33,34

Siegemund wrote Court Midwife with a popular audience in mind. The text was explicitly targeted at aspiring midwives, as can be deduced from its construction. Writing in German and not Latin removed a barrier to education that existed for most medical texts. The book was immediately successful, being translated into Dutch in 1691 and going through seven German editions between the year it was published and 1756.³⁵

Not everyone was a fan of the work, however. Dr. Andreas Petermann—a Leipzig professor—and his student, Tobias Peucer, criticized the work. They also confronted the medical college in Frankfurt that had authorized it, claiming that the book was inaccurate. However, the criticism had little effect on the book’s overall success or Siegemund’s career. Later editions of Court Midwife would acknowledge this episode by including Petermann’s exchanges with the faculty at Frankfurt and Siegemund herself.³⁶

Siegemund did not go on to write other texts, and her fame faded with time. But the work she did for her many patients and for generations of future German midwives should not be understated. She died in November of 1705, and at her funeral one speaker said that she had attended over 6,000 births.³⁷

Notes:

1. Jane Beal, “The Childless Midwife: Justine Siegemund of Eighteenth-Century Germany,” Midwifery Today Winter 2014, 55, https://pubmed.ncbi.nlm.nih.gov/25980115/.
2. Nava Blum, Hilary J. Lane, Elizabeth Fee, “Justina Siegemund and the Art of Midwifery,” American Journal of Public Health vol. 100 no. 1 (January, 2010):
3. 68, doi: 10.2105/AJPH.2009.171371.
4. Ibid.
5. H. Sumner Bridenbaugh, “Owning the Birthing Room: Self-advocacy and Proof of Authority in Seventeenth Century Midwifery Manuals,” Oral Presentation, University of Mary Washington, 2020. https://scholar.umw.edu/rcd/40/.
6. Samuel S. Thomas, “Early Modern Midwifery: Splitting the Profession, Connecting the History,” Journal of Social History vol. 43 no. 1 (fall 2009): 117, 119, https://www.jstor.org/stable/20685350.
7. Jane Beal, “The Childless Midwife” 55-56
8. Nava Blum, Hilary J. Lane, Elizabeth Fee, “Justina Siegemund and the Art of Midwifery,” 68-69.
9. Jane Beal, “The Childless Midwife”, 56.
10. Ibid.
11. Ibid.
12. Nava Blum, Hilary J. Lane, Elizabeth Fee, “Justina Siegemund and the Art of Midwifery,” 59.
13. H. Sumner Bridenbaugh, “Owning the Birthing Room.”
14. Jane Beal, “The Childless Midwife” 56.
15. Ibid.
16. Lynne Tatlock, “Speculum Feminarum: Gendered Perspectives on Obstetrics and Gynecology in Early Modern Germany,” Signs vol. 17 no. 4 (Summer 1992): 729-730, https://www.jstor.org/stable/3174533.
17. Nava Blum, Hilary J. Lane, Elizabeth Fee, “Justina Siegemund and the Art of Midwifery,” 68.
18.  Justine Siegemund, The Court Midwife, ed. Lynne Tatlock, (Chicago: The University of Chicago Press, 2005), 2.
19. Ibid, xxiv.
20. Nava Blum, Hilary J. Lane, Elizabeth Fee, “Justina Siegemund and the Art of Midwifery,” 69.
21. Lynne Tatlock, “Speculum Feminarum,” 750.
22. Mei Chan Lund, “Midwifery And Rhetoric: The Power of Rhetoric in Influencing Social Attitudes About Authority in Female Reproductive Care,” AWE (A Woman’s Experience) vol. 5 (2018): 64, https://scholarsarchive.byu.edu/awe/vol5/iss1/11/.
23. H. Sumner Bridenbaugh, “Owning the Birthing Room”
24. Lynne Tatlock, “Speculum Feminarum,” 749.
25. H. Sumner Bridenbaugh, “Owning the Birthing Room”
26. Justine Siegemund, The Court Midwife, 1.
27. Mei Chan Lund, “Midwifery And Rhetoric” 63-64.
28. Lynne Tatlock, “Speculum Feminarum,” 744, https://www.jstor.org/stable/3174533.
29. Ibid, 752-755.
30. Ibid, 757-758.
31. Nava Blum, Hilary J. Lane, Elizabeth Fee, “Justina Siegemund and the Art of Midwifery,” 69.
32. Lynne Tatlock, “Speculum Feminarum,” 733-734.
33. David H. Cropley, “The Two-Handed Internal Rotation” in Femina Problematis Solvendis―Problem solving Woman: A History of the Creativity of Women, 1st ed., (Place of Singapore: Springer Nature, 2020), 82.
34. Nava Blum, Hilary J. Lane, Elizabeth Fee, “Justina Siegemund and the Art of Midwifery,” 69.
35. Lynne Tatlock, “Speculum Feminarum,” 735.
36. Ibid, 730.
37. Ibid, 748.
38. Jane Beal, “The Childless Midwife,” 56.

References:

• Beal, Jane. “The Childless Midwife: Justine Siegemund of Eighteenth-Century Germany.” Midwifery Today Winter 2014, 55-56, https://pubmed.ncbi.nlm.nih.gov/25980115/.
• Blum, Nava, Hilary J. Lane, Elizabeth Fee. “Justina Siegemund and the Art of Midwifery.” American Journal of Public Health vol. 100 no. 1 (January, 2010): 68-69. doi: 10.2105/AJPH.2009.171371.
• Bridenbaugh, H. Sumner. “Owning the Birthing Room: Self-advocacy and Proof of Authority in Seventeenth Century Midwifery Manuals.” Oral Presentation, University of Mary Washington, 2020. https://scholar.umw.edu/rcd/40/.
• Cropley, David H. “The Two-Handed Internal Rotation” in Femina Problematis Solvendis―Problem solving Woman: A History of the Creativity of Women. 1st ed. City of Singapore: Springer Nature, 2020.
• Lund, Mei Chan. “Midwifery And Rhetoric: The Power of Rhetoric in Influencing Social Attitudes About Authority in Female Reproductive Care.” AWE (A Woman’s Experience) vol. 5 (2019): 61-69. https://scholarsarchive.byu.edu/awe/vol5/iss1/11/.
• Siegemund, Justine. The Court Midwife. Edited by Lynne Tatlock. Chicago: The University of Chicago Press, 2005.
• Thomas, Samuel S. “Early Modern Midwifery: Splitting the Profession, Connecting the History.” Journal of Social History vol. 43 no. 1 (fall 2009): 115-118. https://www.jstor.org/stable/20685350.
• Tatlock, Lynne. “Speculum Feminarum: Gendered Perspectives on Obstetrics and Gynecology in Early Modern Germany.” Signs vol. 17 no. 4 (Summer 1992): 725-760. https://www.jstor.org/stable/3174533.