century. While the thirteenth century was a time of rapid change and increased
legislation in the medical profession, midwifery was one of the last areas to un-
dergo such change. A look at more plentiful early modern sources can confirm
some of our medieval findings. For example, early modern records from both
England and Germany attest that most midwives were older women who no
longer had young children under foot. Most midwives were of the middle class
and some only worked in periods when their families needed additional in-
come. Many widows who were midwives began to practice shortly after their
husband’s deaths, as they were then in need of a steady means of support.^129
All midwives, both Jewish and Christian, appear to have been mothers them-
selves. This seems to have been a requirement. They learned their profession
by accompanying other more senior midwives and by attending many births.
Until the end of the fourteenth century, there was no formal period of ap-
prenticeship. However, only those women recognized as professionals were
called midwives. At the end of the fourteenth century, some German cities es-
tablished licensing requirements for professional midwives, but no such rules
seem to have existed within the Jewish communities.^130
Our knowledge about midwives is hampered by the dearth of records on
their practice. The secrets of the trade were passed down from generation to
generation. Since the practitioners were all women, few could read Hebrew or
Latin and the extent of their literacy is questionable.^131 The extant literature
was written by men. Consequently, scholars have questioned the relation be-
tween these writings and the actual practices of the midwives. Many of the
medical sources that have reached us from Christian Europe are Latin trans-
lations of Greek and Arabic treatises. Only one group of these texts, those at-
tributed to the Trotula of Salerno, is said to have been written by women or
based on the directions given by women.^132 A number of Hebrew translations
of Greek, Latin, and Arabic treatises from Spain and Provence from the late
twelfth century onward have survived. Among them is a Hebrew version of
Salernus’s gynecological treatise Genicias, as well as a Hebrew translation of
one of the Trotula texts. These treatises, however, as well as others, such as Joel
Ibn Falquera’s Z·ori Haguf were not known in Ashkenaz before the fifteenth
century.^133
There is only one central extant medical source that we can be sure was well
known in Ashkenaz during the High Middle Ages: the physician Assaf’s book
known as Sefer Assaf haRofe.^134 This book originated in the Gaonic period and
contains cures copied from Latin, Greek, and Arabic sources. The German
manuscript of this book contains some German medical terms as well as ref-
erences to physicians in Germany.^135 There are several gynecological and ob-
stetrical cures in this book, mostly translations of Galenus’s medical treatise.^136
The information in Sefer Assaf is too sporadic to enable detailed understand-
ing of the methods they employed. The same can be said for the references to
midwives’ practices in the halakhic materials discussed earlier. In addition, in
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