Part of Waiting Room – Women Healers and Patients on the Periphery of Medicine
“Our project takes the collection of the Semmelweis Medical History Museum (SOM) as
its starting point and focuses on a specific scientific topic, namely the presence of women
(doctors, health visitors, healers, midwives) in the history of medicine and the different
roles attached to the female body.”
/curators: Őze Eszter, Lázár Eszter, Gadó Flóra, Nagy Edina/
My installation reflects on the specifically female knowledge around birth (an indisputably female capacity) that has become a profession over the
centuries through midwives’ dedicated work.
An enquiry into the Hungarian history of midwifery makes it clear that despite continuous attacks, midwife-led care has managed to survive and
still has committed representatives who strive to raise the status of their profession within the larger domain of maternity care.
The installation is a subtle yet poignant intervention that employs its chosen technique, materials, and motifs to try and grasp the web-like,
often outcast form of knowledge that midwifery is. Crocheted and knitted from mohair and silk, its patterns were inspired by the herbs whose
Hungarian name contains the word ‘bába’ (midwife): bábaguzsaly (horse-tail) and bábakalács (carline thistle). Ethnographer Vilmos Voigt notes that
medical books from the 16th to 18th centuries seem to have completely omitted any reference to the midwife; the word ‘bába’ appears only as a prefix
in the name of herbs.
The work was co-created by Sarolta Kremmer and Bori Palkó.
Sarolta Kremmer graduated as a sociologist from ELTE University in 2018 and is currently
a student of Midwifery at the Semmelweis University as well as an activist at Másállapotot a szülészetben
(Movement for Obstetric Reform in Hungary). Her research focuses on reproductive rights and the social
implications of birth and motherhood. Concurrently, she also runs her own business, Kis Kos Workshop,
where she rediscovers wool as a material, works with natural plant-based dyes, and creates crocheted
and knitted pieces.
Bori Palkó is a mother of three children, one of them with special educational needs.
She works as a volunteer in several projects aimed at eliminating obstetric violence and has been educated as a doula.
Knitting has been a part of her life for 10 years: for her, it is a form of therapy, self-expression, and passion.
She views birth as a natural life event. She is also a member of the Kis Kos Workshop.
Accompanying essay by me:
“In the Global North, the taboo surrounding birth is closely connected to a 19th-century paradigm shift that replaced birthing women and midwives with doctors and the home with the healthcare system, converting birth from a family affair into a heavily medicalized event. This transformation also meant that the mechanisms creating gender imbalances increasingly gained ground in a domain that used to be ruled exclusively by women. Institutionalization removed the birthing woman from her community, interrupting the continuity of informal knowledge transfer between women. Thereby the mother’s fear of death was replaced by a fear of the unknown.”
(Sarolta Kremmer: How Did Women Become Invisible in Perinatal Care? Új Egyenlőség, 17. 04. 2019)
In my artistic research, I examined the history of Hungarian midwifery, with a special focus on perinatal knowledge as a traditionally female form of knowledge.
Up until the mid-20th century, it was common for women to birth their children on their own or with the help of family members, who were traditionally female and mobilized knowledge rooted in local customs. The first midwives were most probably courageous women who also performed other forms of healing and, according to written sources, developed their own role within the community quite early on. The midwife occupied a special place in society: she dealt with both life and death, sanctity and impurity; performed abortions and forced conversions, fabricated birth control devices, or decided over the fate of disabled newborns, often going against local or state-sanctioned legal practices. Her marginal position allowed her to be in touch with different social worlds, acting as a bridge between them. This, however, also condemned her to a form of solitude, as her ambivalent status and extensive knowledge and power could induce suspicion in members of the community.
After the general healthcare reforms of the 18th century, midwifery gained a somewhat more solid professional status, yet some of its basic facilities were still lacking 100 years later. In the 18th-century Austro-Hungarian Empire, midwifery offered a regulated education, a source of income, and a respected status to women who could, if necessary, use it as a socially endorsed way of leaving their families or communities behind. Midwifery was also a way of gaining a respectable social position for women who were previously shunned or condemned, such as spinsters, young widows, or “fallen” women. The society of midwives had several different “castes”, the spectrum ranging from urban, well-educated midwives to those who worked in small villages with women of lower socioeconomic status. The urban-rural rivalry between these two groups was escalated by the advocacy work of the Hungarian Midwives’ Association (initiated in the early 20th century by male doctors) and related publications, such as the Midwives’ Journal (Szülésznők Lapja) or the Midwives’ Guide (Bábakalauz).
As a result of the 20th-century institutionalization of birth, midwives, who previously worked in the home, were ushered first into birthing homes and later on into hospitals; a move that greatly curtailed their independence, downgrading them to second-rate health workers. Besides the gradual elimination of their original profession, regulated by the world of local customs, this shift also lead to the homogenization of the birth experience and the interruption of birth-related rites. With the marginalization of midwifery and the increased authority of medicalized obstetrics, the knowledge surrounding female anatomy and reproductive functions was on its way to becoming a male monopoly. Yet, according to research, this was a gradual process, as retrained midwives continued to show some attachment to the values medical professionals considered to be quackery. The importance of intuition and female community, as well as the careful attention to postpartum care was still palpable, yet the faith in the positive effect of interfering with natural processes, as well as the rationality of a technocratic view on birth was already present. The latter is an attribute of modern birth culture, also characterized by a controlling institutional system, medicalization, an authoritarian attitude, and the radical separation of soul from body. By the mid-1950s, almost half of the births in Hungary took place in the hospital, but as recollections testify, most mothers still felt averse to giving birth in an institutional setting, far from their home.
The technocratic transformation of birth in Hungary was completed by the 1980s. By 1980, only 1% of births took place at home, and the state withdrew all support from home births. This medicalization brought about a complete withdrawal of midwifery alongside an increase in (not always justified) invasive interventions (including amniotomy, episiotomy, and C-section), which, according to WHO data, still have extremely high rate in Hungary compared to other developed countries.
Concurrent with the processes described above, in 1977, a young medical student, Ágnes Geréb, started allowing fathers to attend births at the delivery room of a Budapest hospital. At first, she was condemned for her actions that defied the official protocol, but as institutions became increasingly sensitized by the 2000s, the presence of relatives at births became more normalized.
Geréb and her followers have fought a much longer and much more agonizing fight with the authorities and the medical community over the attempt to reinstate women’s right to home birth as well as to restore the official status of independent midwifery. This on-going struggle is an enlightening example of the irreconcilability of human rights and the interest of those in power. Two positive outcomes, however, are the 2011 re-legalization of home birth in Hungary (with certain restrictions) and the 2014 law that allows midwives to perform prenatal care if the pregnancy was previously deemed low-risk by an obstetric specialist.
The kind of postmodern, evidence-based model of midwifery and extra-institutional maternity care, represented by Ágnes Geréb and others, challenges the dominant Hungarian practice by transferring the right to exercise control from the doctor to the mother. While this midwife-led, holistic form of care, also supported by the WHO, fully acknowledges the need for medical intervention whenever that is actually warranted, it also prioritizes the importance of mothers’ access to information and their freedom of choice. In turn, however, the medicalized model does not recognize the indispensability of midwives’ work even in the case of low-risk pregnancies and sees no merit in providing information to the mother and other non-professionals around the birth.
The installation reflects on the specifically female knowledge around birth (an indisputably female capacity) that has become a profession over the centuries through midwives’ dedicated work. An enquiry into the Hungarian history of midwifery makes it clear that despite continuous attacks, midwife-led care has managed to survive and still has committed representatives who strive to raise the status of their profession within the larger domain of maternity care. The installation is a subtle yet poignant intervention that employs its chosen technique, materials, and motifs to try and grasp the web-like, often outcast form of knowledge that midwifery is. Crocheted and knitted from mohair and silk, its patterns were inspired by the herbs whose Hungarian name contains the word ‘bába’ (midwife): bábaguzsaly (horse-tail) and bábakalács (carline thistle). Ethnographer Vilmos Voigt notes that medical books from the 16th to 18th centuries seem to have completely omitted any reference to the midwife; the word ‘bába’ appears only as a prefix in the name of herbs.
Bibliography:
Deáky Zita: A bába a magyarországi népi társadalomban. Bp, Centrál Európa Alpítvány. 1996.
Deáky Zita: Egy női szerep – közösségi feladatok és egyéni lehetőségek a bábamesterség tükrében. In: Hagyományos női szerepek. Nők a populáris kultúrában és folklórban. Bp, Magyar Néprajzi Társaság, Szociális és Családügyi Minisztérium. 1999.
Deáky Zita, Krász Lilla: Minden dolgok kezdete – A születés kultúrtörténete Magyarországon. Bp, Századvég kiadó. 2005
Novák Julianna: Normális szülés Magyarországon a 20. század elejétől napjainkig. In: Létkérdések a születés körül. Bp, L’Harmattan. 2015.
Svégel Fanni: A bábamesterség átalakulása a XX. század közepén. In: A Kaposvári Rippl-Rónai Múzeum Közleményei. 2018
