©Wellcome Library, London

City of London Lying-in Hospital

In the foreground is a mother breastfeeding an infant while 2 children play at her feet. On the left is a figure in rustic dress and a horn of plenty. Surgeon-apothecaries who trained at these hospitals sometimes expressed distaste for the midwifery element of their general practice, largely because it was time consuming and poorly paid. In addition, a maternal death could destroy a practitioner's reputation more completely than anything else. Richard Smith (1772-1843) who practised in Bristol, bemoaned the fact that a surgeon-apothecary ‘cannot be compensated at all by the mere lying-in fee, unless it leads to other business. I know of no surgeon who would not willingly have given up attending midwifery cases provided he could retain the family in other respects.'