Helena Malheim was an eighteenth-century midwife who worked to improve maternity care and to that effect authored a text on the art of midwifery.
Helena Malheim was born in Uppland in 1716. Her mother, Helena Tolstadia, was the daughter of a clergyman from Almunge. Helen Malheim lived with her mother in her maternal grandparents’ home while her father, field surgeon Justus Andreas Maellem, was in active service for King Karl XII on campaign in Fredrikshald, Norway. Her father returned in 1718, at which point he retired from the army and moved his family to Uppsala, where he became an academic surgeon. Helena Malheim lost her mother when was 14 years old, and just ten months later she also lost her father. She later wrote that she had had a ‘”famous surgeon as a father” and that she herself “as a child had developed a great interest in everything related to medical sciences”. It is likely that she had access to the textbook on midwifery called Hebammen Licht, by the Dutch doctor Hendrik van Deventer, as she referenced it in the text she later wrote.
Helena Malheim married the iron merchant Anders Ekström in 1739 and they settled in the residential area near Uppsala castle. Their first child was born in 1741 and Helena Malheim went on to have at least nine children. At some point around 1751 she must have formally trained as a midwife and taken the midwives’ oath in Stockholm. From that time onwards she worked as a municipal midwife in Vänersborg. As such Helena Malheim was one of the remunerated servants of the town, receiving an annual salary of 100 daler silver coins, along with her rent. By comparison, the municipal butcher was paid an annual sum of 300 daler silver coins, whilst the town surgeon’s annual salary was 160 daler silver coins.
According to the midwife regulations of 1711 it was necessary to pass an exam and to take the midwives’ oath in order to be an official midwife. Helena Malheim referred to this when she complained about the untrained women who assisted at childbirths in the town. In 1756 she made a public complaint about them to the town council. That same year she composed her text on childbirth and the art of midwifery, which she sent to the medical college in the hopes of getting it printed. At this point in time she had begun instructing ordinary country women in the art of midwifery but was seeking the permission of the college to train one woman in every parish in Älvsborg region and in Dalsland to be a midwife.
In the summer of 1758 Helena Malheim travelled to Stockholm to attend a gathering at the medical college on 12 July. It was extremely unusual for a member of the “unlearned sex“ to be present at such meetings. The college finally responded to her request at their meeting on 24 July, at which she was also present. Her written submission was viewed as unfinished but she was still allowed to teach the subject of midwifery on the condition that the women she taught did not take the midwives’ oath. Midwives were only allowed to be examined at the medical college in Stockholm.
Helena Malheim continued to fight for official recognition of her profession and she frequently submitted letters to Vänersborg town council. She threatened to start working in Uddevalla as she would receive a higher rate of pay there. She had the support of the town mayor and the town doctor but the elders of the town did not agree to an increase in her annual salary. However, as her husband was an unwaged councillor it was decided that he could be awarded an annual salary instead and that this would satisfy her demands. Helena Malheim re-petitioned the council in March 1759 seeking an increment of 100 daler silver coins on her yearly pay, and made a promise that she would treat the poor free of charge. She eventually succeeded in getting a pay rise but lost her position as the sole midwife as untrained women retained permission to assist during childbirth.
Helena Malheim never gave up her campaign to train women in the art of midwifery and sent another letter to the medical college. This time she additionally sought the position of provincial midwife, but her request was rejected by the college, which at that time was headed by the first Swedish professor of obstetrics, David Schultz (ennobled as von Schulzenheim). It was still illegal for midwives to be trained and examined outside of Stockholm at this time. This meant that few ordinary women had access to the necessary training, and Helena Malheim’s midwifery teachings also remained unpublished.
Helena Malheim was widowed in 1773. She was living with her daughter Ulrika when fire broke out in 1777, destroying her home, as well as two-thirds of the town. Her daughter then got married and Helena Malheim ended up living with her until around 1784. Helena Malheim died in 1795 in the Vänersborg poorhouse.
Helena Malheim’s manuscript on midwifery techniques then fell into the hands of the county governor, Adolf Mörner, who took it with him when he moved to Esplunda in Närke. It has subsequently been preserved as part of the Esplunda archives in Riksarkivet (the Swedish national archives). 200 years after Helena Malheim’s death the manuscript was finally reworked and published by Pia Höjeberg.