"But don't you wonder to find me scribble so much about family and birth?"
–Pamela Andrews, in a letter to her parents
Scribbling about childbirth
 In The London Hanged, a painstaking catalogue of eighteenth-century juridical practice, Peter Linebaugh briefly laments the absence of equivalent work on childbearing of the period: "The demographic explosion of mid-century has been studied by historians without much reference to women's attitudes to the labour of childbirth," he remarks.1 Similarly, Michel Foucault's The Birth of the Clinic tantalizes us with a single nod to eighteenth-century childbirth among masses of data on ungendered diseases: "One might mention the setting up of a maternity clinic in Copenhagen in 1787," he says, as if in spite of himself.2 In this paper, I treat such passing allusions to the technologies of eighteenth-century childbirth as calls-to-arms: a half-hearted but sufficient invitation to engage in the work of recovering women's neglected medical history. But I also depend here upon less evasive examples of feminist historiography, including recent arguments positioning the ostensibly private matters of women's sexuality, lactation and menstruation at the center of epoch-altering negotiations of public and national power.3
 Shocking as it is that the ancestor of the maternity ward eludes Foucault's "excavating" gaze in The Birth of the Clinic — or, more vividly, that the "birth of the birth clinic" is an unnoticed absence in a book of that name — it is more surprising still that the rejoinder to Foucault resides in Samuel Richardson's celebration of virtue defended and motherhood thwarted, the 1740 novel Pamela. Yet Pamela manifestly exhibits all the curiosity about the eighteenth-century confinement chamber that The Birth of the Clinicconspicuously lacks. I begin with the presumption that something has been elided in each of these texts: in Foucault, women's medical history; in Richardson, the medical endorsement of a heterosexual courtship premised on coercion and physical force. Hence, the work of this essay is the work of compensation: when we bring the two texts together, the gender-torture of Pamela's Lincolnshire confinement and the gender-bias of Foucauldian historiography begin to speak to each other in unexpected and illuminating ways.
 Many eighteenth-century novels offer glimpses of contemporary medical practice; the forceps delivery inTristram Shandy is one unusually explicit example, but we would be hard-pressed to unearth a novel of the period that did not feature a bleeding, emetic or clyster. Nevertheless, Pamela is absolutely unique in that it offers an extended, involuntary "stay" in the politicized and contested space of the eighteenth-century birthing room. In order to read the novel as informed by childbearing politics, this essay begins by showing that Pamela, which is on the surface the story of a successfully evaded seduction, abounds with metaphors and topoi delineating the after-affects of the very sexual congress it relentlessly defers. For example, quite early in the novel, Pamela permits herself an outburst which economically summarizes the future worries she might have as a worn-out, multiparous wife, a few years into a marriage with Mr. B.: she pleads, "Give me courage to stand before this naughty Master! O soften him! or harden me!"4 This extraordinary wish aptly captures the conflict of the breeding wife of an eighteenth-century aristocrat: she can hope that her husband's body will become soft and emasculated, and that through his early impotence she might escape the statistical sentence of ten or more pregnancies that such a woman could expect in her lifetime. Or, she can hope that her own refined, delicate body will flourish and strengthen through the trials of childbearing — though neither a coarsened Pamela nor an impotent Mr. B. fulfills the readerly expectations engendered by Richardson's narrative. By focusing on this and other rich contradictions voiced by Richardson's heroine, I show that, inPamela, a resolute and illogical fixation on pregnancy and birth coexists with an inflexible commitment to a virtue defined solely as sexual inexperience.
 To demonstrate that Pamela's confinement at Lincolnshire is saturated with anxieties about the changing technologies of eighteenth-century childbearing, I draw Richardson's characters into the dynamic midwifery debates captured in pamphlets and medical texts printed in Britain between 1670 and 1790. The three principals of Richardson's narrative, Pamela, Mr. B., and Mrs. Jewkes, are dealt with in turn as character sketches of the modest patient, the libidinous male physician, and the coarse unschooled midwife: the stock figures who people the dramatic debates of childbearing technology in the eighteenth century as invariably as the jester and the harlot animate the commedia del l'arte. While I argue that Richardson has aptly, if unintentionally, condensed the national power struggles over who would control the medical care, the comportment, and ultimately the lives of reproducing women, I am not wholly prepared to equate his concern with the reproductive risks to young women of the eighteenth century with a kind of prescient …(a portion may be missing from the archive from which this post was derived)… Richardson's hands, an acute sensitivity to the physical sufferings of Pamela is marshaled against the older female character Mrs. Jewkes in a cynical class-consolidating gesture characteristic of the misogynist writers of the man-midwifery movement.
 I conclude by aligning my reading of Pamela's confinement with other examples of "body criticism," and by examining this methodology's goal of recovering the historical real through careful attention to literary bodies. Because "body criticism" has often unwarily represented itself as a fatherless school, I think it important to admit that the methods of this paper have an ancestry.5 My reading of Pamela derives from psychoanalysis, for it interrogates the subconscious fixations of a novel that wants very much to be about something else; yet, those Freudian traces are here located within the historical context of an English juridical and medical plot to revolutionize childbearing technology. This is not a paper about the Oedipal family; it is a reading of a series of national interventions in family organization and reproduction which occurred in the eighteenth century and whose after-affects continue to determine our obstetric practices today.
The Discipline of Confinement
Pamela, I find, . . . was in the Time of her Confinement, (that is, when she was taken Prisoner, in order to make me one; for that is the Upshot of the Matter).–Mr. B., Pamela
 When Goodman Andrews is finally moved to travel to Lincolnshire on his beleaguered daughter's behalf, he enters the estate in a fevered pitch of anticipation. Fearful that his daughter has preserved her life at the expense of her virtue, he expects to see material signs of that transgression: he is prepared to read the mark of paternal inattention and of Pamela's own moral inadequacy written on her body in the unmistakable inscription of pregnancy. Judging from his extreme agitation upon entering Lincolnshire, Mr. Andrews virtually supposes that Pamela is "on the table" at the moment he has chosen for his visit, as though this dawdling novel might suddenly adopt the brisk timetables of dramaturgy and surgery. With Mr. Andrews poised at the door, nearly hoping for the worst, a servant informs Mr. B. that a visitor has come; this announcement in turn leads the guest Sir Simon to infer that a "bastard child" has been delivered to Mr. B., a predictable remnant of his notorious dallyings (247-8). Once admitted, Pamela's father reinforces the comic misunderstanding with his slow comprehension: "'Don't be uneasy, Goodman Andrews, [says Mr. B.], your daughter is in the way to be happy!' This alarmed my father, and he said, 'What! then, is she dying? . . . May not I see my poor child? Is she virtuous?' he asks, to which Mr. B. answered, 'As the new-born babe'" (248). Mr. B. allows, or even encourages, Mr. Andrews' misinterpretation. The former's standard of virtue, "the new-born babe," gestures toward a newly delivered child resting by Pamela's side; in this figuration, the baby's presence corroborates, rather than destroys, Pamela's legendary chastity.
 Goodman Andrews may himself be as simple as a child, but we ought not discount his interpretation of a lengthy period of fits and faintings as symptomatic of a premature pregnancy. Pamela's letters to her parents have reported that she is "confined," which in eighteenth-century parlance means both imprisonment and post-puerperal convalescence. Even simple Goodman Andrews would know that a woman of his day is "confined" at the onset of labor and is only released from her medically-enforced imprisonment in the very chamber where she delivered four to six weeks later. Furthermore, Mr. Andrews' reaction is by no means the only proof that Pamela's letters anticipate pregnancy. Pamela writes to her father and mother in a tangle of double-talk, interpretable as a series of signals that she is expecting. Within those letters, she also quotes Mr. B. saying a number of things that indicate his knowledge of a secret pregnancy. For example, the scene when the two try to set their wedding date is rife with such references. In a Monday interview, Mr. B. elects the proximate Thursday for their nuptials, because his mother prepared on a Monday for his birth and was "brought to-bed on the Thursday following" (275). Pamela, regretting associations with another confinement, asks for a full week, Monday to Monday, to prepare for the wedding. But Mr. B. objects, saying: "Why, Girl, 'twill be Seven Months till next Monday" (276). Now, given the explicit connection with his mother's confinement which already appears in the discussion of their wedding date, seven months becomes a calculated exaggeration of his anticipation: the expression "seven-month's babe" knowingly winks upon a child conceived before the wedding of its parents, yet delivered safely under the banner of legitimacy.
 In many other entries during the Lincolnshire confinement, Pamela can be caught referring obliquely to little "bundles" and "blessings:" by troping resolutely on these terms, she continually negotiates the class-bound prerogatives of legitimacy for her child, who does not even exist yet. When Pamela makes clothes "proper to her station" to leave her position as maidservant, Mr. B. says, "for now, at least, you may call your two other bundles your own; and for whatever you may want against the approaching occasion" (335). Pamela responds: "in obedience to my master's commands, [I] took possession, in a happy moment, I hope, of my two bundles, as my good master was pleased to call them" (336). With "bundles" and "the approaching occasion" implying the arrival of a child, Mr. B. imitates Pamela's verbal fixation by adopting a metaphorics of confinement to talk about her imprisonment and release. Pamela refigures the collected packet of her belongings that Mr. B. had troped as an illegitimate child as the vehicle of her virtue when she "invites" one of her bundles, which "were to be the price of my shame:" "come to my Arms, my dear third Parcel, the Companion of my Poverty, and the Witness of my Honesty" (80).
 At one point, Pamela and her employer discuss how her Lenten period has produced sympathetic injuries of ire and distress in him: "I have been in pain for you!" he greets her. And she says: "O sir . . . it was You! And all you do must be good. But this was a Blessing so unexpected!" (250). On the one hand, Pamela appears to think that Mr. B. has made a gift to her of his own pain, to alleviate her own confinement by a mimetic acknowledgment. On the other, each character could legitimately be said to appear happiest when the other suffers in his or her place. Mr. B. smiles when reflecting on Pamela's many trials: "These tender fair ones, I think, bear fatigue better than we men" (220). This exchange seems to confirm that women are childbearing machines, for it echoes all too uncomfortably pseudo-anthropological rumors of marvelously strong peasant women who drop newborns in the field and go right on working. And Pamela, who had said that she "did not think [she] could have liv'd under such a fatigue" (219) now expresses enthusiasm for Mr. B.'s simultaneous moral and physical reconstitution through illness, exclaiming, "How kind a dispensation is sickness, sometimes!"6 During this same reconciliation, Mr. B. says, "'Tis true, my dear Pamela . . . we have sufficiently tortur'd one another;" he anticipates the "comfort that can result from" this mutual punishment (229).
 Amidst the proliferation of "bundles" and "blessings," the most important signal for my thesis thatPamela is a record of a major shift in eighteenth-century childbearing technology is simply the repetition of the multiply signifying term "confinement." Pamela's minutely exact diary of precisely forty-two days of boredom, fever, fainting and limited exercise relieved merely by "squabbling with Mrs. Jewkes" tallies very well with medical records of the obligatory puerperal confinement of the eighteenth century. Charles White of Manchester gives the following, highly disapproving description of the typical confinement adopted by an affluent woman in his Treatise on the Management of Pregnant and Lying-In Women (1773): "As soon as she is delivered . . . [she] is covered up close in bed with additional cloaths, the curtains are drawn around the bed, and pinned together, every crevice in the windows and door is stopped close, not excepting even the key hole, the windows are guarded not only with shutters and curtains but even with blankets, the more effectually to exclude the fresh air, and the good woman is not suffered to put her arm, or even her nose out of bed, for fear of catching cold. [S]he is confined to a horizontal posture for many days together."7 When anticipating the birth of her daughter in 1797, Mary Wollstonecraft "was so far from being under any apprehension as to the difficulties of child-birth, as frequently to ridicule the fashion of ladies in England, who keep their chamber for one full month after delivery. For herself, she proposed coming down to dinner on the day immediately following."8 If late eighteenth-century Romantics and reformers repudiate the discipline of the month-long confinement as unnatural and counter-productive, we can be sure it was rigorously upheld in their time and the previous generation.
 When speaking of her involuntary stay under Mrs. Jewkes, Pamela uses the words, "Bondage and Misery," "distress," "imprisonment" and "my heavy restraint."9 But after Mr. B. arrives at the estate, and particularly after the two have decided to marry, the imprisonment is referred to by all the characters as a "confinement." After their marriage, Mr. B. becomes unexpectedly nostalgic for that time when "my dear Pamela thought herself confined," and he looks back indulgently on that by no means benign phase of their courtship as his wife's "sweet confusion" (280-1). There is a lot of "confusion" in the novel about Pamela's symptoms, and whether or not they signal a puerperal confinement. In effect, Mr. B. comes close to applying our modern term, "hysterical pregnancy" when he protests that "Pamela thought herself confined" at Lincolnshire. Yet, Mr. B.'s reading of Pamela's confinement as self-generated hysterical symptom is a patently self-serving interpretation, one that willfully obscures the force he exerts to keep Pamela confined at Lincolnshire. In effect, he posits the subconsciously motivated symptom as the involuntary component of her confinement, thereby excusing his own role in the imprisonment at Lincolnshire.
 My position on "hysterical pregnancy" is this: while my goal has never been to proclaim that Pamela is literally pregnant throughout the greater part of the novel, or that we have been duped into believing she cares something for her virginity, I believe we should not see the confinement as an "hysterical pregnancy." To this nonproductive confinement in Lincolnshire, I do not apply the term "hysterical pregnancy," nor Mr. B.'s preferred translation, "sweet confusion," on the supposition that "hysteria" bears the burden of its etymology and its inherited uses. Medical writers like Galen rely on "hysteria" as an index of their accusation that the uterus was the locus of female disease and the origin of mental illness. As a substitute, I prefer the term "untenanted pregnancy," which allows us to see Pamela's confinement as a productive performance: a dress rehearsal for the many pregnancies she will have as Mr. B.'s wife.10 Pamela's untenanted pregnancy allows the novel to test the effects of torture on the female body without risking the life of the child, who remains offstage; it is a social agreement arrived at by Mr. B. and Mrs. Jewkes and tacitly by Pamela herself to work through problems that impede the B.'s marriage. The symptoms that Pamela endures are by no means ineffectual or directionless, as "hysterical" might imply: on the contrary, Mr. B. indisputably responds to sitting in attendance on the ailing Pamela. While dressed as the drunken Nan during the attempted rape scene, Mr. B. actually releases her from the assault as a result of watching her body in convulsions: he stops torturing her because her body tortures itself. He first admits: "My passion for you was all swallow'd up in the concern I had for your Recovery," and then resolves that "your confinement should be made easier to you" (178).
 In another sense, Pamela is the tenant of her pregnancy, because hers is the body confined. A vivid enactment of this premise occurs in Pamela's thwarted escape from Lincolnshire. In planning the flight in a letter to her parents, Pamela envisions her exit thusly: "I can then but get out between the two Bars of the Window, (for you know, I am very slender, and I find I can get my Head thro')" (149). She writes hopefully of an easy deliverance from harm, for she is "light" and "small," and feels assured of surviving a slight drop from her window. But Pamela's real escape is as difficult as a primiparous birth: her head can pass through the bars, but she sticks at the shoulders and hips, and has to wiggle out by degrees, like an unassisted baby. Indeed, she would never have succeeded in evacuating this narrow passage without her great resolve (150). For a long time afterwards, she suffers from bruises, and sprains, and feels "deadly sore, as if I had been soundly beaten" (219). The odd and affecting connection between this rehearsal of labor and the torture it resembles conjures some invisible jailer who has "beaten" Pamela for her attempt to leave the confinement chamber by putting herself in place of the newborn child.
 By directing our attention to the nearly bottomless cache of word-play about pregnancy in Pamela, I hope to designate the novel's fixation on pregnancy specifically as unrealized, but no less momentous for all that: Pamela is gravid, or weighty with import, if not actually "breeding." Now, any account of pregnancy as a recurrent trope in Pamela must acknowledge the role of Lady Davers in Richardson's novel, where she is featured expressly to thwart the interpretation I undertake here. For example, when the couple are newly married, Mr. B.'s sister, Lady Davers charges the bride: "[Thou] wilt find thyself terribly mistaken in a little while, if thou thinkest my Brother will disgrace his Family to humour thy Baby-face!" (318). Lady Davers connects the innocent expression adopted by Pamela's own youthful mien with an unseen child of uncertain status and legitimacy, when she calls Pamela "beggarly Brat," and accuses her of "setting up for a Family" (328). By harping on Pamela's "wretched obscurity" and the equally secretive nature of her confinement, Lady Davers continually expects the forthcoming issue of the Lincolnshire confinement, a charge made more concrete when she alleges: "I'll lay thee a Wager, Child, thy stomach's too full to eat" (326). The repellent Lady Davers, like other Richardsonian villains, uses interpretation to express hostility and aggression toward the irreproachable heroine.11 By putting the theory of Pamela's pregnancy into her mouth, Richardson makes curiosity about Pamela's reproductive theatrics a function of Davers' paranoia, and an unattractive position for the reader to adopt. Nevertheless, I do not abandon my reading of the metaphorics of confinement in Pamela because the spectre of Lady Davers recommends retrenchment. Rather, by foregrounding the juridical and medical analogies of Mr. B.'s private imprisonment of his servant-girl, we can begin to recognize the role of class in social coercion of eighteenth-century confinement. Lady Davers and Mr. B. understand Pamela's imprisonment as the logical punishment for servant girls who are either (in Mr. B.'s view) ridiculous and hysterical, or (in Lady Davers') sexually knowing and greedy; with this interpretation, the aristocratic siblings attempt mask their class investment in confinement by focusing on Pamela as deserving her own imprisonment.
 Notably, Richardson uses the same word for Pamela's period of curtailment and surveillance at Lincolnshire and for Clarissa's incarceration in a sponging house on false charges of debt. Foucault also terms the widespread incarceration of the mentally unstable in eighteenth-century France "The Great Confinement."12These diverse confinements have structural matters in common: the individual singled out for restraint is to be deprived of mobility for reasons of protection. What is less clear is, who is protected by the imprisonment of such persons? People are typically confined for these reasons: 1) when mad, they are incarcerated to regain reason; 2) when acting illegally, they are sent to penitentiaries, to feel sorry for a designated time, a notion which allows us to think of years, days, months, as payment for, or as exchangeable with, crimes; 3) when uncontrollable, or medically interesting, to be observed; 4) when roaming, to stop mobility. Why, then, confine parturient women, and why, specifically does puerperal confinement take one specific form? Just exceeding a calendar month, eighteenth-century puerperal confinement compares to quarantine, a military and medical practice for restricting the movements of those suspected of contagion; in Italian, quarantina means forty, for the standardized period of forty days. That quarantines and confinements agree upon a structural matter, the efficacy of a forty-day isolation, is suggestive. More suggestive still is the information that forty weeks is the length of gestation for human fetuses. As a tenth proportion of that gestation, forty days might temptingly present itself as the perfectly reasonable period for a woman's body to recover from that gestation: nature's mandate for universal maternity leave. Yet, because forty days is also the quarantine for ships exposed to scarlet fever and the plague, I am inclined to resist the naturalistic explanation and pursue the connection between puerperal confinement and state-sanctioned limitations of freedom and movement.13
 This section and the next, "Miss Sally Godfrey and the Return of the Repressed," seek to answer the question of why state imprisonment and private confinements cohere in so many factors by arguing that pregnancy in Pamela is understood as punishment, the sentence which predictably attends the crime of sexual congress. The predestined term of pregnancy only compounds the naturalness of reading it as a sentence. When John Bender shows through the lens of literature that the eighteenth-century penal system succeeded in making the criminal coterminous with the crime, he follows Foucault in asserting the superfluity of torture in the panoptic penal system.14 But considering the limitations imposed on pregnant and parturient women of the eighteenth century as a species of para-criminal confinement will allow us to test the hypothesis that torture does not disappear in Richardson's text as Bender and Foucault would suppose, but rather becomes a self-generated penitence which predicts reform far better than a juridically-imposed one.
 Foucault's 1977 round-table discussion "Confinement, Psychiatry, Prison" enjoins us to see the incarceration of non-violent persons as a "condensation" that occurs "on the border between medicine and penality."15 According to his findings, the juridically-endorsed authority to incarcerate large numbers of citizens was "sorely missed" after the French Revolution emptied prisons (188). Once people had been given a civic right to denounce and confine, they resented the abeyance of that right as much as they resented the paranoia and self-indulgence of the regime that had brought it to them (188). The rantings of madness and illness, then, are "unfree speech," specially negotiated to protect the speech of denunciation and reprisal (179). Psychiatry stepped in to grant that right of imprisonment by denunciation, this time constructed as a dictate of public hygiene, to citizens once again. Mr. B. guards his own reputation by locking up Pamela, and especially by intercepting her letters and seeking (unsuccessfully) to limit her ink and paper supply; he believes she and her parents have been very "free" with his reputation even as they trembled under his unilateral power. His imprisonment of Pamela at his private residence in Lincolnshire makes of his home a private lying-in ward, certainly, but also a private Bedlam and Bridewell. Foucault writes that the modern definition of mental illness is impossible without "the invention of a site of constraint," for: "From the middle of the seventeenth century, madness was linked with this country of confinement and with the act which designated confinement as its natural abode."16
 In the logic of disciplinary confinement, madness becomes a place one is removed to: for Pamela, that site is Lincolnshire, "my prison/ my palace" (293). Because Pamela's gravest duty is to ward off Mr. B.'s sexual assault, his restriction of her movement through confinement emerges as a tit-for-tat punishment. She polices a sensate boundary extending all around her body; he responds by putting her in a house of surveillance, walls with ears and eyes. These walls symbolically extend her bodily borders, thereby thwarting the logic of protection and access. If she has been ambivalently lodged in an attractive body that Mr. B. could seize and wrest from her control, she comes to lose all mobility precisely because her boundaries are larger and more acutely watched than ever. This confinement is brutal; more brutal still are the occasions when Mr. B. imposes himself, hidden or disguised, in Pamela's prison of sensations. When Pamela's forty-day confinement is over, she and her employer reconcile and agree to marry; Mr. B. predicts that their troubles will end with the resolution of Pamela's "sweet confusion." Yet, in defiance of Mr. B.'s prediction of general good-will, the haunting memory of Miss Sally Godfrey disrupts the early days of the Mr. B.'s and Pamela's marriage, insistently reminding Pamela, even after her release from imprisonment, of the technologies of torture used in disciplinary regimes eighteenth-century of puerperal confinement.
Miss Sally Godfrey and the Return of the Repressed
Indeed, indeed, Sir, I bleed for what her Distress must be in this Life. –Pamela on Miss Sally Godfrey
 It would be one thing to fill page after page with potent double entendres and treat them as references to childbirth: but without the figure of Miss Sally Godfrey, Mr. B.'s "true harlot" and the text's moral antonym to Pamela, such wordplay lacks direction. More important than tallying an infinite cache of puns about pregnancy is answering the question: why clutter up the story of a successfully eluded seduction with dozens of red herrings signifying pregnancy? These signals about confinement are emphatically not false leads, but rather crucial debates of class difference, of legitimacy, and of childbearing technology; problems to be resolved before the marriage can begin in earnest, and before the figural representations of confinement can give way to the literal childbearing that Mr. B. anticipates. Sally Godfrey is the one bit of repressed information that Lady Davers provides and Mr. B. attempts to conceal; acknowledging her as such gives direction and shape to the text's figurative images about pregnancy: she is the "little Weight [that] turns the Scale" (228). Pamela calls Miss Sally Godfrey, suggestively, "the only difficulty I had to labour with" in accepting Mr. B. as a mate (364). Godfrey, according to Lady Davers, was Mr. B.'s "first harlot," and moreover, an upper-class woman far above Pamela in the social strata. Yet Godfrey's immoral family allowed her to become Mr. B.'s mistress, presumably to make a desirable social connection and cement his affections permanently. Sally Godfrey became pregnant, bore Mr. B.'s daughter, and summarily renounced her seducer. Some hush-money allowed Godfrey to move to Jamaica, where she lives at the time of the novel, passing herself off as a widow of good fortune. Godfrey's daughter remains in England at a boarding school under Mr. B.'s financial guardianship (396).
 While she reads Mr. B.'s tedious marriage contract, Pamela reacts to his priggish and egotistical strictures with the apparently unmotivated musing, "I wonder whether Miss Sally Godfrey be living or dead?"17 Pamela's distraction registers her recognition that Sally Godfrey apparently accepted the first contract presented to Pamela, which offered such shaky assurances in exchange for a sexual relationship as, "I know not (but will engage not for this) that I may, after a twelvemonth's cohabitation, marry you" (167). Charlotte Sussman declares Miss Sally Godfrey's totemic name the single locus of rebellion in Pamela, something which "continually disrupts Pamela's descriptions of her happy married life."18 Here, Sussman alerts us to the valence Godfrey brings to the text:
At moments like this, Pamela's suppression of her curiosity about Sally Godfrey's fate becomes a sign of her continued love and loyalty toward Mr. B., indicating that there are certain areas of experience of which a good wife should remain willfully ignorant. . . . The few rebellious thoughts that Pamela thinks are often thoughts of Sally Godfrey — thoughts whose almost simultaneous expression and suppression are central to Pamela's articulation of her new identity. The possibility that there is a story about women that is different from her own both produces Pamela's resistance to Mr. B. and suppresses it. (97)
Yet, why Miss Sally Godfrey, and no other, is the ideal spectre to haunt Pamela does not emerge from this passage. Simply characterizing her as the "road not taken" in Pamela's relationship with Mr. B. remains, I think, insufficient to account for Pamela's obsession with her master's former lover. In truth, Sally Godfrey's unfortunate motherhood stands not for Pamela's averted past, but for her imminent future, for she will soon be dealing with Mr. B. as a sexual partner and co-parent. And, as his own admissions indicate, Mr. B. was a most callous companion to Miss Sally Godfrey during her pregnancy and confinement. Mr. B. says that Sally Godfrey "suffer'd so much in Childbed, that nobody expected her Life" but that he himself so much depended on her resuming "her former fault" that he "intended to make her a Visit as soon as her Month was well up" (396). Mr. B.'s self-satisfied conclusion, "These tender fair ones, I think, bear fatigue better than we men" is, consequently, derived as much from witnessing Sally Godfrey's recovery from a life-threatening confinement as from watching Pamela's Lincolnshire sufferings.
 The late announcement — four-fifths of the way through the novel — of Godfrey's tortuous delivery and slow convalescence positions her as an apt coda to the story of Pamela's confinement: the reader has seen a woman confined but not delivered; a motherless child appears, and the story of the child's conception and birth follows shortly. Taken together, Sally's and Pamela's tales constitute one complete pregnancy and parturition, with one live offspring. Pamela is deeply affected by the tale of Sally Godfrey, and the suggestive rhetoric of her response reinforces the sympathetic association between the bodies of the two women:
–Indeed, indeed, Sir, [Pamela said] I bleed for what her Distress must be in this Life: I am grieved for her poor Mind's Remorse, thro' her Childbed Terrors, which could have so worthy an Effect upon her afterwards; and I honour her Resolution; and should rank such a returning dear Lady in the Class of those who are most virtuous, and doubt not God Almighty's Mercies to her; and that her present Happiness is the Result of his gracious Providence, blessing her Penitence and Reformation. (396)
 No doubt, Pamela sounds quite charitable towards her husband's former mistress, except in one respect: her problematic supposition that the very difficulty of her childbirth inspired Sally Godfrey's reform, that "her Childbed Terrors [had] so worthy an Effect upon her afterwards." This pious speech smacks of "just deserts" and seconds the early gynecological establishment's moral teachings that labor should be painful for all women, but especially so to punish those wicked enough to conceive out of wedlock.19Pamela fixes on Miss Sally Godfrey as an object of bodily sympathy for her own confinement, but also seeks to strongly disavow her susceptibility to such a sexual history. She "bleeds for Sally" at this narration, and arguably suffers for our eyes on behalf of the repressed and absent Sally Godfrey, but the idea that Pamela would imitate Sally in relinquishing her sexual life with Mr. B. after the "moral lesson" of a single labor flies in the face of expectations created by their long-postponed consummation: it contradicts readerly understanding of this narrative as a recipe for producing the bourgeois family.20
 Sally Godfrey's dual purpose of identification and disavowal makes her an anchor for the text, in Elizabeth Grosz's terms: she is a point where power articulates its ideological stance. Here, in Grosz's digestible version of the Foucauldian position on pre-bureaucratic discipline, are the uses served by the scapegoat figure: "Where punishment is envisaged as a system of clearly legible signs to be read by the populace, the criminal's body must become 'literary,' capable of bearing meanings and of being deciphered as a sign of prevention. No longer a force against which the sovereign's might is pitted, as in the earlier system, the body becomes a book of instruction, a moral lesson to be learned."21 Consorting with Sally Godfrey figures ironically as a "lesson" for Mr. B., though one which he takes years to profit from: "That they afterwards met at . . . every neighboring Place to Oxford; where he was then studying, as it prov'd, guilty Lessons, instead of improving ones; till, at last, the effect of their frequent Interviews grew too obvious to be concealed" (395). The wry use of "lessons and interviews" may have as its intended target Mr. B.'s schooling habits, and his habit of poring over women's bodies instead of books. But, for the moral education of Pamela which is the novel's real concern, Sally's swelling body is the paramount lesson of the past; truly, her instructive value for Pamela is "too obvious to be concealed." Confinement and concealment of female sexuality within the watchful bourgeois family are the violent suppressions which conjure the ghostly figure of Sally Godfrey.
 The "harlot's" body thus instructs Pamela, though her defining characteristic, extramarital sexuality, is roundly disavowed, just as reading the criminal body makes citizens' bodies more pliant and well-behaved even as they learn not to imitate the crime. Pamela is relieved to "have had the Grace to escape the like Unhappiness with this poor Gentlewoman" (393). As a repressed story of an injured body which continually returns to Pamela's consciousness in the early days of her marriage, Sally Godfrey's narrative ultimately elects pregnancy, labor, and confinement as punishments exacted on misbehaving bodies, equivalent to state-mandated corporeal punishment but frighteningly pervasive because private, domestic, and undecried. Confinement is, in short, all the more fruitful a discipline for the writing it leaves behind on changed and worn skin.
 Until Sally Godfrey's story is completed, the text offers no assurances for the survival of a parturient mother, and especially threatens the lives of seduced and unmarried girls. Before the settling of the marriage contract, when Pamela still fears a "sham-marriage," a gypsy visiting the Lincolnshire gate puts a curse on Pamela: "[Y]ou had best take care of yourself: For you are hard beset, I'll assure you. You will never be marry'd, I can see; and will die of your first Child" (195). This premonition must be exorcised by the assurance of Sally Godfrey's living (and uninspected) body, and, importantly, by the successful interview with the beautiful daughter of Sally and Mr. B. Shortly after their marriage, Mr. B. presents Pamela with four "little Ladies" from a nearby boarding school and asks her which is the prettiest. Pamela prefers "genteelest shap'd" one, the pretty black-eyed Miss Goodwin, a spontaneous choice which gives Mr. B. the confidence to own Miss Goodwin as his daughter by Sally Godfrey (391-2). With the disingenuous charm of a magician who tenders a doctored deck of cards, Mr. B. approves the felicitous accident of her selection. Despite the "fixed" aspect of the gamble, Mr. B. does allow her, in choosing the daughter, to have the assurance of a lovely and healthy child after her exhausting "untenanted pregnancy;" the nomination of the prettiest child accedes more power to Pamela than she has so far had in any aspect of her "sexual contract" with Mr. B.
 Sally Godfrey's childbearing is emphatically not an experience about which, as Sussman writes, "a good wife should remain ignorant" (97). Rather than establishing her virtue by ignoring the fate of Sally Godfrey, Pamela seems to be trying to learn how to survive her own confinement by prodding Mr. B., who slowly and tantalizingly yields Sally's whole story. Not only does Godfrey's horrific delivery loom as the medical possibility Pamela contemplates while reading her marriage contract from Mr. B.; so too does Miss Godfrey's fate — of being subject immediately to postpartum caresses from the inconsiderate Mr. B. — promise to repeat itself in Pamela's near future. Formerly an illicit suitor of Miss Godfrey with few legal claims on her, Mr. B. was refused audience by the young woman and her family after her confinement. But he would be within his rights as a petitioning husband when Pamela's time has come. When Mr. B. regrets his attachment to "Precise, perverse, unseasonable Pamela," this epithet condenses a number of issues raised by Sally Godfrey's confinement, and particularly to Mr. B.'s declared intent to make sexual demands of Godfrey "as soon as her Month was well up."22Pamela is "precise," so she is likely to follow to the minute a medical recommendation to abstain after delivery. She is "unseasonable" during her Lincolnshire confinement, for she never "comes into season:" i. e., renews her will to copulate and conceive.23 Finally, she is "perverse" because she diverts textual energy away from the business of reproduction with her copious writing, arguably generated to keep pregnancy at bay.
 When Pamela frets, "this new condition may be subject to worse hazards than those I escaped," we enrich our understanding of her dilemma by recalling that well-documented aristocratic preferences for hiring wet-nurses ensured almost perpetual pregnancy for women of Mr. B.'s class. As we saw in the introduction to this essay, Pamela's lament — "O Soften him! or harden me!" — alerts us to the potential for future exploitation of the heroine's body in the creation of a patriarchal family. Dorothy McLaren has pithily translated the eighteenth-century debate on wet-nursing so that there can be no mistake in understanding the harshly constricted options of a young mother of Richardson's day: "the choice for wives during their teeming years in preindustrial England was an infant in the womb or at the breast."24 The commonplace exploitation of women's fertility would vitally concern any young woman contemplating marriage in 1740; but more so, if she understood that marrying in her mid-teens, like Pamela, very likely meant embarking on three decades of breeding.
 Often we swallow the fiction of Mr. B.'s "cost" and Pamela's "gain" in the marriage wholesale, for we fail to note that Pamela's vertiginous rise up the social ladder will have specific bodily repercussions for her, due to divergent technologies of childbearing espoused by the class Pamela left and the one she joins. It is important to note that in Pamela II, Mr. B.'s competing desires for Pamela to breast-feed their offspring, but for only one month, give voice to well-documented aristocratic male preferences of the eighteenth century. Mr. B.'s first desire is that his wife will not be aged and inconvenienced by breast-feeding; more implicitly, he partakes in the long-standing tradition of preventing aristocratic women from taking advantage of the fact that nursing inhibits ovulation. Here Felicity Nussbaum's thesis that "for Mr. B. the issue of breastfeeding involves both class privilege and male prerogative," illuminates a feminist interpretation of Richardson's didactic marriage plots.25 I also endorse Nussbaum's theory that "[Mr. B.] wishes to prevent Pamela's descending to her origins," but I think it less important to pursue the linguistic dimension of that fear that "she will become an insipid, prattling nurse . . . a fool and a baby herself" than to make more explicit than Nussbaum does the striking class features of the expression "descending to her origins." Pamela's class-origins would certainly have recommended her as an eighteenth-century wetnurse, if she had returned to her parents and married within her class instead of undertaking the Lincolnshire confinement. Mr. B., like any aristocratic heir of his day, was certainly lodged in a cottage very like the Andrews' for the first two years of his life while being breast-fed by a woman of Pamela's class. By marrying Pamela, Mr. B. is not only regaining his nurse-figure, and recuperating her problematic social standing to make her into an object worthy of his love; but he is also "rescuing" Pamela from the fate of being a hired breast. So Mr. B.'s need to dictate the conditions of Pamela's lactation bears a complex relationship to the idea of "origins."
 Recall Mr. B.'s theory that his own indulgence of Pamela's acquired pursuits — reading and writing — have made his servant ill-fit to be the "Wife too of some clouterly Plough-boy" (202). Being the wife of a "clouterly Plough-boy," though impoverishing, has distinct advantages strictly related to childbearing. While aristocratic families, or those with pretensions to their status, were producing so many infants, married women of the lower classes had more control over their fertility, a control arising from paradoxical causes. Breast-feeding as a monetary good in the rude cottages of Mr. and Mrs. Clouterly Plough-boy at the very least supposed that the lactating woman's health was worth preserving, if only because she needed to continue to produce marketable milk. Meanwhile, wealthy women cast off living children to maximize their future production of unborn ones. There can be no doubt that "wet-nursing endowed lower-class women with this form of bodily self-management by systematically taking it away from the mothers socially above them."26 When Pamela wonders: "O why was I not a Duchess . . . but must labour under the Weight of an Obligation," we should listen carefully to this by-no-means idle reference to childbearing practices (215). Had she been a Duchess, or at least a Darnford, Pamela's expectations of her new role would have been markedly different, in starkly material ways: her labor, a future trial "so sore upon her" does not impact the whole "weak sex" the same way. As Ruth Perry notes of the early eighteenth century, this is childbearing on a production-geared model, all-too-analogous to the multiplication of goods and capital in agricultural or industrial arenas (185). With this in mind, Pamela's attempts to gauge her own value as a "cypher" in the arithmetic of the aristocratic family come to resonate with the compensatory message that multiplying in her womb will make "conceiving" both her "duty" and the "honor" of her condition. Here is Perry's industrial maternity recast as pious and sentimental by Richardson's heroine:
Then shall I not be useless in my Generation! Then shall I not stand a single Mark of God's Goodness to a poor worthless Creature, that in herself is of so poor Account in the Scale of Beings, a mere Cypher on the wrong Side of a Figure; but shall be place on the right Side; and tho' nothing worth in myself, shall give signification by my Place, and multiply the Blessings I owe to God's Goodness, who has distinguish'd me by so fair a Lot! This, as I conceive, is the indispensable Duty of a high Condition. (303)
"Squabbling with Mrs. Jewkes": The Midwifery Debates
"Mrs. Jewkes was on the Spot, Madam, at the happy Time." –Mrs. Jervis, Pamela
 Having traced the childbearing motif through Richardson's novel, we can now underscore the novel's complementary fixation on the confinement room servants. First we must record a thorough-going revolution in the technologies of childbearing which occurred between 1700 and 1790 — a revolution first perceptible in the shifting population of the confinement room. Naturally, the laboring woman remains an undeleted component, but heretofore numerous female attendants, including midwife, wet-nurse, mothers and sisters, female friends and female servants, winnowed quite abruptly by the end of the century, to a male obstetrician and his assisting nurse. Because male surgeons incorporated as a guild in the Middle Ages to protect their exclusive right to use surgical implements, the removal of women caregivers from the birth chamber was most easily accomplished by making childbirth a surgical event.27 That is, technologies of childbearing including the forceps and the caesarean-section had to be normalized in as many cases as possible to render a surgeon an indispensable character in the confinement room. This ascension of the surgeon, in turn, depended on a campaign to depict obstetrics as a very dangerous and delicate science, one requiring the skill of a specialist. Moreover, the technological revolution in childbearing relied on a profound shift in class alliances of precisely the type rehearsed in Richardson's Pamela.
 Prior to the mid-eighteenth century, a sexual division of labor in childbearing and childrearing extended beyond the immediate parents to the ancillary figures who attended labors, supervised confinements, and nursed children. That these duties were the province of women had long been accepted as fiat, a by-product of the perceived immutability of gender itself. A notable exception to this rule was the employment of male physicians in royal labors. Certainly the queen and her royal progeny warranted special care, but a more cynical supposition placed the male doctor in the palace bedchamber: his job was to prevent female conspiracies involving substitution or mistreatment of the heir. The royal preference for man-midwives gradually descended through the classes so that by 1720 hiring a man-midwife is understood as a way of "aping the quality."28 A centuries-old prejudice against men in the confinement room unprecedentedly dissolved in approximately seventy years, replaced by equally ardent propaganda in favor of the gentleman obstetrician. This revolution was galvanized by class desires: families far from aristocratic exercised the prerogative to employ a smart young male accoucheur who had studied in Paris or Edinburgh and who arrived at the front door in his own barouche. They could rejoice in not being observed by their neighbors receiving midnight visits from an aging sage-femme.
 Some male doctors resisted this revolution and disdained practicing obstetrics precisely because they believed in the status and learning of their own sex, and hence deplored their petitioning as "mere nurses."29But frankly, many more men protested their exclusion from the arenas of obstetrics and pediatrics with vigor and self-interest because these were and are among the most lucrative professions capitalist medicine affords. Male insinuation into these fields is recorded in the many troubling caricatures of the ignorant midwife, the filthy and inattentive wet-nurse, and the mercenary "dry-nurse" or nanny in "household companions," or books aimed at the aristocratic and merchant-class women who had been used to depend on such women for the delivery and raising of children.30 Men who had themselves been instructed by midwives used their access to the press and to medical theaters to rail against their instructors as women who were dangerously ignorant and cavalier about human life.31 Indeed, it was virtually a requisite "post-doctoral" exercise to follow-up one's training under French midwives with a publication in England proving women's ignorance of the specialization; for extra credit, one might author legislation entitling oneself to license and educate those female teachers in the art of delivering children. As Henry Jones, the "bricklayer poet of Drogheda," flattered the founders of the Dublin Lying-In Hospital, men alone would "Train the Midnight Dame to save the Wife;" the "rational sex" would supervise and ultimately replace woman in obstetrics, lest she "strangle Nature in the Porch of Life."32 By the mid-nineteenth century, infanticide scares rendered the male obstetrician an expensive necessity for nearly all women, for everyone needed protection from the charges of female conspiracy in the event of a miscarried or stillborn baby, and none more so than the poor and unwed who might be accused of having the most to gain by destroying their children.33
 To reconnect Richardson's Pamela with this documented trajectory to scold the midwife out of existence, I examine two crucial figures in the novel, Nan and Mrs. Jewkes: women so wholly consonant with eighteenth-century medicine's misogynist representations of midwives, as to be in no small way a gratisadvertisement against employing midwives for confinements for women of sensibility. Mrs. Jewkes' personality is constructed from the simplest inversion of the good midwife's traits, as described by James Wolveridge: "The best Midwife is she that is ingenious, that knoweth letters, and having a good memory, is studious, neat and cleanly over the whole body, healthful, strong, and laborious, and well-instructed in women's conditions, not soon angry, not turbulent, or hasty, unsober, unchaste, but pleasant, quiet, prudent; not covetous, but like the Hebrew midwives, such as fear God."34 It is possible to use this list of traits to read Mrs. Jervis as the benign midwife figure in the text who is usurped by Mrs. Jewkes because the latter is more amenable to Mr. B.'s devious plans for Pamela's imprisonment at Lincolnshire: the two women together comprise the two sides of midwife propaganda, with Mrs. Jervis as the endorsement and Mrs. Jewkes as the cautionary example. But the novel's extended focus on Mrs. Jewkes indicates where its ultimate sympathies lie: with the gentleman physician, and against midwifery full-stop. The class-straddling alliances promised by this novel compound this hostile message, by marking the aversion to older women of Pamela's class as the surest nomination that a young woman deserves to be delivered from that class, and into the care of men who confer status upon her in recognition of her acute sensitivity to coarse femininity.
 The "muttering maid" Nan, whose rare appearances in the novel emphasize her association with primitive medical care, is a shadowy sketch of an ignorant midwife. In the absence of an apothecary's license forbidden to their sex, midwives allegedly developed a professional dependence on alcohol, as the only stimulant and anaesthetic in their arsenal. In Tristram Shandy, the maid Susannah summons the man-midwife Dr. Slop to replace Mrs. Wood, a "daughter of Lucina [who was, through Mrs. Shandy's preference] placed obstetrically over his head" when "the drops are done — and the bottle of julap is broke."35 "Julap," or more familiarly, julep, is a sugar syrup enhanced with liquor such as bourbon or brandy; with her elixir dashed on the floor, the midwife can no longer offer the laboring mother anything to counteract pain. This stereotypic love of spirits is repeated in Nan's character flaw: "The Maid Nan is a little apt to drink, if she can get at Liquor" (173). Male doctors abused midwives as "ignorant beldames . . . who only crammed their patients with cordials, all the while ridiculing them and making fun of their distress."36 These traits are distributed between Nan and Mrs. Jewkes, with the first bearing all the unflattering associations with alcohol, and the latter all the charges of callous teasing. As Mrs. Stephen has written, "Those who have found it in their interest to bring midwives into disrepute, have charged them with intemperance and obscenity" (Donnison, 34). When Pamela is found after her failed escape, Mrs. Jewkes and Nan doctor her:
Mrs. Jewkes order'd Nan to bathe my Shoulder, and Arm, and Ancle, with some old Rum warm'd; and they cut the Hair a little from the back Part of my Head, and wash'd that; for it was clotted with Blood, from a pretty long, but not deep Gash; and put a Family plaister upon it; for if this Woman has any good Quality, it is, it seems, in a Readiness and a Skill to manage in Cases, where sudden Misfortunes happen in a Family. (156)
It's not hard to derive genital symbolism from this "pretty long, but not deep Gash" with clotted blood, and see Nan's ministrations as remedies to a metaphoric sexual hurt, itself referencing an unseen rape or delivery. Less symbolic than the nature of Pamela's hurt is Nan's method of treating it; for here, she is admitted to have some skill and ability in "sudden Misfortunes" that happen in a Family, including, perhaps, accidents which threaten the safe reproduction of its members. But, in contrast to the grudging compliment above, recall that in the averted rape scene of Pamela, Mr. B. poses as Nan, benefiting from her notorious drunkenness to gain admittance into the forbidden sphere of the confinement room (173-76). One of the "near contemporaries of Eucharius Rösslin, a sixteenth-century author of the medical/conduct book, A Rosegarden for Pregnant Women and Midwives, was burned at the stake for attending a labour dressed as a woman, so that he could witness what happened."37 Mr. B.'s masquerade seems to say: "in this situation an ineffectual and dissipated woman cannot do better than a sharp-witted man, though you would permit her and exclude him."
 In the same scene, Mrs. Jewkes and Mr. B. hold Pamela's arms between them, mimicking the calisthenics of the old style husband-and-midwife-attended labors. The two work together to control the sexual conduct of this symbolically parturient mother. Yet, this scene also marks the beginning of Mr. B.'s dissatisfaction with Mrs. Jewkes as an attendant for Pamela: "since I found Mrs. Jewkes so offensive to you, I have sent her to the Maid's bed," he says after Pamela has regained her composure (177). Though he appreciates Jewkes' loyalty and her willingness to act as jailer in Pamela's confinement, Mr. B. finally begins to take seriously Pamela's charge that Mrs. Jewkes treats her "vilely." More than the obliquely characterized Nan, the literally fleshed-out Mrs. Jewkes stands for the midwife whose professional reputation falters for the very reasons encoded in Jewkes' characterization. For example, Mrs. Jewkes most clearly embodies her role as midwife in the confinement at Lincolnshire when she effectively signals the end of the symbolic parturition with this arresting injunction to Pamela: "Find your legs, Miss, if you please." Pamela is notably angered by this explicit reference to her body's presence at the center of the metaphorics of confinement; she shows the reader how insulted she feels at this statement, which ends, moreover with an injurious touch: "I stood up, and she tapp'd my Cheek!" (324). Pamela's virulent distaste for Mrs. Jewkes' physical presence is worth examining in some detail for its coincidence with misogynist tracts against the midwife:
Now I will give you a Picture of this Wretch! She is a broad, squat, pursy, fat Thing, quite ugly, if any thing God made can be ugly; about forty Years old. She has a huge Hand, and an Arm as thick as my Waist, I believe. Her nose is flat and crooked, and her Brows grow over her Eyes; a dead, spiteful, grey, goggling Eye, to be sure, she has. . . . She sends me a Message just now, that I shall have my Shoes again, if I will accept of her Company to walk with me in the Garden –To waddle with me, rather, thought I. (107)
The hands of Mrs. Jewkes are singularly provocative to Pamela. Practically, their size marks her as brutishly unsuited to the delicate examinations of midwifery. By attributing large hands to a middle-aged woman, and fear of them to her young female charge, Richardson simply applies to Mrs. Jewkes the typical depiction of male attendants, most vividly put by eighteenth-century writers on obstetrics, physician William Douglas and midwife Elizabeth Nihell. William Douglas's 1748 pamphlet against man-midwifery avows that, "a raw-boned, large-handed Man is no more fit for the Business [of deliveringbabies] than a Ploughman is for a Dancing-Master. . . such Monstrous Hands are, like Wooden Forceps, fit only to hold Horses by the Nose, whilst they are shod by the Farrier."38 Elizabeth Nihell peppers her 1760 Art of Midwifery with a complementary obsession with hands, reinforcing Douglas's theory that class-coded physical traits mark one for animal husbandry, or any profession rather than the "delicate arts" of obstetrics. She writes that a man-midwife has "the delicate fist of a great horse godmother."39 Douglas and Nihell, for their part, are compensating for a trend in anti-midwifery tracts, where gentleman-physicians characterize the artisan-class midwife as more animal than human, and as better suited to deliver calves and foals than the heirs of fine families. When Pamela cries "O what vile Hands am I put into!" of Mrs. Jewkes' care during her confinement, she offers male obstetricians an inroad: the male who "put her into" such a woman's hands could engage for the future a clean, gentlemanly pair of hands, perhaps an Edinburgh-trained doctor's.40
 That Mrs. Jewkes "can hardly keep her Hands off [Pamela]," casts medical examination in Mrs. Jewkes' execution as an act of sexual aggression. With this allegation and innumerable others, Pamela endeavors to discourage Mrs. Jewkes' proximity to the confinement room bed. When Mrs. Jewkes "ask'd if [Pamela] will have her for a Bedfellow in want of a better?" Pamela rejects her bed-time companionship (though she had enjoyed the same with Mrs. Jervis), saying, "I would see how it was to lie by myself one Night" (315). The conjunction of sexual depravity and coarse physicality comes from the "long-standing and unsavory reputation" that the midwife moonlighted as "a manager of sexual intrigues."41 By complaining that Mrs. Jewkes talks "more like a vile London Prostitute, than a Gentleman's Housekeeper," Pamela alludes to stereotypes of sexually available women: namely, that in middle age, their faded looks do not curb their interest in sexual matters, but rather compel them into professions like madam and midwife where they may be continually proximate to sexual intrigue and its aftermath. Mrs. Jewkes' service to Mr. B., even to the point of holding down Pamela for his sexual attack, delineates this midwife figure as the "truest friend to lecher."42
 Ned Ward's comic play, The Rise and Fall of Madam Coming-Sir, chronicles the antics of one of Mrs. Jewkes' sisterhood, a legion Ward considers a generic confusion: the "Amphibious Necessary, between Bawd and Midwife." Jean Donnison seconds Ward in declaring that some midwives "were procuresses, or worse." Without lingering over what could be "worse," Donnison continues in this vein, surmising that, "many, like 'Mother Midnight' of Defoe's Moll Flanders, ran private lying-in homes where 'ladies of pleasure' or others anxious to keep their pregnancy hidden, might be aborted, or await the birth of their child in secret" (34-5). For my part, I am not sure whether we should derive the truth that most midwives were "amphibiously" talented in both nursing and procuring from Donnison's fictional sources. I conclude instead that a handful of influential male authors were evidently at pains to depict the figures of midwife and madam as indistinguishable to any person of nice habits. The midwife is an "amphibian," I maintain, not because she is madam and midwife, procuress and nurse, but because her age and appearance cause these male writers to wish her into a new category, a third sex. Separating the older woman from the female gender leaves that category to signify such allurements as "young," "capable of defilement," and "in the bloom of reproductive capacity." One man-midwife captured the gender-crimes of female caregivers in a phrase very evocative of Pamela's complaints about Mrs. Jewkes: "the practice of women" in professional obstetrics, he said, "is much to the injury of the sex."43 Pamela sees Mrs. Jewkes according to the gendered perspective of male physicians which tinge complaints about midwives reiterated a hundred times over in any obstetrical textbook of the eighteenth century: "She is a Disgrace to her Sex" Pamela says of Mrs. Jewkes — not, significantly, "she is a disgrace to our Sex." The midwife, then, must be understood as an obstacle to possessing the young woman, not a middleman negotiating her purchase. Obstetrics, meaning literally, to "stand before," or "stand in the way," positions the midwife between the legs of the young female of childbearing age who is the object of male desire; the station of the midwife and her physical traits are apparently so distasteful that she herself figures as the agent of corruption, merely through her willingness to stand there.44
 Not coincidentally, Mrs. Jewkes' "fat sides" repeatedly "shake with laughter" whenever Pamela pleads her innocence or modesty: the combination of a protesting Pamela and a heaving Mrs. Jewkes is a revisited image throughout the Lincolnshire confinement. Mrs. Jewkes is clumsily made and has none of the graceful litheness of a Pamela: she is far too commanding as a body to appease a young woman who desires not to be reminded of her own embodiment. Particularly crucial are the references to Mrs. Jewkes' size and girth that are given in scale to Pamela: the former has "an arm as thick as [Pamela's] waist." Mrs. Jewkes brags of her own overpowering size with a decidedly unfeminine bravado: "I'll warrant I can take such a thin Body as you are under my Arm" she says to Pamela (117). The proportion between their two dimensions must be always before our eyes, for Richardson's purpose of designating Mrs. Jewkes as outside of Pamela's desirable gender.
 D. A. Miller's fugue on health-care and hypochondria, "The Late Jane Austen," glances into a semiotics of fat characters that we can compare to Mrs. Jewkes: he focuses on the immobile Aunt Bertram ofMansfield Park, the obtrusive Mrs. Jennings in Sense and Sensibility, and the "fatly" sighing senior Mrs. Musgrove inPersuasion. The leap to Jane Austen is a useful one because it situates the older woman's body within the context of the ritualized heterosexual marriage plot, where slender girls and thin plots coincide in the readerly imagination until the occasional disturbance of the fat female body surfaces as an obstacle to happiness, sensibility, modesty and true feeling. Miller writes that, "the fat body, even in the abuse it here receives [in Jane Austen'sPersuasion], figures as a body whose materiality is most clearly irreducible to whatever it may be made to mean — the body most likely to baffle the operations of semiotic liposuction into bearing witness to the violent mutilation that is their truth. The fat body matters, so to speak, but it doesn't signify."45 The large female body poses a semiotic problem, Miller believes, for it "ill qualifies unlike Anne [Elliot's] "slender form" to signify anything so refined and un-Falstaffian as affliction."46I contend that Miller's theory becomes even more intriguing when the slender girl — well-suited to represent affliction because she is thin — must undergo the fascinating and watchable processes of pregnancy, labor, and delivery for the edification of a reader or viewer. The stress engendered in Pamela by this contradiction appears most vividly shortly after Pamela and Mr. B. marry. Mr. B. spans her "Waste" with his hands and says, "What a sweet shape is here! It would make one regret to lose it; and yet, my beloved Pamela, I shall think nothing but that Loss wanting, to complete my Happiness!" (312). Even the expansion of Pamela's body has to be figured as a "loss" and not a gain, and the variant spelling of waist previews nostalgia for its passing which must be mourned in advance. The information that Pamela's body will expand in pregnancy has been repackaged as a fact that might almost be prevented by regretting it. The problem that these weight issues encode is the paradox: how can she suffer in pregnancy, and still be worth watching suffer? Simply put, her body's expansion must be displaced onto the "fat, shaking sides" of Mrs. Jewkes, the incessant quiverings of which are calculated to firm up an imaginary resilience in Pamela's body (314). Mrs. Jewkes "waddles" everyday so that Pamela might never seem too, even when nine months pregnant (107). In a wish-fulfillment gesture belying all that she might learn from the lesson of Miss Sally Godfrey, Pamela says shortly after her marriage, "I have the Pleasure to think I am not puffed up with this great Alteration" (386).
 Richardson's conflation of the midwife's body and the pregnant one she attends was repeated in a 1797 attempt to establish legal ruling on the respective training and duties of male and female midwives through the Surgeons' Court of Assistance. University-educated surgeons simply dismissed the whole idea of a serious consideration of the midwives' demands for a fair hearing "by conjuring up visions of Lincoln's Inn Fields swarming with the drunken blowzy old hags."47 The motion to hear the case was laughed out summarily, but not before the poetaster Belfour immortalized the event:
….. Mr. Howard
Neither peevish nor froward
Who his sentiments never conceals,
Said such nasty old sluts
With their prominent guts,
Should ne'er rump him in Lincoln's Inn Fields.48
The doctor who made the witticism may never conceal his feelings, or his misogyny, but midwives cannot conceal their capacious bellies. The parturient mother, in whose fate the College of Surgeons' claims so much interest, is absent here, but her physical state has been absorbed and exaggerated by the body of the midwife, which is great-bellied without being pregnant. The midwives' "prominent guts" bespeak their proximity to parturient women, and the difficulty of distinguishing patient from caregiver in a birthroom where gender is not the most reliable sign of occupational difference. "Rumple," meaning to "tousle, wrinkle or make unkempt," is here abbreviated to "rump," in part signifying that the "rumpus" in the law courts over midwives would be raucous and unseemly. Moreover, the abbreviation suggests that the rump as the seat of impropriety particularly denotes gross physical femininity in the midwives. In sum, the poem credits hips and bellies alike with making visible and self-evident the ill-suitedness of women to professional realms, like surgeon's quarters and law courts.
 By acting as a lightening rod for anxieties about the physical changes of childbearing, Mrs. Jewkes serves an important function in the confinement room. She deflects weight issues away from Pamela by linking girth explicitly to her personality flaws, suggesting that weight is as unlikely to accrue to Pamela over the course of her marriage as Jewkes' vulgarian taste for bawdy jokes. For this reason, I reckon Mrs. Jewkes would be allowed to remain in the confinement room but for Pamela's complaints, not about her physical embodiment, which we have seen are strategic and necessary, but her language. Pamela rebukes Mrs. Jewkes even when the two are reconciled after the B.'s marriage, saying, "thy chastest stories would make a modest Person blush" (292). The kiss of death for Mrs. Jewkes as a midwife is her disregard for her patient's modesty. She wants to share knowledgeable jokes about how one comes to be confined, about sex, and about female performances of suffering. While continually reinforcing her interpretation of Pamela's confinement as a theatrical effort, Mrs. Jewkes offers a contrasting view of Mr. B.'s desires, as natural, vital, and especially, as well-anticipated by Pamela herself. Jewkes' voice, strength and cruelty are read as masculine; her round body and easy sexual familiarity aggressively female. In the midwifery debates, medical commentators depicted a midwife who leveraged only her sex and her modesty against a male doctor's skill: Mrs. Jewkes disallows even these meager compensations. Because Mrs. Jewkes meets the criterion of a bad midwife, according to the warnings of male obstetricians, she must be removed from service. But, the text does not really offer a licensed male obstetrician to attend Pamela. Rather, Mr. B. will arrogate that role to himself late in the novel and in Pamela II.
"Matrimonial Fantasies": Mr. B. as Gentleman Physician
The feebly eroticized vocabulary of 'encounter' and of the 'doctor/patient relationship' (le couple médecin-malade) exhausts itself in trying to communicate the pale powers of matrimonial fantasies to so much non-thought. –Michel Foucault, "Preface" toThe Birth of the Clinic
 Randolph Trumbach has written that the involvement of gentlemen in the childbearing concerns of their wives was the decisive factor in the closing of the "dark ages" of midwifery and the initiation of an Enlightenment era. He announces that, "the equality of the sexes produced an effort to preserve women from the dangers of childbirth . . . Accordingly, aristocratic men had by 1720 come to agree that in difficult cases of childbirth, men midwives should be employed, and these physicians, once given their opening, managed after 1750 to change the opinion that pregnancy was a disease."49 In effect, Trumbach credits male physicians with curtailing the influence of old wives' tales on the childbearing couple. Yet, I confess I am rather baffled by the common "progressive" notion that, before the eighteenth century, "people thought pregnancy was a disease." Ruth Perry echoes Trumbach's supposition, although her project interprets the same historical shift in an antithetical fashion, for she writes that "companionate marriage is also interpretable as a more thoroughgoing psychological appropriation of women to serve the emotional needs of men than ever was imagined in earlier divisions of labor by gender."50 The statement that pregnancy once appeared to be a disease to our superstitious ancestors smacks of late twentieth century self-satisfaction and technophilia. More than that, such a heroic conception of obstetrics is absurdly short-sighted. In the period Trumbach, Perry, and I research, obstetrics did organize as a profession on the premise of the riskiness of delivery, by arguing that nearly all labors are so potentially life-threatening that making such a process the jurisdiction of uneducated women would be criminally negligent. More recently, the "natural childbirth" movements of the last thirty years present themselves as interventions, not in a superstitious midwifery of the early modern period, but in a quasi-religious reverence for surgical instruments inherited from the eighteenth century. Finally, we have to admit that in our enlightened epoch, pregnancy is being treated as an illness, for it warrants surgical interventions, continual medical supervision, and prescription medicines at every stage of gestation.
 Though we look with satisfaction at the closing of the "dark ages" of midwifery, the fatality rates of parturient women increased demonstrably with every innovation physicians introduced in an attempt to bring childbirth out of the bedroom and into the scientific theater. With the invention of the forceps, came tragically common internal injury, permanent incontinence, or death by hemorrhage; with the hospitalization of parturient women in the early birth clinics came raging epidemics, "childbed fevers," and sky-rocketing mortality rates.51 Midwife Elizabeth Nihell's poignant and exasperated question, "Why do women love their torturers?" is all too apt as a frustrated response to both the man-midwife's ascension and Pamela's turbulent relationship to Mr. B. Pamela's unsatisfactory answer of her bewitchment, "love is not a voluntier thing" may be excused in a romance plot, but is unacceptable for an historical account of medical practice and gender relations. My explanation has been that class desires go a long way toward explaining the ascendancy of the man-midwife: an unflappable faith in the technologies and skill of the male obstetrician has everything to do with the status men brought to obstetrics when they first began to practice it in significant numbers in the mid-eighteenth century. The task at hand now is to restate the connection between the torture-love I have used to characterize the man-midwifery movement and the heterosexual marriage plot in Richardson's novel.
 To pursue my theory that Mr. B. is best understood as a young doctor replacing the midwife figure Mrs. Jewkes, I rely upon Foucault's idea of "le couple médecin-malade" ["the doctor-patient couple"] to show how the obstetric revolution, which resulted in our present two-hundred-year-old tradition of male obstetrician-gynecologists, sought to adapt the gender dynamics of the heterosexual couple to the interactions of the labor room and doctor's office. As a template of that dynamic, I am using the highly charged examinations and conduct-advice which Mr. B. exacts and imposes on his young housemaid and bride. While I admire Foucault's beautifully turned phrase in the epigraph to this section, which protests that the examination of women by male doctors is "feebly eroticized" and possesses "pale powers" of association derived from marital symbolism, my position of necessity contradicts that depiction of a tepid sexual ideology. By deriving the scene of the medical exam from Mr. B.'s confinement and undressing of Pamela, I deduce that, in the mid-eighteenth century when the man-midwife was a newly-minted creature, discourse about the medical examination of women is highly eroticized, and that the resultant matrimonial fantasies are anything but pale in their rhetorical powers.
 Foucault's "couple médecin-malade" is the essential step in the transformation of Pamela and Mr. B.'s relationship from the dyad of "rake and his victim" to "husband and wife." In that intermediary stage where he adapts the medical practice of strict examination to his desire to control Pamela's sexuality, Mr. B. learns reverence for Pamela's modesty: a simple lesson. Yet this simplicity should not foreclose our enquiry into eighteenth-century medicine's deployment of modesty as the central term in the man-midwifery debates. As we will see in our study of the totemic value of the word in eighteenth-century man-midwifery manuals, obstetrics' foundational belief in female modesty turned out to be the best method ever devised for guaranteeing female consent: declaring physical propriety to be the bedrock of female behavior produces pliant and shy bodies, while the obstetrician's own politeness masks the coercion of the exam in a sacramental correctness. Richardson's Pamela demonstrates that imbibing modesty from the shy female patient brings the rake closer to his goal of possessing the female body than rank threats ever did, under the aegis of respected system authorizing unilateral male power over female sexuality.52
 One of the most important sources for illustrating the eighteenth-century's consolidation of the patriarchal powers embodied in the husband and the gentleman physician is John Blunt's 1793 Man-Midwifery Dissected. Blunt's pseudonym, cheeky and self-referential as it is, also pays homage to the great seventeenth-century English midwife, Jane Sharp, in keeping with his case that the midwife is a figure of learning, dexterity, and honor, more fit for obstetrics than her male counterpart. Blunt's text is the most extended case against the man-midwife ever published by a man, and one who was, moreover, trained in obstetrics. Despite this rarity, Man-Midwifery Dissected owes most of its sources, ideas, and blistering rhetoric to Elizabeth Nihell's 1760 Art of Midwifery; and unashamedly so, for originality was not a hotly debated quality among medical texts of the early modern period, and having little to add to Galen or Vesalius was considered rather commendable. And yet, I want to attend to the difference that the unprecedented portions of Man-Midwifery Dissected make: Blunt's addition to Nihell's critique of man-midwifery is to alter her representation of professional obstetric encroachment as a species of gendered warfare with an economic motivation, by duplicating her themes and often her very prose, but in the service of a bourgeois conduct-book lecture on women's modesty and comportment. Blunt, in effect, writes a jealous husband's conduct guide for wives in the guise of a debate on childbearing technology: which is to say, he subjects the scene of obstetric examination to the powers of "matrimonial fantasy." My comparison of Blunt's volume to conduct books of the eighteenth century is not an idle one: Man-Midwifery Dissectedliterally offers itself as the "closet companion for women," in direct reference to the intimate connection between domestic sites and domestic literatures (193). Like the novels of Richardson, Blunt's text is composed as a series of letters, addressed in this instance to a male physician dissuading him from the study and practice of obstetrics. Meanwhile, eavesdropping on their conversation is endorsed by Blunt, who dedicates the epistolary tract to the young bride whose recent marriage authorizes her sexual curiosity. If not quite an epistolary novel, Man-Midwifery Dissected models itself on literary genres directed at female readers in the eighteenth century, especially those which purport to teach women how to imitate the chastity and refinement of sensibility's heroines.
 Blunt's recommendation throughout his febrile book is that a national training system for female midwives is wholly in order. But even such a well-governed body of female professional training as England was patently unwilling to pay for, would never exempt husbands from attending their wives in labor, in Blunt's estimation. A midwife's skill, which Blunt ardently endorses, enables her to catch the infant and cut the cord; but a bourgeois husband's vital interest in the reproduction of his family qualifies him to be present in the confinement room, and, most spectacularly, to appear on every page of Man-Midwifery Dissected. Blunt, in effect, alters the stock cast of the midwifery debates from the trio of libidinous doctor, slatternly sage-femme and modest parturient by consistently directing readerly attention off-stage, where a forlorn usurped husband waits to be told of his wife's crimes with the "peeping" man-midwife. His lurid rumors of divorce suits brought by men finding their wives in compromising bed with the man-midwife the day before or two weeks after delivery compounds Blunt's high-melodramatic pitch and suits his tone of shocking revelation.53 His sole recommendation to alter the inevitable outcome of a man-midwife's employment: dismiss the obstetrician and take his part yourself, reading his lines if necessary and dispensing his prescriptions, provided you are a husband who wants to maintain control of the confinement-room drama.54
 The physician in Blunt's cosmology is himself a clever but puerile sex deviant, morally immature but paradoxically so cunning as to get "free access to the persons of so many fine women, to get their kind husbands out of the room, then to get well paid for their peeping in the bargain" (63). When Elizabeth Nihell asks the savage question "Why do women love their torturers?" she is earnestly at a loss to explain the conspicuous fact that unskilled men are making successful careers though — by their own admission — "the most fatal accidents frequently and inevitably happen to them despite all their science and dexterity" (131). Blunt answers her question by arguing that this love of torture is the same as matrimonial love: that the woman of quality wants to expose herself to a fine young man rather than an older woman: "women can be so men-mad, as to prefer them to skillful midwives, notwithstanding the dreadful risk they run in consequence thereof." Because Blunt sees the obstetric exam as a version of marital sex, he presumes that the wife "tricks" her husband into employing a man-midwife because she wants to be handled by someone as much like the husband as a rival could possibly be. In John Blunt's interpretation of the sexually-charged obstetric exam, the dangers that male obstetricians oblige their patients to accept for their own professional convenience are actually consented to, or viewed as incidental to the bargain, by the smitten women patients. The parturient, we may infer, is more than willing to accept the risks of injury and fatality occasioned by "trysting" with her suitor-physician, because marital life is itself a gamble which leverages the pleasures of sexuality and economic security against the physical dangers and discomforts of reproduction. That the male physician –moneyed, genteel, at home in polite society — might be a suitable lover for the woman of fashion makes him more attractive to the wife and more subversive to the unilateral control of the husband: "No proper transaction can take place between a married woman and a man who is not her husband, which requires her husband's absence," Blunt writes. Moreover, a man who employs a gentleman physician in the cases of his wife's labors has consented to be "a cypher in his own house" (55).
 Mr. B., a young gentleman of rakish habits who is reformed by the strict moral modesty with which a young woman regards her body, is the ideal condensation of Blunt's anxieties about the "giddy boy-midwife." The wedding of Pamela and Mr. B. is replete with assurances of the latter's newly acquired modesty and tact. Pamela quotes her husband as saying, moments before their consummation, "And yet I will indulge my dear Girl's bashful Weakness so far, as to own that so pure a Mind may suffer from Apprehension" (294). In effect, recognition of the "purity" of the Pamela as patient stresses the high-mindedness of her doctor (Mr. B. had always attributed his own sexual thoughts to his serving-maid; now he adopts her squeamishness). Pamela gratefully describes the Mr. B. of the wedding night as bearing little resemblance to the cad who held her protesting body in bed under his own more powerful form just a few weeks before: "No light, frothy Jests drop from his Lips; no alarming Railleries, no offensive Expressions, nor insulting Airs, reproach or wound the Ears of your happy, thrice happy daughter" (296). These are not idle expressions, but particularized qualities of verbal restraint that fashion Mr. B. into the idealized gentleman physician, and make Pamela's wedding night the perfectly strict and proper medical examination, successfully encoded by "matrimonial fantasies." Mr. B's embryonic respect for the female body designates him as the gentleman physician who stands in the place evacuated by the vulgar Mrs. Jewkes: his care with language compensates for not only his own previous error, but for that of the older woman as well. In effect, Mr. B.'s qualities animate both the villain and the hero of Man-Midwifery Dissected, for he begins the novel as the craven encroacher troubling the morality of confinement, and ends as a husband who wants to remain faithfully by his wife's side, taking an active interest in her reproductive events. Mr. B.'s reform realizes the fondest hope of Blunt's text: that the matrimonial fantasy of the gentleman-physician would cease to be illicit, because the doctor would be the husband. Or, in the fullest realization of Blunt's husband-dictatorship, Mr. Cypher would become his wife's medical advisor, so that the enforcement of his every whim and pleasure would have the force of medical prescription.
 Though Mr. B. says "this lovely creature is my doctor, as her absence was my Disease," the inverse dynamic characterizes their interactions (220). We never see him taking her advice, but rather examining her at will and dispensing his own advice freely on the topics of comportment, modesty, and breast-feeding, a collection of concerns perhaps unrelated in the twentieth-century mind but never separate in the medical manuals of the eighteenth century. The medical vexations of Pamela's examinations at Mr. B.'s hand permit us to interrogate a common practice, scarcely ever examined: the inception of other-directed sexual impulses in a childhood episode of "playing doctor." In this indelible memory of role-playing, "patients" recall how they learned to quietly endure inspection, while the dominant child, perhaps not uniformly the male, reveled in the pleasures of exacting consent. While Pamela says, "I am of a Sex that gives no Challenges," she is at that moment (her wedding morning) in the full flush of playing patient to Mr. B.'s strict examiner (320).55 But there is a more figural, or iconographic representation of Mr. B. interposing as a male physician in the text. Though many have been struck by the letter-search scene, where Mr. B. says, "I never undrest a Girl in my Life, but I will now begin to strip my pretty Pamela," this conspicuous declaration has not yet been contextualized by medical convention of the day. Given the soon-to-be-revealed history of Miss Sally Godfrey, this assertion makes no sense at all as a pretense to sexual innocence. Yet, Mr. B.'s memorable proclamation does presage the consolidation of male obstetricians around the rallying-cry of "protecting the patient's modesty." Mr. B.'s attitude of affront-cum-submission as he kneels before Pamela to fumble under her clothes for "evidence" recalls the much-reproduced illustration of the Parisian gynecologist Jacques-Pierre Maygrier (1771-1835) in his own book, Nouvelles Démonstrations d'Accouchements. In this engraving, the author crouches in a cutaway coat to perform an exam upon an erect woman; her skirt is raised slightly by his hand, while her own arms are folded quietly under her bosom. The most noticeable detail of this picture is surely Dr. Maygrier's eyes, which are directed determinedly out of the frame.56 What this most memorable scene of "an indelicate character" illustrates is that when the elaborately clothed Dr. Maygrier averts his gaze, he fixes all the more indelibly in our minds the sexual valence of his examination, precisely because he strives to hide it from himself.57 Eighteenth-century gynecologists usually preferred to examine the patient without undressing her, or facing her directly. As Jean Donnison has noted, "out of deference to the woman's modesty, the man-midwife commonly worked blind, with his hands under a sheet, a practice which sometimes led to serious error" (11).
 Mary Poovey's recovery of the anaesthesia debate in mid-Victorian England exposes a later manifestation of the modesty-fears which continued to trouble the professional status of gynecology for generations. "The professional problem implicit in this scenario" of the exam had, she writes, "stalked male midwives ever since they had entered the lying-in chambers. It stemmed from the charge, set out at mid-century at great length by Samuel and George Gregory, that encounters between medical men and female patients were inevitably sexual."58 Throughout the history of professional gynecology, technology's encroachment into the confinement room has reactivated the modesty debate: in each case, the introduction of forceps, specula, twilight sleep, and ether provoked anxious discussions of sexual collusion between physician and female patient. Obstetrics adapted to these charges in a supple fashion, celebrating what it characterized as an extreme modesty in its examinations. This modesty-effect was garnered by patterning gynecological examination upon the template of the heterosexual couple's ideal consummation, a private transaction between near-strangers whose polite, ritualized conduct reflects the enormous public consequences of their behavior. The examination room is an antiseptic, pared-down echo of the bridal suite, the original scenario where female modesty is an unsacrificeable ideal. Both rooms should be provided with a screen behind which she must undress, a bed where she can be examined, and white sheets to record evidence. Modesty became a kind of hygiene in the obstetric chamber; it is no longer possible to say whether shame or cleanliness dictates the architecture and appointments of that room, for the demands of the two forms of bodily discipline are so neatly in sync.
 In contrast to a crowd of "labor-hunting females," as one man-midwife called them, the population of the consummation/examination room was reduced to two: a man in a position of knowledge about her body, and a woman waiting anxiously under the sheet in a position of ignorance, enduring his assessment.59 The theatrical requirements of the obstetrical discipline begin to offer explanations of why the field could simultaneously celebrate its modesty and fret, as Poovey's work indicates, over the presence of sexual feelings during the exam. While the woman being examined may feel far from sensual in her position as patient inspected by a doctor, there is another way to interpret why the sexual haunts the traditional gynecological exam. The relationship between a man-midwife and his female patient does affirm the primacy of the heterosexual couple-form, though it is not "inevitably" a source of sexual pleasure. In offering women a "modest" alternative to an over-populated confinement room, where females of many classes encircle parturient mother and newborn infant, the new obstetrics frames a couple: man and patient, a pairing as symmetrical but unequal as the "man and wife" of the wedding ceremony. Yet this very potent and clamored-for imitation led to inevitable charges that the male doctor usurped too much of the husband's privilege, even his libido, thereby jeopardizing the sanctity of the bourgeois marriage. As the case of Mr. B. shows, the concerns of doctor and husband should ideally coincide so that the two functions, public and private monitoring of female sexuality, are really expressions of one will. This means that the public doctor should be as private as possible in his relations with the female patient, while the husband should be as clamorous and unmistakable as possible in asserting the civic dimension of his ownership of his wife's body.
 After what we have learned about the making of man-midwifery as a discipline out of the preexisting patriarchal force a husband is entitled to exert, Mr. B.'s struggle to control his own aversion to "the married state" takes on a new significance. Mr. B. explains his obstinacy to himself thusly: wealthy men "cannot think of confining ourselves to common Paths" (240-241). What he fails to notice is how common and predictable the deviation of aristocratic men is: even to an innocent like Pamela, the rake persists as an identifiable type, whose refusal to be disciplined causes him to observe strict clichés about the seduction of women: he cannot think of "confining himself," but he regularly causes women to be confined on his behalf. Mr. B. marvels at how difficult it has been to keep Pamela locked away: "I cannot help observing, that if the mind be not engaged, there is hardly any confinement sufficient to restrain the person" (230). He might be puzzling over his own conversion from a rake, who carelessly and incidentally fathered children, to a man consumed with interest in the power negotiations of marriage and childbearing. These last two, he deems "joys which the narrow soul of the libertine cannot take in, nor his thought conceive!" (300). The physical traits of the male body which authorize his power over women resurface here as an insufficiency for pregnancy and labor: the male can neither "conceive" nor deliver, due to his "narrowness." What he fails to remember, is that for him at least, the engagement of his mind was an attendant effect of his body. He became sympathetically linked to Pamela's body by observing her convulsions and transports in her untenanted pregnancy: "my Passion for you was all swallow'd up in the Concern I had for your Recovery" (178). He stops torturing her because her body tortures itself — in ways that make an interested spectator and an authoritative interpreter out of him, the unsymptomatic physician figure. Through the figure of Mr. B., the conflicting authorities of physician and husband reconcile their mutual fears of usurpation, by fashioning from a reformed rake the idealized "gentleman physician" who gradually learns to be courtly toward his patient-wife, and in so doing, averts the possibility that he will ever be "a mere cypher in his own house."
Operating in the Lincolnshire Theatre: A Conclusion on Critical Practice
"Let us not desert one another; we are an injured body." –Jane Austen on readers and writers of novels,Northanger Abbey
 This concluding section seeks to put my reading of medicine's gender politics into the context of one of contemporary critical theory's most successful cottage industries, "body criticism." I refer to a theoretically non-cohesive and trans-periodist formation of critics drawn by their belief in the centrality of metaphors of the literary body to cultural meaning and reading practice. Among its eighteenth-centuryist practitioners, body criticism understandably seeks to return the languages of anatomy and symptomology to the defining role they command in novels of sensibility. But here I want to apply some pressure to the rhetorics of "natural interest" and naturalism which permeate body criticism. In short, I am presuming that it's worthwhile to be exacting or even a bit cynical about the aims of body criticism and its fascination with the dramatic worth of the injured female body.
 I want to begin my discussion of body criticism with the trope of the operating theater as it recurs in criticism of Richardson'sPamela. Charlotte Sussman's essay, which we have already examined for its implementation of Miss Sally Godfrey, is also a review of Nancy Armstrong's book Desire and Domestic Fiction, and in her deconstructive reading of that book, Sussman takes issue with a scene of a woman being dissected in an operating theater. When Armstrong writes that Lincolnshire analogizes nicely to a panoptic hall of surgery, "that characteristically modern theater," Sussman indicates that Armstrong's metaphor is semi-digested (123). Without disputing Armstrong's notion that Pamela is essentially the "docile body of the cadaver undergoing dissection" throughout her confinement at Lincolnshire, Sussman does regret the unhappy marriage of the dissection analogy and the anti-corporeal reading of the ideological force of Richardson's novel which is at the heart of Armstrong's book:
Armstrong here ignores the disjunction between her claim that power resides in the observer's control of an incorporeal truth which exists beyond the body and the image of the dissector's manipulations of the cadaver on the table — an image of the observer's control over the body itself — with which she illustrates her claim; the truth the doctor discovers beneath the skin is still a corporeal truth. . . . If that body is no longer a site of power, it is still the matrix of a "truth" that must be mastered. (95)
Lincolnshire is never described as a surgery in Pamela, though it is, as we have seen, unconsciously imprinted by political struggles over the eighteenth-century confinement chamber. Yet the dissection motif which forms this striking reading of Pamelapersists in Armstrong and Sussman's readings. Though I would term the attribution of cadaverous traits to Pamela a "misdiagnosis" — a register of the importance of medical rhetoric in Richardson's novel but an incomplete investigation of medical themes in that work — I want to spend more time asking why critics are attracted to a metaphorics of dissection. By shifting the attention from the heroine back onto ourselves, we might recognize dissection not as work of the novel, but as a concretization of our critical practice. Skillful writers like Sussman, Armstrong and Sedgwick conjure surgery, cauterization, and autopsy as suggestive figures emanating in some ghostly way from withinPamela and Sense and Sensibility, but the drive to dissection and diagnosis is misattributed. We must admit as literary critics that the post-mortem is our own praxis: rhetorical figures of surgery in our analysis on novels of sensibility recollect the concealed ancestor of the heroine-focused critic, the character of the women's physician.
 Sussman's own supplement to the autopsy-patient tradition hints at the persistence of this trope in criticism of novels which require patience, even to the point of masochism, from their readers:
Armstrong's choice of metaphor is a telling one, however, because it indicates the paradoxical role of the female body in eighteenth-century ideas of gender. Pamela herself exhibits the fascinating qualities of a cadaver being autopsied during her confinement at Lincolnshire . . . the wasting away of her body serves only to focus Mrs. Jewkes' attention on her extraordinary beauty — a beauty so "deep" that were a surgeon's knife to remove Pamela's flesh from her bones it would find a structure of beautiful bones. (96)
This is a rather paradoxical flight, in itself; one in which the flayed Pamela quietly reclines in Sussman's paragraph for our study and delectation. Her dissected body pays unconscious tribute to the most influential anatomy textbook of the early modern period, Vesalius's De Humani Corporus Fabrica, where skinless cadavers pose calmly on Florentine landmarks. We nearly forget that this harvest of interior beauty constitutes a violent act because Sussman engineers this operation to be performed by an unmanned scalpel: "the surgeon's knife" alone gouges Pamela's body searching for value; "it" alone discovers the beauty in Pamela's nude bones. Pamela may be a mesmerizing spectacle for Mrs. Jewkes because she remains beautiful while starving and hysterical: why need she be an inactive and de-sexed corpse? By neutering and neutralizing Pamela as a "fascinating cadaver," Sussman, I think, overlooks the true stakes of Pamela's ailment during her Lincolnshire confinement. Armstrong's theory that the living Pamela is a cadaver in an operating theater appears and evanesces within a single paragraph, utilized for rhetorical force and then discarded. What I want to highlight here is the critical work of this concentrated trope, the dissected patient, as it recurs in ideology critiques searching for rhetorical tools which will enable us to talk about "real bodies." My dispute with "cadaver criticism" has its origins in the presumption of the docility of bodies in the gendered dynamics of the medical profession. As we have seen, the obedience of the confined female body is a hard-won triumph of the male medical establishment, a by-product of the imposition of family hierarchies, and juridical methods of confinement and torture, onto the scene of treatment. In effect, by making Pamela's body a cadaver, Armstrong obscures the many live and unanaesthetized subjects of surgery and treatment we have found in the troubled history of obstetrics.
 To understand why the dissected cadaver remains the most concise and revisited sign for a dispassionate "anatomy of reading," I return to Foucault's Birth of the Clinic, where the transition from early modern to late eighteenth-century methods of medical symptomology utilized "as its field of origin and of manifestation of truth the discursive space of the corpse: the interior revealed" (196). If "disease was the non-assignable negative" in a live patient whose symptoms and testimony were unreliable, then, "the constitution of pathological anatomy at the period when the clinicians were defining their method is no mere coincidence: the balance of experience required that the gaze directed upon the individual and the language of description should rest upon the stable, visible, legible basis of death" (196). For literary critics drawn to this trope, the cadaver also figures as a reliable alternative to the protagonist-in-process, whose "diseases" of uncertain interiority are so difficult to diagnose. This substitution of static for shifting becomes particularly tempting in the varied terrain of Richardson criticism, for Richardson's accretive, "unpruned" plots ever foil our efforts to make single accurate statements about the enduring motivations of a character. In order to make Pamela a patient we can assess with a quick and reliable diagnosis, we must cast ourselves as her doctors, or, better still, as morbid anatomists. "Seen in relation to death," Foucault writes, "disease becomes exhaustively legible, open without remainder to the sovereign dissection of language and of the gaze" (196). Field-consolidating critics of the body, like eighteenth-century physicians, are "clinicians defining a method;" and the researchers, like our models of scientific objectivity, we prefer a corpse to a living patient. As dissectors of the text, we are able to make irrevocable postulates because the still form before us provokes no sympathetic response, nothing to trouble the sovereignty of our gaze.
 To explain why I think exploiting the surgical injury of the living female body is more problematic than Sussman or Armstrong's fixation on dissected cadavers would indicate, I will briefly read a critical essay which, like this one, straddles the divergent genres of medical history and literary analysis. Eve Kosofsky Sedgwick's "Jane Austen and the Masturbating Girl," a reading of Marianne Dashwood's scenes of transport in Sense and Sensibility, arrives at the very persuasive and historically-functional argument that Marianne is best understood according to a prevalent understanding of sexual minority in the nineteenth century: the compulsive masturbator.60 Despite the soundness of her reasoning and the lusciousness of her prose, Sedgwick's essay is quite difficult to read because of its dramatic introduction of prepubescent sisters, obliquely analogous to the Dashwood girls, whose genitals are cauterized before our eyes, to prevent the purportedly identical obsessive pleasures we see transporting Marianne Dashwood. Sedgwick, curiously enough, finds this medical mutilation very palatable, and unapologetically derails and resumes her essay while the reader's imagination remains writhing, unanaesthetized, in a septic Victorian operating theater. "The Masturbating Girl" demands our submission to medical torture by failing to give us a forum to object, eliminating even the obligatory dismissal of suffering from the doctor's office: "you may experience some discomfort during this procedure."
 I dispute Claudia Johnson's defense of Sedgwick in the otherwise excellent Equivocal Beings, because she allows only one generic description to writing that would talk about the discomfort provoked by "The Masturbating Girl" — namely a "savage attack" — and only one motivation for attempting to intervene in its bewitching spell: historical mystification motivated by prudery.61 I hope to convey that readers seeking out this text for the sensuous pleasure reliably yielded by Sedgwick's deft pen experience at least as much disappointment as Johnson's presumed target, those who want only to be protected from sexual information. I believe that the erotic trajectory which gives shape and energy to "Jane Austen and the Masturbating Girl" is a seduction whereby readers are lured into a theater for pleasure, and then punished for seeking it there.
 Johnson builds her defense of Sedgwick on the indispensable authorization of the body critic's platform: the somatophobia of the rest of the world. In Johnson's estimation, Sedgwick's critics are afraid of the body; the most unctuous and rose-tinted anglophilia causes them to protect "their" Jane Austen from a fleshy world where little girls masturbate and are medically tortured for their compulsion. Perhaps Austen studies are unusually recalcitrant to both historical materialism and sexuality studies; yet I want to ask a larger question about the benefits that accrue to one critic who can level charges of "body fear" at another. Even if we catch other critics engaging in the old dream of transcendence, have we trumped them if we merely invoke the body as a mute given, as unassailable a standard for our time as truth and beauty were for another era? Body criticism often presumes that the organic and hydraulic body of the eighteenth century is transparent to us today, and that it endures in prototype despite the lamentable fragility of individual bodies. What this biology faith offers the critic is at base a troublesome motto: the female body doesn't lie. This post-Freudian arrogance presumes that symptom is the natural language of women, and hysterical embodiment her terribly irrational but most useful communication to us, her diagnosticians and anatomists.
 Sussman writes that Armstrong "characterize[s] Pamela herself as a disembodied mouthpiece of an ideology that gradually subsumes the other voices in the novel" (93). "Disembodied mouthpiece of ideology" resonates marvelously, signaling Richardson criticism that irresponsibly evades organic questions of desire, shame, or of historical materialism, more broadly considered. As Sussman teaches us, to ignore the throbbing body of Pamela is to be seduced by the Puritan cosmology the girl herself ventriloquizes. Further, Sussman's best point may be that readings of the novel as a "battle over signification," while persuasive, unhappily elide the fact that bodily testimony and psychological truth are "mutually constitutive" in sentimental fiction (94). When Sussman arrestingly asks us to acknowledge that Richardson has engineered a five-hundred page brouhaha over an "intact hymen" she evinces palpable impatience with those who would miss this point. Her impulse, to name the hymen as the bodily location of virtue, no longer an abstraction but a membrane, registers as demystifying and frank, and prompts a laugh of recognition: we are all on the familiar terrain of the female body, it seems to say. We know about legibility and virtue in this landscape. The female body wouldn't lie to us.
 I conclude with a puzzling axiom in Armstrong's book, which I struggle to classify either as rhetorical truth or contamination by the anti-corporeal ideology Sussman sees spreading from the puritanical Pamela to her critics. That axiom is: "Mr. B.'s repeated failures suggest that Pamela cannot be raped because she is nothing but words" (116). First of all, we might respond that characterizing Pamela as "nothing but words" devalues the verbal effusions that are expressly generated to convey her suffering to us. As if she understands the literary value of women's suffering, Pamela writes coyly to her parents in a rare rapture that faults her typically class-belying diction: "Don't your heart ake for me?" (56). Of course, Pamela exists only on the page. She is merely language, but we are not, and she knows how to make us ache.
 "Pamela cannot be raped because she is nothing but words" is a neat aphorism; it has the seductive powers of a chanted motto. I think I truly want it to be accurate because it is so catchy. I also want it to be true because it promises to produce a league of safe heroines, unencumbered by fragile membranes. Armstrong's challenge promises to rewrite Austen's sentence, the epigraph of this section: "You may certainly desert us; we are an un-injurable body." Perhaps it is too simple to say that this statement actually fails to describe what it feels like to read Pamela. When I readPamela, my body is afraid for her body. And the perpetual dispersal of rape threats does not prevent the "sensible" reader from conjuring repercussions of sexual encroachment, including pregnancy, confinement, and injury. Finally, though, what this aphorism presumes is that rape is the only way to injure a female body; that unauthorized, extramarital access to the female body, because physical and economic in its impact, is the prototype of all damage; but that such events as occur on the boundary between criminal confinement and health care, between medical torture and childbearing technology, are without detrimental result. I have avoided the continually threatened rape of Pamela –and the "intact hymen" of Sussman's essay–in my belief that mimicking the persistent obsession of Richardson's heroine causes us to assess her, as Armstrong does, as uninjured and unharmable. Proliferating rape metaphors — as in readings of Richardson's novels which equate publication, epistolary circulation and even the act of interpretation with rape — obstruct the realization thatPamela's enduring subconscious fixation turns on the dangerous scene of the eighteenth-century childbed. I have not wanted to simply postdate rape with labor as the "primal scene" through which the truth of women's oppression by men can be read, and thereby succumb to the temptation to treat childbearing as it has been "Ever Since Eve," as one book on confinement is titled. We have seen that the symptoms of Pamela's "distress" are historically specific, though hard to recognize because eighteenth-century medical torture and the domestic immobilization of women have been an under-theorized disciplinary regime.
 My reading of pregnancy in Pamela and eighteenth-century medical writing has tended to forestall interpreting pregnancy as an ailment, but without utopian possibility: in regimes of surveillance, pregnancy is understood not as a sickness but a punishment, a sentence served by, and conveniently inscribed upon, the female body. Finally, my survey of literary criticism's recent theories, which offer literature's relationship to the sensate body as our license to speak about material history, asks if treating the heroine as a patient and arrogantly nominating ourselves as her doctors might miss the point: that we ourselves are symptom-riddled bodies rather than unruffled gazes.
The author wishes to acknowledge the invaluable help of her readers Harry Shaw, Laura Brown, Ewa Badowska, Anne Mallory, Talia Schaffer and especially Margot FitzGerald Backus, for coining this the "gravid herrings" paper.
- Peter Linebaugh, The London Hanged: Crime and Civil Society in the Eighteenth Century (Cambridge: Cambridge University Press, 1992), 325.back
- Michel Foucault, The Birth of the Clinic: An Archaeology of Medical Perception, trans. Alan Sheridan (New York: Vintage, 1975), 58.back
- Including Ruth Perry, "Colonizing the Breast: Sexuality and Maternity in Eighteenth-Century England,"Eighteenth-Century Life16 (1992): 183-215; Valerie Fildes, Breasts, Bottles, and Babies: AHistory of Infant Feeding (Edinburgh: Edinburgh University Press, 1986); and Gail Kern Paster, The Body Embarrassed: Drama and the Disciplines of Shame in Early Modern England (Ithaca: Cornell University Press, 1993).back
- Samuel Richardson, Pamela, or Virtue Rewarded, ed. T. C. Duncan Eaves and Ben D. Kimpel (Boston: Riverside, 1971), 44. All future quotations, except where noted, are from this edition and will be cited parenthetically in the text.back
- Elaine Scarry's The Body in Pain and Francis Barker's The Tremulous Private Body, books of ambitious transhistorical and interdisciplinary scope, were among the earliest examples of this school which has flourished through the eighties and nineties while paradoxically decrying its marginal status. Characteristically diverse in theoretical training, body critics include Mark Seltzer, Americanist, theoretician, and author of Bodies and Machines; psychoanalytic critic of French literature, Jane Gallop, author ofThinking Through the Body; critic of Renaissance drama and culture, Gail Kern Paster, author of The Body Embarrassed; and Elizabeth Grosz, Australian feminist philosopher, theoretician of subjectivity, and author of Volatile Bodies.back
- In Penguin edition only. Pamela, ed. Peter Sabor (London: Penguin, 1985), 292.back
- Quoted in Ian Campbell Ross, Public Virtue, Public Love: The Early Years of the Dublin Lying-In Hospital the Rotunda (Dublin: O'Brien Press, 1986), 157.back
- Mary Wollstonecraft and William Godwin, A Short Residence in Sweden and Memoirs of the Author of 'The Rights of Woman,' ed. Richard Holmes (London: Penguin, 1987), 265.back
- Richardson, Pamela, 110; 143; 148; 150; 158.back
- Judith Barbour, "Mary Shelley's Mathilda and Myrrha." Paper presented at the Literature Club Forum, Cornell University, Ithaca, NY, 15 March 1995.back
- Lovelace is another such hostile interpreter of the virtuous heroine's bodily signals, and he focuses obsessively on Clarissa's putative pregnancy. Though he has more to gain from Clarissa's pregnancy than Lady Davers does from Pamela's (medical and juridical belief that women's orgasm was a necessary condition for conception would color his rape with a retroactive consent), what I'm after here is the airtight nature of a Richardsonian ethos, where our villainy is assured when we attribute any somatic meaning to the heroine's acts.back
- Michel Foucault, Madness and Civilization: A History of Insanity in the Age of Reason, trans. Alan Sheridan (New York: Vintage, 1988).back
- The question of whether confinement primarily protects the parturient mother from the outside world, or the world from her would be answered unequivocally by David Cooper, who says in the dialogue with Foucault: "the ideology of pain and of 'relieving pain' means relieving the pain of everybody around that object — everybody else [protected from the spectacle of another in pain]." Michel Foucault, David Cooper, Jean-Pierre Faye, Marie-Odile Faye, and Marine Zecca, "Confinement, Psychiatry, Prison,"Michel Foucault: Politics, Philosophy, Culture: Interviews and Other Writings 1977-1984, ed. L. D. Kritzman (New York: Routledge, 1988), 197. One reason for confinement might be to signal to the husband and community the precise spatial and temporal parameters of a dangerous period of contamination, as Jane Sharp says of confinement in her Midwives' Book: "And remember that it is the time of her purification that her husband must abstain from her." (London: Simon Miller, 1671), 211-2. In a rare nod to anthropology's binarism, Foucault offers the possibility that confinement revives "the old rites of excommunication"–the lines between clean and unclean, suffering and well, changeable and static.back
- John Bender, Imagining the Penitentiary: Fiction and the Architecture of Mind in Eighteenth-Century England (Chicago: Chicago University Press, 1987).back
- Kritzman, 181.back
- Foucault, Madness, 60; 39.back
- Richardson, Pamela 370; 376; 395.back
- Charlotte Sussman, "'I Wonder Whether Poor Miss Sally Godfrey Be Living or Dead?': The Married Woman and the Rise of the Novel," Diacritics 20:1 (1990): 88-102.back
- Mary Poovey notes that the Biblically-authorized belief declaring painful childbearing as Eve's punishment for eating from the Tree of Knowledge and conspiring with the serpent significantly retarded the medical establishment's introduction of anaesthesia in childbirth. Uneven Developments: The Ideological Work of Gender in Mid-Victorian England (Chicago: Chicago University Press, 1988).back
- For a fuller articulation of this reading, see Nancy Armstrong,Desire and Domestic Fiction: A Political History of the Novel(Oxford: Oxford University Press, 1987).back
- Elizabeth Grosz, Volatile Bodies: Toward a Corporeal Feminism (Bloomington: Indiana University Press, 1994), 151.back
- Richardson, Pamela 209; 396.back
- When Elizabeth Shandy interrupts her husband Walter in the midst of conceiving Tristram to inquire after the clock, the narrator calls it "a very unseasonable question." Though she is "in season," ripe for conception, her speech is out of season for the event. Laurence Sterne, The Life and Opinions of Tristram Shandy, Gentleman (New York: Everyman's Library, 1991), 2.back
- Quoted in Paster, The Body Embarrassed, 44.back
- Felicity Nussbaum, "Polygamy, Pamela, and the Prerogative of Empire," Torrid Zones: Maternity,Sexuality, and Empire in Eighteenth-Century English Narratives (Baltimore: Johns Hopkins University Press, 1995), 85.back
- Paster, 252.back
- "Under medieval guild system, the use of obstetrical instruments was reserved for barber-surgeons alone." Ross, 127.back
- As Philip Thicknesse subtitled his 1779 book, Man-Midwifery Analyzed.back
- Jean Donnison, Midwives and Medical Men (London: Heinemann, 1977), 24. One eighteenth-century student of medicine who refused a specialization in obstetrics wrote: "He who sets up to attend natural labours in a town where there are skillful midwives, may as well offer himself as a lady's maid; nor would it be a more disgraceful employment." John Blunt [pseud.], Man-Midwifery Dissected; Or, The Obstetric Family-Instructor (London: S.W.Fores, 1793), 57.back
- The wet-nurse was vilified as a principal cause of infant mortality, because of her alleged practice of "overlaying": i.e., falling asleep next to the suckling infant and smothering her. In many counties nurses were obliged to provide a crib out of their own money to insure that they would not sleep with the child. Valerie Fildes, "The Wet-Nurse as a Cause of Diseases and Death," Breasts, 188-204.back
- One midwife writes that the famed obstetricians of the day, including William Smellie, were trained by French sages-femmes at the Hôtel-Dieu in Paris, and that as soon as they learned all they could from them, they began lamenting the extreme ignorance and lack of skill of midwives. Elizabeth Nihell, A Treatise on the Art of Midwifery (London: A. Morley, 1760), 145.back
- Henry Jones, "An Ode to the Founders of the Dublin Lying-in Hospital," 1745. Reprinted in T. Percy Kirkpatrick, The Book of the Rotunda Hospital (London: Bartholomew Press, 1913), 7-8.back
- "Under existing law, an unmarried mother who gave birth to a stillborn child was presumed to have murdered the child and was subject to capital punishment." Adrian Wilson, The Making of Man-Midwifery: Childbirth in England, 1660-1770 (Cambridge, Mass.: Harvard University Press, 1995), 180.back
- James Wolveridge, Speculum matricis; or, the Expert Midwives' Handmaid (London: n.p., 1671), 131.back
- Tristram Shandy, 200.back
- Donnison, 33.back
- Philip Rhodes, Dr. John Leake's Hospital: A History of the General Lying-In Hospital, York Road, Lambeth 1765-1971: The Birth, Life and Death of a Maternity Hospital (London: Davies-Poynter, 1977), 18.back
- William Douglas, M.D. A Letter to Dr. Smelle Shewing the Impropriety of his New-Invented Wooden Forceps; and also the Absurdity of his Method of Teaching and Practising Midwifery(London: J. Roberts, 1748), 17-8.back
- Nihell, 35.back
- Even more oddly, Mrs. Jewkes menaces Pamela so that the latter actually feels the fear not of a laboring mother, but of a newborn babe delivered into Mrs. Jewkes' grasp: "I'm afraid she would dash me at her feet in an instant" recalls the monstrous nursing fantasy of Lady Macbeth: I have given suck, and know / How tender 'tis to love the babe that milks me; / I would, while it was smiling in my face, / Have pluck'd my nipple from his boneless gums, / And dash'd the brains out, had I so sworn as you / Have done to this. (Macbeth, I.vii. 54-59). Casting herself as the destroyed nursling allows Pamela to protest Mrs. Jewkes as both midwife and nurse: she imagines herself as the infant who would choke when made to take Jewkes' "milk for gall." Such indications of infantilization as "she said I may have my shoes," substantiate the reading that Pamela is confined to nursery and sickbed simultaneously, playing the part of child and parturient mother to Jewkes' nurse and midwife. Pamela also calls Mrs. Jewkes "goggle-eyed," a trait which Eucharius Rösslin and other medical authorities specifically cautioned parents to avoid in wet-nurses, because of the belief that unbecoming habits could be passed to the child through breast-milk. Eucharius Rösslin, The Rose Gardenfor Pregnant Women and Midwives, Newly Englished, trans. Wendy Arons (Jefferson, North Carolina: McFarland Books, 1994). The Riverside Shakespeare, ed. G. Blakemore Evans (Boston: Houghton Mifflin, 1974), 1318. back
- Donnison, 34.back
- "As the seventeenth-century poet Rochester put it." Donnison, 34.back
- quoted in Blunt, 180.back
- John Blunt captures the image of obstruction barely concealed in the term "obstetrics," and returns to earlier themes of farming and animal husbandry when he says, "a gentleman told me that he wished all the man-midwives were sent to the plow's tail; a much more becoming situation for them, than the tails of married women." Blunt, 189.back
- D. A. Miller, "The Late Jane Austen," Raritan 10 (1990): 61.back
- Ibid., 61-2.back
- Donnison, 44.back
- Quoted in Donnison, 44.back
- Trumbach inadvertently peppers his rhetoric with opportunistic metaphors of female anatomy. In my view, the "opening" the physicians "are given" in Trumbach's passage is symbolically the vagina, which they have not been "given," but rather, which they have forcibly enlarged for the convenience of their own viewing by introducing such surgical instruments as specula and forceps. In sum, I conclude that Trumbach has inadequately distanced himself from the male physicians' self-promotional project to represent in their very maleness a remedy to a corruption spread by women to women: midwifery. Randolph Trumbach, The Rise of the Egalitarian Family (New York: Academic Press, 1978), 166.back
- Perry is quoting Linda Pollock, 190; 192.back
- For example, the rate of maternal death at the Dublin Rotunda tripled between 1757 and 1826. Ian Campbell Ross, historian of Europe's first maternity hospital, asserts, "the eighteenth century came sadly to realize [that] institutional delivery might prove more dangerous to the very women and children hospitals were designed to assist, than giving birth in noisome tenements" (142). According to figures for the London and Dublin Lying-In Hospitals, the acceleration in the maternal death rate over the eighteenth and nineteenth centuries was due to the influx of medical students who came there for accreditation. The same hands that dissected corpses for their anatomy lessons were implemented, unsterilized, for the delivery of babies. Reports of forceps accidents, on the other hand, are reported by the midwifery writers Blunt, Smellie, de la Motte, Nihell and Douglas: an extensive list of names demonstrating that evidence of malpractice abounds on both sides of the man-midwifery and forceps debates. For the most extended account of the "mischief" of eighteenth-century childbearing technology, see Blunt's Man-Midwifery Dissected. His presumption that the parturient woman is primarily an erotic object lends a vivid tone to his lamentations of the female body made "repulsive and disgusting" to the husband by such "obstetric butchery" as bowel or bladder perforations occasioned during forceps delivery.back
- For the best discussion of contemporary gynecology's deployment of modesty as sexual coercion, see Terri Kapsalis,Public Privates: Performing Gynecology from Both Ends of the Speculum (Durham: Duke University Press, 1997) 1-30.back
- Blunt reports that a man who waited all night outside the confinement chamber to hear of the birth of his child burst in at dawn to find the labor arrested, his wife sanguine, and the man-midwife with "his hand in her vagina, dozing." Like many fretful eighteenth-century men, Blunt has recourse to myths of strange cultures to delineate his fears of a British civilization brought down by female inconstancy: "Such couples are well-qualified to live among the Kovnakic Russians, where custom requires husbands to prostitute their wives and daughters out of very hospitality"; on the other hand, "even the Hottentot women are too modest to employ men [as midwives]–they leave that abandoned custom to our English ladies–yet they are so fruitful, they furnish slaves for the globe!" (174; 204).back
- To reply that everyone has not the knowledge or skill to be his wife's obstetrician is to be subject to Blunt's reckless metaphorizing. By the same logic, he snarls, "If I were not capable of counting my gold, I ought to turn my back, while I commit my purse to a stranger, that he may count it for me." There's no mistaking Blunt's meaning: a wife's vagina is her husband's purse, and no intelligent man would suffer it to be rifled by another. With this in mind, Blunt's concern for the infants "so helplessly wrecked" upon the "rock" of man-midwifery becomes tinged with the same economic jealousy (41). The children are the reproductive capital that another man is robbing of value by his illicit access to the purse-vagina. A husband who employs a man-midwife, or, as Blunt would have it, who pays a "giddy boy-midwife" to enter into a criminal sexual familiarity with his wife, should be "crowned with asses ears, though not entitled to cuckold's horns" (50). In implicit defiance of Blunt's allegations of widespread adultery, Jean Donnison reports only one case of a documented affair between a man-midwife and his patient. In 1741, the year after Pamela was published, one George Baker sued his man-midwife Dr. Morley for seducing his wife, and was awarded damages of £1000 (30).back
- Obviously, in the course of their courtship, she has presented the greatest challenge to Mr. B. that he has ever encountered in a woman through her stubborn adherence to virtue.back
- Reprinted in Cutter, Irving S. and Henry R. Viets, A Short History of Midwifery (Philadelphia: W. B. Saunders and Co., 1964), 232. The authors write that this image remains so charged with meaning and fascination that it "is usually removed from the volume by vandals." We might say, more accurately, that one does not come to the text a "vandal," but rather becomes one after encountering this odd and affecting image, and feels prompted to incorporate it into extra-textual life.back
- This sentence paraphrases the title of Mary Poovey's chapter on the anaesthesia debates of mid-Victorian England.back
- Poovey, 39.back
- Dr. Buchan writes in his Domestic Medicine, "We cannot help taking notice of that ridiculous custom, which still prevails in some parts of the country, of collecting a number of females together upon such occasions. There instead of being useful, they serve only to crowd the house." Quoted in Blunt, 27.back
- Eve Kosofsky Sedgwick, Tendencies (Durham: Duke UP, 1993), 109-29.back
- Claudia L. Johnson, Equivocal Beings: Politics, Gender, and Sentimentality in the 1790's (Chicago: Chicago University Press, 1995), 192.back