The exam by the Real Tribunal del Protomedicato (Royal Tribunal of Protomedicate)

During the reign of Fernando VI, the Royal Decree of 21 June 1750 was issued which was to change the training of future midwives. This Royal Decree made it compulsory for women who wanted to work as midwives be examined by the Real Tribunal del Protomedicato de Castilla, an institution created by the Catholic Kings to regulate professionals in healthcare. The Protomedicate consisted of proto-doctors who acted as examiners and issued licenses to work in the different healthcare professions of the time. Furthermore, this regulation specified that if a man wanted to work in assisting at delivery, he must previously qualify as a surgeon.

So that women who wanted to take the exam could study, the King ordered Antonio Medina, Doctor to the «Royal Family» and proto-doctor, to prepare a short book for those women who wanted to prepare for the exam. The book, titled ´Cartilla nueva util y necesaria para instruirse las Matronas, que vulgarmente se llaman comadres, en el oficio de partear´ (new and useful primer necessary for instructing matrons, commonly called midwives, in the office of delivery), was published that same year, 1750, and can be seen above. The book made certain recommendations about the characteristics of a good professional, among them being in good health, because of the hardships of working at night and the strength needed for certain manoeuvres; being of a «proportionate» age –neither too young nor too old; not having big hands or calloused hands; not having twisted arms or fingers as it limits the sense of touch; good Christians, merciful, alert and careful, cheerful, modest, loyal and quiet, that is, able to keep any secrets confided to them. They also had to be docile to the decisions of «their elders in proficiency», a clear attempt to maintain patriarchal subordination. Lastly, probably the most difficult requirement, to know how to read and write, which, given the high rate of illiteracy at the time, must have been a difficult condition to meet.