Die Hebammenausbildung an der Marburger Entbindungsanstalt um 1880 und der praktische Arbeitsalltag dort ausgebildeter Hebammen

In the present study, an attempt was made to portray midwifery education in Marburg around 1880, based on the notebook of Agnes Dörr. The source promised a gain in knowledge about the organization of teaching at the Marburg midwifery school, which has not yet been the subject of a region-specific historical study. Furthermore, the research on the person of Agnes Dörr as well as on the fellow students listed in the source allowed an insight into the social collective of the midwives trained here. The day-to-day work of midwives at the end of the 19th century, their financial situation and professional perspectives were discussed, also under the aspect of the increasing academization and professionalization of the profession. Difficulties arose due to the source and data situation, which turned out to be more meager than expected in advance. For this reason, some of the examples cited in the paper deviate spatially or temporally from the initially established framework. The starting point was the notebook of Agnes Dörr, who completed a course at the Marburg Midwifery School in 1880. She used it as a notebook in her lessons, which were based on Litzmann's "Lehrbuch der Geburtshülfe für die preußischen Hebammen". At the time of her training, Mrs. Dörr was 28 years old, widowed and had a three-year-old daughter. She came from the Catholic town of Rüdigheim, district of Kirchhain, and, if the prayer at the beginning of the notebook is to be interpreted in this way, felt that the Protestant town of Marburg was a distant foreign country. The spelling errors and lack of punctuation in the notebook suggest that Agnes Dörr most likely enjoyed a basic general school education, but no higher education. As the widow of a stonecutter and daughter of a blacksmith, she was probably accepted and integrated in the village environment without having occupied an outstanding social position. After successfully completing the training course, she worked as a district midwife in Rüdigheim, but received only a very low fixed salary from the municipality, and her income from the births she attended was also low, with only a small number of them. It remains unclear whether she additionally provided for her livelihood through another secondary occupation. Of course, at the time of Agnes Dörr's training, the director of the institution, Prof. Dohrn, had a formative influence on teaching at the Marburg Lehranstalt. He had the reputation of being a great friend and supporter of midwives and of having regarded obstetrics as his main field of research and interest. However, it was also revealed that he, like the majority of medical colleagues of the time, was not sparing with criticism, especially of the midwives' previous training and educational ability. The cooperation of physicians and midwives at the end of the 19th century was outlined. Physicians were dependent on the cooperation of midwives, who attended to the majority of births alone and were responsible for calling in the physician. At the same time, the professional competence of midwives was severely challenged for decades. A fully comprehensive account of this topic, also with regard to women's studies, could not be provided within the scope of this study. Prof. Dohrn was also significantly involved in the new construction of the Marburg Maternity and Midwifery School from 1863 to 1868. The old building was considered completely unsuitable for modern obstetrics, and there were frequent outbreaks of puerperal fever there. The new building, with smaller hospital rooms instead of large halls, was considered useful, even after the conviction was enforced that the transmission of bacteria through contact was the cause of infectious diseases. There were strict official guidelines in Prussia for the admission of students to the courses, which were based primarily on age, physical and mental ability, and moral aptitude. The duration of the courses was not uniform at the various educational institutions; in 1880 it was six months in Marburg. At the end of the training there was an examination on the theoretical and practical aspects of the midwifery profession and swearing in. In tracing the professional biographies of Agnes Dörr's classmates, difficulties arose in the field of everyday history research. Hardly any personal documents such as midwife diaries could be found, since these mostly remained in the personal possession of the midwives and were thus probably simply not archived. Therefore, it was only possible to make isolated statements about the duration of midwifery activity. Those midwives for whom this was possible worked as district midwives until their death or until shortly before. Unfortunately, the work of the freely practicing midwives in particular could not be analyzed extensively in the present study; here, too, the material was lacking. However, on the basis of official Prussian statistics, it was possible to prove that training as a midwife at one's own expense and subsequent work as a free-practicing midwife was by no means an exception in the late 19th century. In terms of age, marital status and social background, the composition of the student midwives in Marburg corresponded to that of other Prussian towns from a comparable period. The majority of the students lived in rural Hesse, were under 30 years of age, and came from an artisanal and agricultural social milieu. There were no indications that more women from higher social classes or with higher educational qualifications were trained in Marburg. It was possible to prove that many midwives were already wives and mothers at the time of the training course or that they became mothers in the course of their professional lives. Precise evidence of the practical feasibility of the role as family mothers and the activity as midwives was not found and, remarkably, this was not discussed in detail in the "Allgemeine Deutsche Hebammen-Zeitung". The economic situation of midwives, especially in rural areas, was meager during the period studied; only in exceptional cases did midwives attend to so many births that a sufficient income was provided. The fixed incomes paid by the municipalities to their employed district midwives were often very low. Fair employment contracts in accordance with official recommendations remained the exception. Through the "Allgemeine Deutsche Hebammen-Zeitung" insight could be gained into the challenges of everyday work as well as into professional-political discussions of the time. However, this must be interpreted against the background that the midwives' newspaper was under medical management, so it ultimately did not represent a completely independent medium for midwives. The professional organization of midwives in associations initially took place primarily in urban environments. The easier journey to the association meetings and shorter distances certainly played a role here, as well as possibly the fact that socially more highly placed, better educated midwives tended to operate their practices primarily in cities because of the better prospects of earning a living, and here they may have taken on leading roles in founding associations and shaping the life of the association, which some rural midwives may have shied away from. The work of the midwives was officially regulated by instructions, and the responsible district physicist was their direct superior. Attempts were made to encourage midwives to undergo further training and education by means of regular examinations. These were carried out regularly in Hesse, at least in those counties where the data allowed a statement to be made. In the last quarter of the 19th century, the regulations on antiseptic work resulted in far-reaching changes in the practical day-to-day work of midwives. As a result of the increasing importance of antisepsis, midwives became further dependent on the transmission of knowledge by physicians, which solidified the hierarchy of those involved and represented a facet in the professionalization of the midwifery profession.