Manitoba History: Midwives in the Mennonite West Reserve of Manitoba, 1881-1900
by Conrad Stoesz
Mennonite Heritage Centre & Centre for Mennonite Brethren Studies, Winnipeg
Midwives played an essential role in Canadian society and became an area of study as part of the increased interest and research into the history of medicine in the 1960s. As part of this research, the transition from apprenticed female midwives to formally trained male doctors attending births was known as medicalization. Scholars such as Wendy Mitchinson became experts in the field and focussed on the role of midwives as a group in Canada. Mennonite scholars have also contributed to this research, most notably Marlene Epp. Katherine Martens and Heidi Harms’ compilation of interviews focussing on the experience of Mennonite women giving birth also adds to the discussion.  Most of these works focus on midwives and their role as a group, and name a few well known examples. This is largely due to the fact that records created by midwives are scarce. The memory of midwives in the 1800s has been largely forgotten or tucked away in community and family memories. However, a record from the community in the Mennonite West Reserve of southern Manitoba includes new data and insights into the activity of these women as it provides the names of all the midwives serving at 884 births from 1881 to 1883. The record shows that midwives worked in the regions usually associated with their residence. A few midwives had extensive ranges of influence and could have been recognized for their medical skills other than attending at a birth. The Mennonite community of southern Manitoba had many midwives who served in this capacity in the late 1800s. It is an example of a close-knit immigrant community that was served by women who provided essential maternal care while operating in a legal grey area in Canada. Pragmatic and experienced midwives functioned within defined geographic boundaries to provide care to birthing mothers. Some had a larger repertoire of knowledge that included healing.
The growth of medicalization in the Mennonite community happened gradually, starting in Russia, as midwives introduced new techniques that were proven to be beneficial. In Canada, Anglo-Canadian doctors in the neighbouring areas grew concerned about the success of the midwives and advocated for the enforcement of regulations curbing the growth of progressive and pragmatic midwifery. While midwives were very important to the success of a community, much of the historical research is based on the medical establishment’s own records, due to the fact that midwives of this era have left few records. 
Between 1874 and 1880, approximately 7,000 Mennonites emigrated to Manitoba. Adding to the stress of immigration were numerous deaths and births as the pioneers crossed the Atlantic and half the continent to reach Manitoba. Midwives were part of these life-and-death situations. The set of privileges that the Canadian government offered to the Mennonites was foundational to the Mennonite community in Manitoba. They sought to recreate their communities as they had in Russia without outside interference. With some success they recreated traditional communities with their signature street villages. The Hamlet privilege allowed the Mennonites to hold land in common, rather than having to accept the Canadian plan of populating the prairie west with pioneers on isolated homesteads. This allowed for concentrated settlements which fostered more effective mutual aid, including help from midwives.
When Mennonites arrived to settle on the west side of the Red River, in 1875, they had a six-week layover at Fort Dufferin, just north of present-day Emerson. Here they organized themselves into the Reinlaender Mennonite Church and planned their village locations. They elected officials including a Dorfschulze (mayor) for each village and an Obervorsteher (overseer) for the entire area. Isaak Mueller was elected as overseer and skilfully served until his retirement in 1886. Mueller, together with treasurer Franz Froese and secretary Peter Wiens, constituted the Reinlaender Gebietsamt (the office overseeing municipal affairs) and worked in harmony with the church leadership. 
In 1880, the Manitoba government amended the 1873 Municipal Act. It drew up new municipal boundaries and asked residents to elect their representatives.  The Rural Municipality of Rhineland included the Mennonite portion of the West Reserve.  For the Reinlaender Mennonite church this threatened to usurp the power of the Gebietsamt and the influence of the church. Because of this outside pressure, some church members reportedly threatened to emigrate, if this were forced upon them.  Government officials travelled to the West Reserve and met with church and civic leaders. The Mennonites accepted an offer that allowed them to nominate the current Gebietsamt official, Isaak Mueller, as warden along with six other officials.  With this new title came new responsibilities such as the reporting of more frequent and detailed census data. This revealed that Rhineland had the largest population of any municipality in the province at that time.  The register of vital statistics for 1881-1883 was recorded under the direction of Mueller, serving as Warden of the Rural Municipality of Rhineland and Obervorsteher. In Mueller’s circular of 10 June 1882, he reminded the village mayors to record detailed census information for the government including births, midwives, deaths, causes of death, marriages and witnesses.  Thanks to Mueller, who kept a copy of the government-requested statistics, we now have a unique dataset. Mueller remained Warden until the beginning of 1884, when the Municipality and the Gebietsamt chose separate slates of officials coinciding with a change in boundaries. However, the Gebietsamt continued issuing directives and collecting information as they had done in the past.
The Giebestamt’s record of births and deaths documents 884 births for the years 1881-1883. In 1873, the Manitoba government was moving away from relying solely on the mainline churches to keep vital statistics. According to the Act Respecting Registers of Marriages, Baptisms, Burials, and Vital Statistics in the Province of Manitoba, “Children of those who did not baptise should be registered with the clerk of the County Court by the attending physician or midwife, or parents.”  While midwives were acknowledged in this case, the 1871 Medical Act in Manitoba outlawed unlicensed midwifery. It gave the ability to license medical practitioners to the trained doctors who made up the Provincial Medical Board, later the College of Physicians and Surgeons, and was revised in 1886 to force midwives to become licensed if there was economic gain or hope of reward.  At the time, the medical profession was made up of elite men of British descent, men who were not disposed to issue licences to immigrant woman midwives who did not have the “right” formal training.
The 1881–1883 record provides valuable information about the midwives in the Mennonite community in the RM of Rhineland. Fifty-two midwives who attended a birth are listed in this document with thirty-one serving at three or more births in this three-year period. 
Included are two men, Heinrich Bergen and Gerhard Doerksen, who are listed as the midwives who each served at one birth, likely as a last resort as these are the only two cases and they both happened in the harshest time of year, February and December. The 1881–1883 record uses the German word Hebamme, or midwife. These midwives were likely classified as “granny midwives,” who apprenticed with older midwives.  The role of a midwife and lay doctor were the only two public roles that women were encouraged to fill in this patriarchal society. Women in these roles often felt they had a divine calling and special gift, and were supported by the community.  William Rempel, for instance, of the West Reserve Village of Reinland wrote in 1882 that “Mrs. G. Neufeld, a lady doctor from Mountain lake, Minnesota, has graced us with her presence. She has helped many sick people. God bless her and her work.” 
While these women were well respected in their communities, the term “granny midwife” was used in a derogatory manner by the medical elite.  The majority of Mennonite midwives in this cohort gained their experience in Russia. They were mature women born between 1821 and 1842 (39–62 years old) with three younger women born between 1848 and 1855 (25–35 years old). One of the common qualities for midwives included not only being a mother but also being a mother of several children.  In this cohort the midwives had between four and fifteen children, with an average of 9.3 children each.
Some of the midwives working in the RM of Rhineland attended at 128 births over three years while others attended as few as one. In this small window of three years it is difficult to determine the full extent of a midwife’s career; the women listed only once may have been recognized midwives or simply helpful neighbours who never again attended a birth. Among this group there is, however, a clear distinction among the midwives serving at multiple births. Many served within their own village or nearby villages. Historian Royden Loewen has noted that a pattern of matrilocality existed in early Mennonite villages. Women and their kinship networks were important factors in the makeup and establishment of villages.  Because midwives served in close geographical proximity to their residences, it is possible the presence of a midwife may have been a factor in the planning and makeup of a village.
In Rhineland, the most active midwives had a geographical range that tended to be oriented on a north/south, rather than east/west axis. As the midwives were “fetched,” they would have travelled along paths that connected the villages to get to the women in labour. The most active midwives were Susanna Martens (1836–1917) who helped deliver 92 babies, Elizabeth Fehr (1821–1903) 128 babies, Helen Hiebert, (1830–1896) 104 babies, and Katharina Enns (1823–1909) 66 babies. The midwives’ areas of influence show very little overlap. It is not known whether these areas of influence were prescribed by the Reinlaender church or if there was a “lady’s agreement” where each would serve, such as Scratching River area midwives Maria Warkentin and Helena Eidse who each agreed to practise “... in her own territory.” 
Although the environment was harsh, it seemed to have minimal impact on how the midwives with the largest areas of influence functioned. They continued to travel great distances, more than 15 miles in the coldest months, to help with a birth. In fact, their workload increased in relation to the number of births in the months of December, January and February. When comparing the workload of certain midwives with the rest of the midwifery community, the four most active were busier when travel was most difficult, even though there were other midwives close at hand. For most months of the year their workload mimicked the proportional number of births. For example, during the period between 1881 and 1883, the month of September averaged 7.65 percent of all births. In the same month, these four midwives served at 7.69 percent of births. The difference is seen in the months of December, January, and February which typically have the most severe weather conditions, when they assisted at a higher percentage of births. For example, in January an average of 9.95 percent of births occurred; yet, these midwives served at 12.7 percent of the births. The harsh climate appears to have had little impact on the most active midwives.
While women became known as good midwives due to their knowledge in helping bring forth life, they were deemed exceptional midwives—and even doctors—if they had the knowledge and skills to extend life. The most successful midwives also served as healers and even undertakers. If people tended to have more illness in the months of December, January, and February, it would be understandable that the healers—the midwives—would then be the most active in their visitations. While serving at the bedside of a sick person, they could be called to another home to help with a birth. For this reason, midwives were also more active in the winter months to deal with the increased illness in the population. However, a detailed dataset over a longer period of time would be needed to fully test this hypothesis.
Midwives were known for their healing knowledge and abilities. Aganetha Reimer (1863-1938) of the East Reserve  is remembered as serving as a community midwife, healer and undertaker for thirty-five years. “With her little black medical bag she went out in all weather, summer and winter...” according to one source.  A midwife on the Scratching River Mennonite Settlement , Helena Eidse’s (1861-1938) medical bag contained “... a liquid given to women so that they would not haemorrhage, ties for the umbilical cord, soft white cotton cloth, several steel instruments for bladder problems, needle and thread... handmade bandages... thermometer, two scissors (1 to cut the umbilical cord), sulphur powder, sterile olive oil... small pieces of wood for finger splints, Castoria, homemade cotton balls, Vicks Rub, Red lineament, Rawleighs or Watkins lotion, Antipain oil, and a jar of goose grease and fever pills.” According to writer Lori Scharfenberg , Eidse also sold “... rubbing alcohol, Wonder oil, Lydia E. Pinkham’s Tonic (for women)... Schlachwasser, Alpenkreuter, Magensterker,... and fever pills (quinine tablets).”  Some of these items are also in the list of supplies some midwifery texts suggest to have in a dedicated bag always at the ready. 
During the early 1880s, the face of the West Reserve changed rapidly. The Reinlaender Mennonite church became one of only two Mennonite church communities. Starting in 1878, a second group of Mennonites, the Bergthal Mennonites, relocated from the East Reserve to the West Reserve. The settlement experience in the first five years on the East Reserve was extremely difficult, punctuated with successive crop failures due to early frost, poor drainage, grasshopper infestations and poor agricultural land. Wooded and stony land, obviously poor land for farming, was the dominant land feature in five of eight townships in the East Reserve. 
The new arrivals settled on the eastern portion of the West Reserve, where 90 percent of the land was surveyed as class one, high-prairie agricultural land with well drained woodlands and stone-free grassland. In contrast, only 35 percent of East Reserve land could be described in this way.  An estimated 2500 people relocated, most initially settling in the typical street villages.  But soon these villages broke up and families moved onto their homesteads. This shift is reflected in the 1881-1883 registry of births. In one instance, the location for a birth is given as “farm” rather than a village. Initially there was a good rapport between the two groups, with Reinlaenders offering aid to the new settlers.  However, this soon faded as friction between the groups began to form. 
Midwives tended to serve within their own Mennonite denomination, either Reinlaender or Bergthal, as expectant mothers were more comfortable with attendants they knew. However, the “boundary” between the two groups was not impermeable as some midwives served both groups. The division appears to be more a case of geography and personal preference, rather than differences in the denominations. Most midwives served in one or two neighbouring villages. The four most active midwives practised within an area where they had little crossover with each other but substantial overlap with the less-active midwives who had smaller spheres of activity. The midwives’ geographic regions generally corresponded to their home residence. A few midwives served in both the Bergthal and Reinlaender communities, but Helen Hiebert was the midwife who served both communities the most frequently. Her residence was Neuhoffnung which is next to the “boundary” between the communities. In some cases a midwife from one community would serve at a birth in a community much farther away. These were usually one-time occurrences. For example, Katharina Enns lived in Rosenort, situated in the south-central portion of the reserve. On 1 January 1881, she helped Maria Neufeld enter the world in the village of Wiedenfeld, eight miles distant “as the crow flies” in one of the most difficult months of the year. Katharina Guenther, of Schoenwiese, three miles west of Rosenort, travelled the 15 miles east to Schoenhorst to attend to Katharina Doerksen as she gave birth to a daughter, Katharina on 26 February 1882. Maria Quiring, of Gruenfeld, seven miles west of Rosenort, travelled the long 19 miles east to the home of William and Anna Vogt in Edenburg to help with the birth of David on 27 February 1882. 
Giving birth placed a woman’s health in a precarious situation, but it was only one of a number of causes of death for women. During this time, men had a higher mortality rate. Of the 478 deaths that occurred in the RM of Rhineland between 1881 and 1883, 68 were adults while the vast majority were children who succumbed to the diphtheria epidemic that was sweeping through the Mennonite community.  Of the 68 adult deaths, 31 were women aged 19 and older, and 37 were men of the same age range. (See the table for a list of diseases and mortality rates among men, women, and children in the Manitoba Mennonite community.)
Death rates between men and women during this time were comparable due to the high death toll attributed to typhoid. Death rates in the Reinlaender community during its first five full years in Manitoba (1876–1880) show a large difference based on gender in the age range of 19 to 55. In this period there were 29 female and 18 male deaths. This may point to higher-than-normal maternal death rates in an immigrant population working at establishing itself. 
Maternal mortality in the period between 1881 and 1883 was 11.3 deaths per 1000 births. How this rate compares to the Canadian average is difficult to ascertain because Canada only began to track maternal mortality in 1921.
In Alberta, in 1921, there were 111 maternal deaths and 84 of them were in rural areas.  Some hospitals had even higher rates. The Ottawa Maternity Hospital saw 5000 births between 1895 and 1924 with a maternal mortality rate of 11.4 per 1000 births.  The New York Maternity Hospital in the 1870s had a maternal mortality rate of 41.66 per 1000.  Maternal mortality rates varied by location and through time. 
In 1926, Dr. Helen MacMurchy, of the Canadian Child Welfare Division of the Department of Health, undertook a study to highlight the problem of maternal mortality in Canada. In 1925, Canada’s maternal mortality rate was 5.6 per 1000 live births, the highest of the fourteen countries polled. She found that of her research sample of 1,532 women who died giving birth, 1,302 had no prenatal care at all.  Her solution was to increase the medicalization of childbirth by educating the public that pregnancy was a condition with risks that needed medical supervision.  She advocated for a world where “doctors and nurses must be able and willing to give advice acceptably and mothers must be ready and anxious to receive it.”  MacMurchy highlighted three main medical conditions that caused the majority of maternal deaths, all of which could be better treated in a medical facility, she believed. Puerperal sepsis accounted for 33 percent of deaths. It is characterized by an infection causing high fever, chills, rapid pulse and breathing. The second highest cause, at 23 percent, was haemorrhaging large amounts of blood during or after labour. Thirdly, toxemia or eclampsia accounted for two percent of deaths and occurs when toxins form in the body during pregnancy and can create complications during pregnancy and labour. It is characterized by high blood pressure, retention of water, protein in the urine, vomiting, coma and finally death. 
Filler for the Table
Some of these diseases are detectable in Mennonite diaries of the late 1800s. Diedrich Gaeddert’s American diary covers the period between 1860 and 1879. On 21 June 1878, he recorded that his wife, Maria, experienced difficult labour. She gave birth to a stillborn son that had occupied the birth canal for 15 minutes. Maria died two weeks later on 4 July. Gaeddert’s diary provides enough information to surmise she died of eclampsia, perhaps combined with puerperal sepsis. The entries also show how the community was involved in supporting the family. 
Death during or after childbirth was a real concern and something MacMurchy and others were trying to address. During the same period in which Dr. MacMurchy’s studies in maternal mortality were undertaken, the Manitoba and Ontario governments were also looking into maternal mortality rates. In 1929, Manitoba’s maternal mortality rate was 6.8 per 1000 live births.  These two provincial bodies found five key factors to the survival of childbirth. First, women who survived were between the ages of 20 and 29. Second, the first pregnancy and any more than 3 pregnancies carried the most risks. The second and third pregnancies were statistically the safest. Third, the occurrence of a stillborn birth decreased the survival rate of the mother. The time of year the birth occurred played a role, with spring and summer being the optimum seasons when infections were less frequent. Last, the health of the mother was important. Mothers who were impoverished, had poor diets, or were overworked were more likely to die in childbirth. 
The factors outlined by the Manitoba and Ontario government research can be seen in the maternal deaths in the 1881–1883 sample. Of the ten women who died in childbirth, four were over the age of 29. In nine cases the death happened in the first, sixth, seventh, or ninth pregnancy. The exception was Elizabeth Fehr who died on 18 June 1881, after giving birth to triplets on the 9th and 10th of June. Of the three babies, one survived. The third finding that impacted survival of the mother was the live birth of the child as opposed to stillborn. In six of the 10 cases, the birth was not recorded in the birth register (1881–1883) and some were not recorded in the church family register, possibly suggesting that a live birth did not occur. If it can be assumed that the births not recorded in the detailed church registers represent stillbirths, then the maternal mortality rate drops to 4.5 maternal deaths per 1000 live births.
The time of year does not seem to have had a large impact on the cases, as only four of the maternal deaths occurred in fall or winter (1 September, 2 November, 1 December). The fifth factor, the physical well-being of the mother, played an important role in the survival of the mother in the 1881–1883 dataset.
The ten maternal deaths were evenly distributed between the Reinlaender and Bergthal communities. However, proportionally they represent five of 610 births for the Reinlaender and five of 274 births for the Bergthal community. The maternal mortality is then 7.25 of 1000 births in the Reinlaender community and 16.13 in the Bergthal community—more than double (not taking into account stillbirths). The years between 1881 and 1883 in the life of the Bergthal community on the West Reserve were arduous. Difficult farming conditions (e.g., flooding) on the East Reserve pushed settlers out; and the open fertile land of the West Reserve attracted them.  Having to start over again from scratch within five to seven years of immigration to Canada, including breaking land and building shelters, took a deadly toll on expectant mothers. Immigration-like conditions increased maternal mortality.
While the Bergthal people were working at re-establishing themselves, the Reinlaender community became established and began to prosper. Tax assessments for the years 1881–1883 show an increase in mechanization and cultivated land. Jacob Kroeker lived in the Reinlaender village of Schoenwiese. Between 1881 and 1883 he increased the number of acres he owned from 160 to 320. The total amount of land Kroeker cultivated increased from 38 to 108 acres.  By 1883, he owned a seeder and self-binder. His total assessment increased from $673 to $1512.  Under these conditions, expectant mothers’ survival improved.
An additional stressor for expectant mothers was a diphtheria epidemic that was sweeping repeatedly through the province, hitting the Mennonite communities harder than other communities; the close habitation spread the contagious disease faster. Children ages three months to five years were the most at risk, while adults were usually immune.  Even if diphtheria did not make many adults sick, the high level of care and worry in addition to the pioneering circumstances no doubt played a factor in the physical and mental well-being of the pregnant women.
The village settlement pattern allowed by the “Hamlet Privilege of the Dominion Lands Act” provided improved circumstances in comparison to those of the people in western Canada who lived on individual homesteads. Homesteaders could be 20 to 28 miles from help. This distance proved too much in some harsh conditions. In addition to the remoteness, doctors charged $25 for a house call and did not help with household duties, as many midwives were known to do. Neighbour women, husbands, and even the farmhand, often served as the birth attendant out of necessity, working in conditions lacking privacy, heat, and knowledge. Marion Cran, a visiting English author, commented that if women were to become aware of the conditions in western Canada, it would deter them from coming to the prairies. No other aspect of life on the prairies endangered women’s lives so much as did childbirth.  When a mother died she often left behind children. In the Mennonite context there were traditions and institutions in place to help the bereaved family. Not only was there a community of like-minded people, but the Waisenamt was a long-standing institution that took care of families and the estate after the death of an adult. Under their direction children were cared for and assets divided evenly between the surviving spouse and the children regardless of gender. Historian John B. Toews suggests that “under such circumstances, vulnerability to diseases and death was possibly not as fear-inspiring as we might suppose.” 
In contrast to the Mennonite block settlement pattern, the isolation of homestead women also hampered the natural passage of knowledge from the older generation to the younger. Letter writing was the main form of communication to family and friends who were miles or even a continent away. But many expectant mothers did not know the questions to ask. Talking about pregnancy was a social taboo. Women kept their pregnancies hidden as long as possible. 
While homestead families suffered from isolation, Mennonites who remained in villages were part of the social hub that the village environment created. For example, in January 1885, Elizabeth Kornelson gave birth to a daughter. The first day she left the house she visited her sister and the next day visited her mother-in-law.  By the mid-1880s, however, Mennonite villages were dissolving and families were opting to move onto their own homesteads. Only the more traditional families living in the close-knit villages continued to reap the full benefits community life offered to mothers.
As faith in the science of medicine grew, the role of the midwife began to diminish, as formally trained doctors attended more births. Midwives had little agency to resist this transition. There were no recognized training opportunities in Manitoba for midwives or an organized body that could advocate on their behalf. Under the law they were not allowed to charge for their services unless they were licensed, which was under the authority of the doctors, who tended to be elite men of English background.
The early work exploring the transition of birthing from midwives to doctors has been characterized by a binary approach that saw female midwives, employing non-invasive techniques vs. male doctors who used medical techniques that focussed on the process of labour and used instruments and drugs.  Medical historian J. T. H. Connor suggests from the Ontario context that this binary approach is not adequate to explain this transition. Connor asserts that doctors were not opposed to midwives, but to untrained midwives who did more harm than good. 
Historian Wendy Mitchinson views the situation differently, acknowledging that midwives readily incorporated new techniques they learned from doctors, textbooks, and other caregivers.  She further points out that midwives were not simply passive attendees. They were active in the birthing process with encouragement, techniques and medicines. 
The example of the midwives in southern Manitoba shows an openness to medical techniques that were incorporated by some of the Mennonite midwives. These midwives were pragmatic and slowly incorporated a medicalized approach in their work. As a result, some of the doctors in the neighbouring communities felt threatened by these midwives because of their success and the community loyalty they enjoyed.
Doctors needed patients for their business to succeed; so, doctors tended to set up their practice in urban areas.  The heavily populated RM of Rhineland, with a high birth rate, would have appeared to be a prime location. However, the Mennonite community, especially the Reinlaender Mennonite Church community, sought to be self-supporting and continued to see the privileges outlined by the Canadian Government in 1873 as ensuring this view.  The Mennonites were not opposed to new medical ideas, but sought to incorporate them on their own terms.
For example, Mennonites were not opposed to medical advancements such as formally trained doctors. In 1837, in the Russian Mennonite colony of Chortitza, the church leadership hired Dr. H. V. Grosheim to establish a practice centred in Neuenburg.  In 1860, church leader Jacob Epp records the use of Karl Braunscheidt’s Lebenswekker (life awakener) machine, which was a device that was strapped on to treat a number of ailments.  In 1870, church leader Jacob Epp records that a trained Russian midwife, “... who had developed a reputation in our area from previous visits...” served the Mennonite community. In his diary Epp laments the lack of trained Mennonite midwives.  The Mennonite community in Russia was pragmatic and open to new medical innovations. This pragmatism continued in Canada.
In 1881, Dr. Justina Bergen from the Mennonite community of Mountain Lake, MN, visited the West Reserve.  At the age of 14 she began to accompany her father, Dr. David Loewen, who had travelled to Danzig, Prussia for training. By the age of 15 she was acting as a midwife’s assistant. Dr. Bergen, as she was known, visited the Manitoba Mennonite community again in 1884 and 1892, making house calls as recorded by Bishop David Stoesz of the Chortitzer Mennonite Church on the East Reserve.  During the visit in 1892, the East Reserve male church leadership invited Dr. Bergen to Manitoba to provide a six-week midwife training course to several new volunteer midwives on the East Reserve.  Many home remedies were recorded in notebooks during this course. Student, Aganetha Barkman, also used this book to record the approximately 600 births she attended as a midwife.  This church-sponsored initiative deviates from the classical “granny midwife” pattern of apprenticeship and the handing down of knowledge from an older women to a younger one. In this instance, a course was offered.
A second woman who took the training was Anna Toews. She became a prominent midwife and healer collecting and growing plants for medicinal purposes.  Toews’ notebook is filled with herbal recipes, as well as some manufactured medicines. The notebook includes attention to cleanliness in washing the mother, instructions for complicated and dangerous births, and remedies for ailments afflicting men and women. 
Just as medicinal herbal knowledge was a staple in Aboriginal communities, it had become important with some Mennonite healers. The Aboriginal contribution to settler communities has been undervalued according to historian Kristin Burnett. There is compelling evidence that settlers in Western Canada relied on Aboriginal healers for knowledge of plant remedies, healing and childbirth.  A Mennonite midwife who incorporated aboriginal knowledge was Katharine Hiebert, who was invigorated by searching the woods of her new East Reserve Manitoba home for plant material used for medicinal purposes. She had her own recipes as well as recipes from an Aboriginal healer. Hiebert also spent several weeks with an Aboriginal woman who healed her cancer.  Through these encounters Hiebert incorporated considerable herb healing knowledge in her practice. 
The Mennonite community in southern Manitoba sought to be autonomous in many aspects of life including health care. They had a pragmatic approach to healing and medicine; new approaches and ideas were allowed to be tested and were incorporated if proven helpful. With this understanding, Dr. Katharina Thiessen quickly became a highly regarded doctor and midwife. She handled difficult births, performed limb amputations, administered chloroform, used forceps, and provided medical prescriptions.  At the age of eighteen, Thiessen (1842–1915) travelled from Russia to Prussia for training in midwifery, chiropractic and naturopathic techniques. In 1874 she and her husband Karl Thiessen immigrated to Peabody, Kansas and then, in 1885, to the West Reserve village of Hoffnungsfeld. She continued her medical training by acquiring many medical textbooks and by travelling to Cincinnati, Ohio for further training. Some of her medical textbooks remain, including Lehrbuch der Geburtshülfe für die preussischen Hebammen, published in 1878.  The textbook for midwives is based on a medical understanding of childbirth. The attendant is instructed to watch the woman’s body for changes,  and stages of childbirth are to act as markers.  The focus on the woman’s body as a machine that needed fixing is a central theme in the medicalization process.  Instructions on how to deal with various difficult births and emergencies are also discussed throughout the text.
When Katharina Thiessen arrived at the medical college in Cincinnati, the doctors assumed she was there for treatment.  The climate for females attending medical training was difficult and at times hostile. In one example, students brought a sheep into class saying “... that they understood that inferior animals were no longer to be excluded [from medical school].” 
Although she became a successful doctor, building a large home to accommodate her patients, Thiessen continued to attract negative attention from the medical establishment. Doctors from Morden and Gretna complained to the Manitoba College of Physicians and Surgeons, demanding they put a stop to midwifery and the use of informal doctors. They saw this body as providing “protection of the brotherhood.”  Dr. Burnham was concerned that Katharina Thiessen and Mrs. Bergen might “... take considerable money out of our practise and if there is any way of stopping them I will be glad to assist you.”  The doctors’ main goal—to curtail the practice of midwifery—was for personal gain. After considerable badgering by doctors B. J. McConnell, and F. W. E. Burnham, of Morden, and doctors Donovan and James McKenty, of Gretna, the College acquiesced and proceeded to investigate Katharina Thiessen and Dr. Abraham Hiebert. However finding witnesses to testify against them was difficult. Nevertheless, area doctors pressured the College of Physicians and Surgeons to prosecute Thiessen and others and on their third attempt were successful. The Mennonite community resisted by employing the help of MLA Valentine Winkler, who not only paid Thiessen’s fine but threatened to introduce new legislation that would exempt Mennonites from observance of the Medical Act. In 1898, Winkler submitted a petition to the Manitoba Legislature on behalf of almost 500 people in the Mennonite settlement who wished that “... Miss Susie Isaac be licensed as a physician or midwife.”  Winkler eventually worked out a compromise that ensured the College would not prosecute unlicensed midwives in exchange for not introducing legislation that would exempt Mennonites from the College’s jurisdiction. The Mennonite community continued its practice of midwifery well into the mid-20th century. However, with the successful prosecution of Dr. Thiessen, the natural process of self-sufficient and pragmatic midwifery in the community was curtailed.
The example of Katharina Thiessen and the acceptance she experienced in the Mennonite community concurs with historian Charlotte Borst’s theory that places agency within the immigrant community. It was the community that embraced medicalization; it was not foisted on them by doctors from outside the community.  Because cultural considerations were important to the mother, attendants—including doctors who had similar cultural values—were welcomed into the community to deliver babies. However, in this example the doctor in question was a woman from within the Mennonite community.
The Manitoba example is different from the Ontario experience in which historian J. T. H. Connor claims that doctors were primarily concerned about good care for mothers and their babies, and therefore insisted that midwives be licensed. Conner downplays the argument that doctors were threatened by the success of the midwives which cut into the doctors’ income, claiming that doctors in general were supportive of midwives and that no Ontario doctor has ever taken legal action against a midwife.  Dr. Thiessen was embraced by her community due to who she was and because she provided good care. The letters written by the English doctors in the railway towns of Morden and Gretna clearly show that their criticism of Dr. Thiessen was for personal gain and was less about what was best for the pregnant mother. The doctors continued to advocate for the prosecution of Katharina Thiessen.
A clearer picture of the role that midwives played in the Manitoba Mennonite community can now be drawn. Using an assortment of records created by the Mennonite midwives and their community, a detailed and interesting portrait emerges of the midwives who served their communities. First, midwives were highly valued members of the Mennonite community. They provided good maternal care and some were recognized as healers. Second, midwives worked in geographically defined areas of influence. The hamlet provision that allowed Mennonites to live in villages rather than on isolated homesteads, allowed for a supportive network for mothers, keeping kinship connections intact. Third, the Mennonite community did not resist medicalization; it was open to medical innovation, acquiring knowledge from trained doctors, midwives, and Aboriginal healers. The Mennonite midwives were pragmatic in their acceptance of new ideas coming from societies around them. Fourth, English doctors were threatened by the success of the midwives and the strong community support they enjoyed. The wider Canadian context at the time gives evidence of a society that had a negative view of midwives and females with medical training. Fifth, for commercial and sociological reasons the English doctors used their networks to prosecute the most prominent midwife in the area, hoping to influence all midwives, but the community pushed back. Receiving help from their local MLA, who advocated on their behalf, midwives were allowed to continue practising. In the end, the natural progression of pragmatic midwifery was severely curtailed, but not extinguished. An element of the Mennonite population continued to use midwives into the 1980s,  and ostensibly up to the year 2000, when midwifery became a recognized and licensed profession in Manitoba. 
This paper could not have been written without the record of births between 1881 and 1883 that included the midwife’s name and the location of the birth. This document was preserved by the Reinlaender church leadership in Manitoba for 40 years and then taken to Mexico in 1922, because the Reinlaender church members believed they could not trust the Canadian government. The increasing amount of control the government appropriated from the Mennonites pushed them to emigrate. The Mennonites believed they had been promised the fullest privileges in exercising their religious principles which, for the Mennonites, extended to most areas of life.
In 1992, Bruce Wiebe located this document in a large collection of materials in a trunk in the workshop belonging to former Vorsteher Jacob Froese of Gnadenfeld, Manitoba Colony, Mexico. With the permission of Froese and Vorsteher Heinrich Dyck, and Bishops Jacob Loewen and Franz Banman, Wiebe was allowed to borrow selected items dating 1875–1922 for microfilming in Manitoba. This was done at the Centre for Mennonite Brethren Studies in 1993. 
The births portion of the register was transcribed by Clara Toews in 2011. The deaths portion was transcribed under the supervision of Glen R. Klassen. For a period in 1882 only the last name was given such as “Frau Fehr.” Based on births and the location of these births for the years 1881 and 1883 an educated guess was made as to which “Frau Fehr” served at these births. This method provides the fullest dataset, acknowledging that there are bound to be some errors.
1. Al Reimer, “Johann R. Reimer (1848-1918): Steinbach Pioneer,“ Preservings 9, December ( 1996), p. 41.
2. Katherine Martens and Heidi Harms, In Her Own voice; Childbirth Stories from Mennonite Women, Winnipeg: University of Manitoba Press, 1997.
3. J. T. H. Connor, “’Larger Fish to Catch here than Midwives’: Midwifery and the Medical Profession in Nineteenth-Century Ontario”, in Care and Curing: Historical Perspectives on Women and Healing in Canada, Ottawa, Ontario: University of Ottawa Press, 1994, p. 105.
4. Adolf Ens and John Dyck, “Obervorsteher Isaak Mueller 1824–1912,” in Church, Family and Village: Essays on Mennonite Life on the West Reserve, Adolf Ens, Jacob E. Peters and Otto Hamm, eds. Winnipeg, Manitoba: Manitoba Mennonite Historical Society, 2001, pp. 67-79.
5. Ibid., p. 76.
6. John Dyck and William Harms, eds. 1880 Village Census of the Mennonite West Reserve, Winnipeg, Manitoba: Manitoba Mennonite Historical Society, 1998, p. 3.
7. Ens and Dyck, op. cit., p. 76
9. Ens and Dyck, Ibid., p. 77.
10. Notice from the district office of Reinland: 1. That all births, deaths, and marriages which occurred between 19 December 1881 and 20 June 1882 should be registered. 2. Register the person who assisted in the birth. And the person present at the death and what the cause of death was and who the church official was who officiated at the marriage and register one family present at the engagement of the couple and two families present at the marriage. These should be submitted to the district office by 24 June. 3. Jacob Dyck from Neuendorf should publish the coming marriages 4. Peter Fehr from Grünthal should be notified during the year about any changes to the register. 5. The villages which have not maintained the roads should do so upon receipt of this notice so that the machinery can be used elsewhere. On 10 June 1882, Isaak Müller District Official. Rosenort village papers, Mennonite Heritage Centre, volume 1099 file 29, 10 June 1882, translation by Bert Friesen, 2011.
11. “An Act respecting Registers of Marriages, Baptisms, Burials, and Vital Statistics in the province of Manitoba” Manitoban and Northwest Herald, 22 February 1873, p. 2 www.manitobia.ca. Accessed 26 January 2012.
12. Hans Werner and Jenifer Waito, “‘One of Our Own’: Ethnicity Politics and the Medicalization of Childbirth in Manitoba”, Manitoba History 58, p. 7 (June 2008).
13. In a few cases the identity of the midwives was not ascertainable.
14. An example of the apprenticeship of the granny midwives would be “Mrs. John P. Friesen (1850-1934)... trained her daughter and her daughter’s sister-in-law”. Lenore Eidse, ed., Furrows in the Valley: A Centennial project of the Rural Municipality of Morris 1880-1980, Morris: Inter-Collegiate Press, 1980, p. 328.
15. Werner and Waito, op. cit., p. 5.
16. William Rempel, “Manitoba, Reinland,” Mennonitische Rundschau, 1September 1882, p. 1. Translated by Elfriede Stillger, 2014.
17. Cheryl Krasnick Warsh, Prescribed Norms: Women and Health in Canada and the United States since 1800, Toronto: University of Toronto Press, 2010, p. 107.
18. Alma Barkman, “Free Home Deliveries” in Mennonite Memories Settling in Western Canada, Lawrence Klippenstein and Julius G. Toews, eds., Winnipeg: Centennial Publications, 1977, p. 237.
19. Royden K. Loewen, “The Children, the Cows, My Dear Man and My Sister: The Transplanted Lives of Mennonite Farm Women, 1874-1900”, Canadian Historical Review 10, no. 3, (1992), p. 362.
20. Eidse, op. cit., p. 328.
21. The East Reserve was another portion of land set aside for Mennonite settlement by the government. It lay on the east side of the Red River and was therefore known as the East Reserve. The East Reserve is in the current-day Rural Municipality of Hanover area where Steinbach is the central city.
22. Reimer, op. cit., p. 41.
23. Scratching River Settlement is located near current-day Rosenort, MB.
24. Lori Scharfenberg, “Helena Eidse’s Medical Bag“, Preservings 9, (December 1996), p. 53.
25. J. E. Burton, translator, Handbook of Midwifery for Midwives, London: Minister for Spiritual, Educational, and Medical Affairs, 1884, pp. 76-77.
26. Lawrence Klippenstein, “Bergthaler Mennonite Resettlement to the West Reserve 1878-1882” in Settlers of the East Reserve: Moving In—Moving Out—Staying. Adolf Ens, Ernest N. Braun, Henry N. Fast, eds., Winnipeg: Manitoba Mennonite Historical Society, 2009, p. 305.
27. Ibid., p. 309.
28. Ibid., p. 312.
29. Maria Klassen, “Moving to the West Reserve” in Mennonite Memories Settling in Western Canada, Lawrence Klippenstein and Julius G. Toews, eds., Winnipeg: Centennial Publications, 1977, p. 70.
30. Peter Elias diary, translated by William Kehler, Mennonite Heritage Centre, Volume 3523 file 7, p. 5.
31. Note: Midwives who served in a village only once are not reflected on the maps.
32. Glen R. Klassen and Conrad Stoesz, “Diphtheria epidemics of the 1880s in the Mennonite West Reserve in Manitoba”, Preservings 31 (2011), pp. 41-48.
33. Based on deaths recorded in the Reinlaender Gemeinde Buch, John Dyck and William Harms, eds., Reinländer (Old Colony) Gemeinde Buch: Second edition, Winnipeg: Manitoba Mennonite Historical Society, 2006.
34. Langford, 171 endnote 7.
35. Suzann Buckley, “The Search for the Decline of Maternal Mortality: The Place of Hospital Records” in Essays in the History of Canadian Medicine, Wendy Mitchinson and Janice Dickin McGinnis, eds., Toronto: McClelland and Stewart, 1988, p. 150.
36. Cheryl Krasnick Warsh, Prescribed Norms: Women and Health in Canada and the United States since 1800, Toronto: University of Toronto Press, 2010, p. 91.
37. Wendy Mitchinson, Giving Birth in Canada 1900–1950, Toronto: University of Toronto Press, 2002, p. 262.
38. Langford, p. 171, endnote 7.
39. Buckley, pp. 151-152.
40. Buckley, p. 153.
42. See Diedrich Gaeddert diary translation pp. 211-212, Mennonite Heritage Centre, volume 5562 file 15.
43. Mitchinson, Giving Birth in Canada, p. 262.
44. Buckley, pp. 157-158. Irvine Loudon challenges this conclusion that claims that social class, poor diets (not malnourishment) and poverty do not lead to higher maternal mortality rates. He claims that limited access to good birthing care and the occurrence of virulent strains of Streptococcus pyogenes, the bacterium that causes puerperal fever, are the biggest factors in maternal mortality rates. Sulfonamide drugs that controlled puerperal fever were introduced in the 1930s and were responsible for a long and lasting reduction of maternal mortality. Irvine Loudon, “Maternal mortality in the past and its relevance to developing countries today”, The American Journal of Clinical Nutrition, Vol. 72 No. 1, July 2000, p. 243s. http://www.ajcn.org/content/72/1/241S.full.pdf+html accessed 16 February 2012.
45. Maria Klassen, “Moving to the West Reserve” in Mennonite Memories Settling in Western Canada, Lawrence Klippenstein and Julius G. Toews, eds., Winnipeg: Centennial Publications, 1977, pp. 67-70.
46. Dyck, 1880 Village Census..., p. 123.
47. Colony tax assessment for the village of Schoenwiese, Mennonite Heritage Centre microfilm #654.
48. Glen R. Klassen, p. 44.
49. Langford, pp. 148-151.
50. Toews, p. 468.
51. Langford, p. 149.
52. Loewen, “The Children, the Cows...”, p. 367.
53. Mitchinson, Giving Birth in Canada, p. 9.
54. Connor, pp. 106-109.
55. Mitchinson, Childbirth in Canada, p. 298. See also Marlene Epp, “Catching Babies and Delivering the Dead: Midwives and Undertakers in Mennonite Settlement Communities” in Caregiving on the Periphery: Historical Perspectives on Nursing and Midwifery in Canada, Myra Rutherdale, ed., Montreal: McGill-Queens University Press, 2010, p. 68; Langford, pp. 156, 158.
56. Mitchinson, Giving Birth in Canada, p. 9.
57. Kristin Burnett, Taking Medicine: Women’s Healing Work and Colonial Contact in Southern Alberta 1880–1930, Vancouver: University of British Columbia Press, 2010, p. 55.
58. Werner, p. 5.
59. David Epp, The Diaries of David Epp 1837-1843, translated and edited by John B. Toews, Vancouver: Regent College Publishing, 2000, pp. 38, 46.
60. Jacob D. Epp, A Mennonite in Russia: The Diaries of Jacob D. Epp 1851-1880, translated and edited by Harvey L. Dyck, Toronto: University of Toronto Press, 1991, p. 151.
61. Ibid., p. 306
62. Delbert Plett, Dynasties of the Mennonite Kleine Gemeinde in Imperial Russia and North America, Steinbach: Crossway Publications, 2000, p. 349.
63. Delbert Plett, “Pioneer Women of the East Reserve” Preservings 10, June (1997): 6.
64. Cathy Barkman, “Anna Toews (1868-1933): Midwife” Preservings 10, June (1997): 53. See also Martens, p. 27 in Martens’ interview with Sara Kroeker about her midwife mother Aganetha Barkman. The length of the course is “around three weeks” whereas, in the reference in Cathy Barkman’s article on Anna Toews, the length of the course is six weeks.
65. Martens, p. 27.
66. Cathy Barkman, p. 53
67. Anna Toews midwifery notebook, translated by Edward Enns, 2011 in possession of the author.
68. Burnett, pp. 51-52.
69. Regina Doerksen Neufeld, “Katherina Hiebert (1855-1910): Midwife“, Preservings 10, June part 2 (1997): 14-16.
70. Epp, Mennonite Women in Canada, p. 41.
71. Shirley Bergen, “Life of Mrs. Dr. Thiessen (née Catharina Bornn) -1842-1915”, Mennonite Heritage Centre, volume 5028 file 7.
72. Lehrbuch der Geburtshülfe für die preussischen Hebammen, Prussia: Ministerium der Geislichen, Unterrichts – und Medizinal-Angelegenheiten, p. 1878.
73. Burton, pp. 80-81.
74. Ibid., 78-87.
75. Mitchinson, Childbirth in Canada, pp. 304-305.
76. Bergen, Mennonite Heritage Centre, volume 5028 file 7.
77. Warsh, p. 213.
78. Werner, p. 6.
80. “The Legislature”, Daily Nor’Wester, 5 April 1898. www.manitobia.ca accessed 25 January 2012.
81. Borst, p. 11.
82. Connor, p. 117.
83. Elizabeth Krahn (born 1953) had her second child at home with the help of a midwife, and Evelyn Rempel Petkau had her third child while living in Altona, at home in 1986. Martens, pp. 40, 52.
84. http://www.cmrc-ccosf.ca/node/19, accessed 13 March 2012.
85. Disease translations provided by Glenn R. Klassen.
86. Email from Bruce Wiebe to author, 25 August 2011.
We thank Clara Bachmann for assistance in preparing the online version of this article.
We thank S. Goldsborough for assistance in preparing the online version of this article.
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