Midwifery

The practice of midwifery is respected all throughout the land. Some midwives work for royal families or clans, others focus on a population as a whole and assist any expectant mothers and families in the area they live in. They come from many different walks of life, rich or poor.
Most midwives are female, though some males have been known to give their assistance. Some societies (especially drow-based societies) believe it is bad luck to have an adult male present at a delivery, so it is less common for a man to practice.
She will either work alone, or with an apprentice. In the likeliness of extensive complications, a physician will often be present or on standby just in case. Due to her work, she may also network with other professions such as herbalists or apothecaries to help provide more complicated treatments or if the ingredients she requires to treat her patients are hard to find.

Focus: Drow Midwifery

As a matriarchal society, drow communities take midwifery very seriously. There is even a subset of priestesses that specialize in the practice, who dress differently to present their specialty (they always have their hair pulled away from their faces, the dresses they wear do not have sleeves, and they wear a shawl when traveling to protect themselves from the elements). If a midwife is assigned to a specific house, she will wear a pendant with the house’s emblem on it and may even live with the family. However, it is more common for a group of midwives to overlook an entire section of a populated area and live in a shared living quarters.
In these settings, the senior midwife is in charge of the less experienced and younger women. She is always present at and usually in charge of deliveries, but the younger midwives visit for check-ups and report back to their superior on any updates regarding mothers and their babies. If multiple houses and families need to be checked on, a group of midwives will usually prioritize by which mother is further along in her pregnancy or by how recently a baby was born.
A delivery begins with a prayer from the senior midwife, usually to Lolth, for a successful birth and the arrival of a capable future member of the drow. A variety of herbal and fungal based supplements are available to assist in labor and delivery. The younger midwives usually administer these treatments and tend to the mother as needed, while the senior midwife focuses on delivering the baby. The mother is naked for the birth for the best administration of topical medicines, and for skin-to-skin contact to be made easier after delivery.
At the moment of delivery, the senior midwife cuts the umbilical cord and determines the sex of the baby. One of the younger midwives will deliver the placenta shortly afterward and prepare it for consumption by the mother. It is drained of blood and other fluids, ground into a paste and added to a mushroom-based broth.
A different ritual is conducted based on the sex of the baby and the baby’s birth order. A third-born son is almost always offered for sacrificial purposes, for example. The birth of a daughter is celebrated with a bit more fanfare than the birth of a son, but there is still a special ritual performed for each child.

• Example: A firstborn child, regardless of sex, is blessed in the hopes they will bring prosperity and wealth to their family. The family’s crest is drawn on the newborn’s abdomen in white bioluminescent ink and should remain there for the first week. If the crest rubs off before that time, it is considered a bad omen for the child’s health

Career

Qualifications

A midwife must spend several years learning the traditions of her craft before she can begin to practice. There's a lot of focus on reproductive anatomy, gestation cycles for different races, and the proper application of herbs and poultices. She typically can spend up to two years or more serving as an apprentice under a mentor, where she is supervised for the majority of her work until she is able to successfully perform her duties alone. It's at that point when she is able to work by herself, but she would not be able to train her own apprentice for at least two more years.

Career Progression

Depending on the region and society there are higher positions with different responsibilities. In drow society, a senior midwife (usually an elder priestess) supervises most or all apprentices. She is typically responsible for assigning cases and corresponding with patients and other professionals (apothecaries, etc) as needed.

Payment & Reimbursement

Payment is determined by the region. Some governments will pay a midwife for her work, especially if she does not charge her patients or if she is working for a specific family. In other cases where she charges her patients, the pay is typically increased based on the wealth of the patient's family and if extra work or supplies are needed based on complications.

Other Benefits

Again, depending on the region, some midwives will receive compensation from the government for their services. Other medical workers or those providing services useful to them, such as apothecaries, will usually offer a discount for their supplies.

Perception

Purpose

A midwife's role is to care for mothers and their newborns

Social Status

Midwives are seen on an equal footing to other healers and are equally praised for their work. It is not a job suited for everyone, but it is a job that is overall universally respected.

Operations

Tools

A midwife’s most important instruments are her hands and fingers; she takes good care to keep them healthy and her nails short and clean to avoid harming mother or baby. Other important materials include herbs and poultices with a variety of purposes, a medical knife, a journal for documentation purposes, and potentially other miscellaneous instruments. Her toolkit is in a large sack or backpack she carries with her everywhere. In the event of a major complication or emergency, more supplies may be utilized.

Materials

The herbs and plants a midwife most commonly uses are mint leaves, ginger root, motherwort, raspberry leaves, dandelion, yarrow, and willow bark--as well as any poultices or cordials made using these ingredients. Regional alternatives are used based on what is more accessible in the area. For example, there are fungi and lichen in the Underdark that are used for similar purposes, and a special type of moss--known as Mother’s Moss--can only be found in the Underdark. This particular moss is used to induce labor in the event the mother is overdue and showing no signs of natural labor, so it is greatly sought after by merchants.

Workplace

Most midwives will work in the home of their patients and set up the bedroom or kitchen as needed for the delivery. Sometimes a medical facility or sanctuary dedicated under a deity associated with childbirth (ex: a temple of Taweret or Bes as found in the Thundering Flatlands) can be facilitated as well. Beds, stools, and specially designed chairs are used for the mother to sit or kneel on. The rooms are cleaned thoroughly before a birth, and depending on the situation only select individuals besides the midwife and mother are allowed in the room at a time.

Provided Services

The primary role of the midwife is to aid expectant mothers throughout their pregnancy and especially with the delivery of babies. Check-ups start shortly after the first natural sign of a pregnancy, and continue until the child is old enough to be weaned from their mother (this age will vary by race). Even if the child is weaned earlier, the check-ups will continue until the average age. Frequency of check-ups will depend on how far along the mother is and/or if any health concerns are to be addressed (i.e: a twin or triplet pregnancy, or a history of complications in the mother's family). Other rituals associated with a birth can be performed by a midwife as well, such as circumcision. A midwife can also induce an abortion if it is requested or needed.

Dangers & Hazards

While not hazardous in the sense the work is dangerous, in drow society specifically some families will not take well to the news of a stillbirth, miscarriage, or death of the mother.
One documented case from the Underdark details the execution of a midwife after a matron died in childbirth, despite the fact her death was not caused by malpractice.

Alternative Names

Mudem

Type

Medical

Demand

Staple

Legality

The practice is legal though certain actions taken by the midwife can come under scrutiny. Some regions prohibit the ability for a midwife to induce an abortion unless it is a medical emergency, for example.

Famous in the Field

• Medic Neridia Dhalmane