A clash of cultures: French midwifery meets Peruvian tradition

Birthing Battles: How French Midwifery Clashed with Tradition in Peru

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Samir D’Costa in Health & Wellness June 2025 • 4 min read.

"Explore the surprising collision of cultures and medical practices in 19th-century Lima, where French obstetrics, traditional healers, and local customs fought for dominance in childbirth."


In the early 19th century, Lima, Peru, became a battleground for competing ideas about childbirth. Benita Paulina Cadeau Fessel, a French-trained midwife, arrived with the latest European medical knowledge, ready to reform what she saw as backward and dangerous practices. However, she faced strong resistance from traditional midwives, local healers, and deeply entrenched cultural beliefs.

This clash wasn't just about medical techniques; it was a complex interplay of social class, race, and colonial legacies. While reformers pushed for professionalized midwifery, their efforts often reinforced existing social hierarchies and marginalized the knowledge and practices of indigenous and lower-class women.

The story of midwifery in Lima reveals how the transfer of medical knowledge is never a simple, straightforward process. It's always shaped by the social, political, and cultural context in which it takes place. The struggles in Peru highlight the importance of understanding these dynamics when examining the history of medicine and healthcare.

Why Was Population Growth a Concern in Peru?

A clash of cultures: French midwifery meets Peruvian tradition

Concerns about population size and the need for population growth were a theme long before the arrival of Cadeau Fessel in Lima in the mid-1820s, or even pre-dating Peruvian independence in 1821. Physicians, surgeons, and government officials debated the extent of a perceived population crisis in the colony, and they implemented a variety of medical reform measures to increase life expectancy and reduce the risk and severity of epidemics.

Some reforms, such as the introduction of smallpox variolation and vaccination, were technologies doctors adopted from abroad. Others, like a supposed cure for leprosy and various kinds of hygiene reform measures in Lima, were the products of medical innovations and theories of disease transmission that doctors developed within colonial society itself. Still other efforts focused on the training, licensing, and policing of various kinds of healers in Lima and other parts of Peru. Physicians sought to reinforce their position of authority over surgeons, in particular, but they also sought to ensure that bleeders, pharmacists, and other healers were competent in their professions and worked within the limits of their expertise.

  • Spain: Bourbons initiated a midwifery campaign to achieve formalization of knowledge.
  • Traditional Midwives blamed: High rates of infant mortality and problems with depopulation.
  • Authorities’ Action: protomédicos in Spain and the colonies to evaluate the competence of such women and police their behavior
Basic understanding of the anatomy of the pelvic region. However, the measure was applied rarely or not at all in Peru. While the eighteenth and early nineteenth centuries were important periods for the development of new ideas generally, the implementation of new policies on issues like childbirth and midwifery occurred only sporadically and remained “truncated throughout the period of profound instability that marked the country after the wars of Independence."

A Lasting Clash of Cultures

Cadeau Fessel’s story reveals the complex dynamics of medical change in a society grappling with its colonial past and striving for modernization. Her efforts to impose French medical knowledge on Lima's birthing practices highlight the challenges of cultural exchange and the enduring power of local traditions. While she aimed to improve maternal and infant health, her approach often reinforced existing social inequalities and marginalized the voices of women whose knowledge and practices had long been central to the birthing experience.

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This article is based on research published under:

DOI-LINK: 10.1590/s0104-59702015000100011, Alternate LINK

Title: Between The Foreign And The Local: French Midwifery, Traditional Practitioners, And Vernacular Medical Knowledge About Childbirth In Lima, Peru

Subject: History and Philosophy of Science

Journal: História, Ciências, Saúde-Manguinhos

Publisher: FapUNIFESP (SciELO)

Authors: Adam Warren

Published: 2015-03-01

Everything You Need To Know

1

What was the main conflict in 19th century Lima regarding childbirth?

In 19th century Lima, Peru, French obstetrics, represented by figures like Benita Paulina Cadeau Fessel, clashed with traditional birthing practices due to differing views on childbirth. Cadeau Fessel sought to introduce European medical knowledge, while local healers and traditional midwives maintained their established customs. This conflict reflects a broader struggle between modernization and the preservation of cultural heritage.

2

Why was there so much focus on population size in Peru at the time?

Population growth was a concern in Peru even before Cadeau Fessel's arrival, driving medical reforms aimed at increasing life expectancy and reducing epidemics. Physicians, surgeons, and government officials were actively involved in implementing measures such as smallpox variolation and vaccination to address the perceived population crisis.

3

How were traditional midwives viewed and treated by authorities?

The role of traditional midwives was viewed with scrutiny, as they were often blamed for high infant mortality rates and population problems. Authorities implemented measures through protomédicos to evaluate their competence. However, these measures were inconsistent, highlighting the challenges of implementing new policies during a period of instability.

4

What does Cadeau Fessel's story tell us about medical changes in Peru?

Cadeau Fessel's story illustrates the complexities of medical change in a post-colonial society. Her efforts to introduce French medical knowledge to Lima's birthing practices reveal challenges in cultural exchange and the resilience of local traditions. While her goal was to improve maternal and infant health, her approach inadvertently reinforced existing social inequalities and marginalized the knowledge of local women.

5

Besides medical methods, what else was involved in the clash between French midwifery and traditional practices?

The clash between French midwifery and traditional practices wasn't just about medical techniques. It involved social class, race, and colonial legacies. Reformers' efforts to professionalize midwifery reinforced social hierarchies, marginalizing indigenous and lower-class women's knowledge. This reflects how medical knowledge transfer is influenced by social, political, and cultural contexts.

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