The Great Midwife Campaign: Procedures and Ideas

28 Jul, 2026

Most roleplaying games are about the planning and execution of murders. This campaign is about the other end.

In March 14, 2021, at 00:06 EST, Retired Adventurer said:

You know, when you think about it, Harn's the only game that makes being a travelling midwife a viable PC concept that's as mechanically supported as the dog-kicking and murder simulation.

The campaign concept is strongly supported by Harn Herb Lore, which includes a variety of contraceptive and abortifacient herbs

Which includes rules for gathering said herbs that push PCs to travel the island, going into swamps and other dangerous places, to collect, process, and transport these herbs to people who need them

I don't know if this was when he came up with it, but there was born the concept of the Midwife Campaign, following a midwife and herbalist and focused on that.

I became aware of it 3 years later, naturally became obsessed with it for a while, and scribbled a bunch of material for it.

I cannot run it right now, I have way too many games going on - as does R.A. - but I do have a ton of study done on it, so I make this post as an alpha version of resources anyone who wants to run it might desire to look at. This is very maximalist, take this as me going through the process of pregnancy and proceduralising everything before deciding what should or shouldn't stick to make an interesting game.

Needless to say, content warning for very graphic descriptions of medical conditions and the potential for a lot of horrible stuff happening to foetuses and pregnant women. My sister had been pregnant the year before I wrote this and it made looking at my 1 year old niece a bit terrifying.

Procreation Procedures

Fertility

Humans have 2d6-2 Fertility (0% to 10% averaging 5%). This is the percentage chance of procreating per month. Use the lower attribute from the couple. On a critical, multiple conception occurs (if the Fertility is at least 5%). In that case, roll 1d20; on a 20, increase it to triplets, and so forth.

This assumes normal frequency of sex, for system purposes that's up to once or twice a week. Halving the frequency (once every other week) actually increases the Fertility by 5.

Nursing mothers have a Fertility of 1%.

Malnutrition reduces the fertility of the woman up to 50%.

An athletic lifestyle for women reduces fertility by 50%, but reduces the chance of miscarriage for physical trauma.

Spirit inhabiting womb (Endometriosis):¹ 15%² of women are affected by it. If affected, there is a 25% chance of being asymptomatic, and a further 50% chance of being entirely infertile. If fertile, is at increased risk of ectopic pregnancy and generally has more pain during menstruation.

Proper rituals and such can keep the spirit dormant, but they must be made repeatedly.

Pregnancy

Noticing the pregnancy: Roll 2d6+6 to check which day of the menstrual cycle the woman gets pregnant. Then count it out until the 28 and count 5 days more. This is around the time when she'll notice that she is pregnant, but the clock is already ticking for the evils below.

• Testing: Most common method of noticing pregnancy is, of course, visually. At 12 weeks (after the first trimester) it will become apparent. But divination may also apply, as well as the wheat and barley test: urinate on wheat and barley over the course of a few days. There is a 70% chance of the seeds sprouting. People also believe that if the wheat sprouts it's a boy, and if the barley sprouts it's a girl, but that's unrelated. (The midwife knows this, but others do not, or don't care)

Due Date: If the pregnancy is not ectopic, set the due date from the first day of conception (since we have perfect information). In-world the due date is usually set from the first day of the last menstrual period.

Roll 2d6+30 weeks.

• On a 32, that's a very early preterm baby.

• 33 and 34 are early preterm.

• 35 and 36 is late preterm.

• 37 to 40 is a regular pregnancy.

• 41 is a late-term pregnancy.

• 42 is post-term.

Add +1 if: first pregnancy, has already had a post-term baby, it's a boy, or has a Heavy frame.

Add -1 if: has had a premature baby before, the pregnancy is unwanted, has a Light or Scant frame.

Late and post-term deliveries have greater risks of vaginal tears, infection, and bleeding. Premature deliveries are easier for the labour, but harder for the infant to survive.

Complications

Ectopic Pregnancy: If conception is achieved, there is a 2% chance of it being an ectopic pregnancy.

+1% if the woman is under 18 or over 35, +2% if she smokes, and +3% if she has endometriosis or had an ectopic pregnancy previously.

If that is the case, there is 10% chance of being asymptomatic and 30% of not having any medical signs. Either way, they will present themselves 1d8+3 weeks after conception. The woman will present 1d3 of the following signs, in order:

• Vaginal bleeding;

• Pain in lower abdomen, pelvis, and lower back;

• Dizziness or weakness.

After symptoms present themselves, check the difference between the week it presents and the 16th week and roll that as a die. If it shows 1, roll 1d7 to see how many days you still have.

Ex: A woman has an ectopic pregnancy, the symptoms show themselves on week 6. Thus the DM rolls 1d10 to see if it will rupture, if untreated, on week 7 or 16. The DM gets a 1 and thus rolls 1d7 for a 4. The midwife has 4 days to correctly diagnose and treat it before it ruptures.

If the tube ruptures, the woman gets a major internal haemorrhage, getting a B1 wound, and 15% chance of being rendered sterile by the experience, if she survives.

• Testing: Barring something that lets one see the format of the vagina, the only relatively sure test is a urine test. If the urine is foamy or bubbly, that indicates it has protein, and therefore it might be it. It might also not be it though, see below.

Miscarriage: is losing the embryo in the first 3 months or so. Roll for miscarriage per week, counting from week 3 because before that it's just inviable.

• Week 3 - 30%

• Week 4 - 25%

• Week 5 - 19%

• Week 6 - 14%

• Week 7 - 9%

• Week 8 - 5%

• Week 9 - 4%

• Week 10 - 3%

• Weeks 11 and 12 - 2%

• Weeks 13 to 20 - 1% per

Add +1% for a Light or Scant frame, for being under 20 or over 35, for smoking, or for drinking. This is non-cumulative.

Make an extra roll in the event of trauma, relative to the mother's lifestyle - a woman who regularly rides wouldn't consider horse-riding a trauma, but one who has never ridden would. Seizures and such always count as trauma.

• Symptoms: Spotting, mild discomfort

Stillbirth: Happens after the 20th week. There's 2% chance of losing the baby before delivery, from weeks 20 to 36. Just roll the odds once and then roll for which week it falls in.

Double those odds in case of smoking and trauma. Reroll in case of trauma, as above.

• Symptoms: The mother will feel it.

Pre-eclampsia:³ The base chance is 5%, but it raises depending on risk category.

• Moderate risk (10%) - If first time pregnancy, Heavy frame or more, being older than 35, family history of preeclampsia (8% if unknown).

• High risk (20%) - Has had high blood pressure, kidney disease, or diabetes; is expecting twins or more; has had pre-eclampsia in a past pregnancy.

• Roll 1d20+20 weeks twice and get the higher number to check in which week it develops. If it's before week 32, it's intense; otherwise it's regular. If the week is after the due date then we have postpartum pre-eclampsia on our hands. For every week that a woman has untreated pre-eclampsia, she rolls Condition (-15 if it's Intense).

  • Success and critical success: Safe, for now.

  • Failure: She suffers a seizure. Roll Condition:

    • Success: No long term consequences, for now.

    • Failure: Internal organ damage, take -1d6 Stamina. If it falls to 1, she enters a coma, and if it falls to 0, she dies.

    • Critical failure: Flip a coin. Heads is coma, tails is death.

  • Critical failure: She suffers a stroke. Test Condition but with multiplier of x3. On a failure or worse, she dies. Otherwise, she is left debilitated and will die in 1d4 years unless brought back.

• Diagnosticating it: Exactly as above. Check urine and see if it has protein in it. If it's Intense she may also experience headaches and dizziness, visual impairment or seeing spots.

Placental Abruption: This is when the placenta detaches from the baby. 1% chance. If it does happen, roll 1d20+20, consider any result after delivery to happen during delivery. Add +1% for pre-eclampsia, if the mother is younger than 20 or older than 35, and if the mother has had 5 kids or more.

If it does happen, roll for 1d20+20 to check which week it happens. If it is equal or after the due date, it will happen during birth; roll for the number of hours labour will take and roll that number for when it will happen. It should happen during stage 1. Also, roll 1d100:

• 1 / 48 - Mild. There may be some blood, but otherwise nothing happens.

• 49 / 76 - Moderate. Vaginal bleeding. The foetus has a 12% chance of death outright. If he survives, there will still be complications during delivery.

• 77 / 100 - Severe. Heavy bleeding. Mother needs to roll against going into shock. Baby has a 50% mortality rate if removed immediately through Caesarean, otherwise the death is certain. If the baby is stillborn or successfully removed, a hysterectomy is needed to save the mother. On top of the Caesarean cut, she'll get another one.

• Detecting it: Vaginal bleeding (bright red or dark), contractions, sudden abdominal pain.

Placenta Praevia: This is when the placenta attaches inside the uterus in a position that partially or completely covers the cervical opening. 1% chance. Increased by 3% per Caesarean survived. Increased by +1% if the mother smoked, if the baby is a boy, if the mother is younger than 20 or older than 35, for pre-eclampsia, and if the mother has had more than 5 children.

If it happens, roll 1d20+20 to check which week it happens. Reduce the due date by 1 week. If it is equal or after the due date, it will happen during birth; roll for the number of hours labour will take and roll that number for when it will happen. It should happen during stage 1.

If it happens on week 26 or before, there's a 10% chance it will go away on its own.

The treatment is the same for excessive bleeding, because that's what's going to happen.

• Detecting it: Should be suspected if there is bleeding after 20 weeks or so. Can be ascertained for sure with an examination.

Other symptoms of protein in the pee: Aside from checking urine, other symptoms could include these. Most women will show 1d4-1 of them:

1. Shortness of breath

2. Tiredness

3. Lack of appetite

4. Muscle cramping at night

Labour and Delivery

Labour is divided into 3 stages:

1. Dilation

This phase is divided into latent and active. Latent is half of the dilation with mild or almost imperceptible contractions; active is more severe.

For a mother's first birth, the latent phase takes 1d10+10 hours.

For a mother who's already had a baby, the latent phase takes 1d10+5 hours.

If you roll a 10, roll again and add that to the total.

For both, the active phase takes 1d4+2 hours.

Add +2 hours in case the labour has been induced.

Complications: In case the latent phase takes 16 hours or more it is considered prolonged, and it is recommended that labour be induced by puncturing the amniotic sac. This shouldn't be done if the baby isn't headfirst, but if he is, there's a 5% chance he'll shift, and another 1% that there will be a umbilical cord prolapse. In case of induction, check for placental abruption again.

If the birth is prolonged, check again for placenta praevia, placental abruption, and uterine rupture.

Breech Baby: Independently of the amniotomy, there is a 4% chance the baby will be in breech position in a regular pregnancy. Add +4% if the baby is premature, for each degree. Add a further +4% for each baby, in case of twins and triplets, and another if you've been pregnant before.

This makes birth very dangerous.

Turning the baby has a rate of 58%, and is done by massaging the belly and takes about 2 hours.

If unable to turn the baby, test this in succession: 4% of baby death and 3% of converting the baby to unhealthy independently of other status.

If this passes, there's an 8% chance of the head getting stuck, double that if premature. In that case the midwife will have to remove and get an assistant to exert pressure and help. Without anaesthetics this is PAINFUL and DIFFICULT. Will require a roll.

This is where making the birth easier will make future deliveries more difficult.

Umbilical cord prolapse: The umbilical cord came out before the baby. There's an independent 1% chance of this happening, another 1% in case of the breech baby. Raise that to 2% in case of premature baby or to 4% in case of an overdue baby. Add +1% if the mother has already had 5 or more babies.

If this is the case the baby will die if not removed asap. Caesarean is the way.

Uterine Rupture: The tearing of the wall of the uterus during pregnancy. 5% base chance, double it if survived a Caesarean before, and again if the baby is late-term, and once more if post-term. This will cause bleeding.

If this happens, immediate Caesarean is required to remove the baby. Even with that, there's a 5% chance of death for the infant.

Bleeding: If anything until here has caused bleeding, the mother starts losing blood at a rate of B1, or B2 if it's severe.

Caesarean: A roughly 6 inch deep and long cut made to remove the baby. As per HM3, this counts as a Grievous Cut on the Groin (G4), thus the mother starts accumulating Bloodloss at a rate of 1 per minute. A roll of Physician is required.

• Critical success - Baby is removed in time for treating bloodloss and closing the cut.

• Success - Baby is removed in 2d6 minutes.

• Failure - Baby is removed in 3d6 minutes.

• Critical failure - Mother dies of blood loss immediately.

2. Delivery

The cervix is fully dilated and the baby is being pushed out.

This phase lasts 3d20 minutes for new mothers and 1d20 for others.

The midwife rolls Physician here:

• Critical or regular success - The baby is delivered without complications.

• Failure - The baby was in an awkward position and the midwife had trouble taking him out, the baby is Unhealthy. The midwife can choose to sacrifice the health of the mother and reduce her Fertility by 1d4 to avoid this.

• Critical failure - The baby suffers something serious and is born Unhealthy. The midwife can instead choose to render the mother infertile to get the baby out (with no guarantee for its health).

3. Placental Expulsion

The foetus is out, we're waiting on the placenta. There are complications to this in real life but we'll elide it.

Infancy

Breast-feeding: If able and willing, a mother will breastfeed her child. After birth, the mother tests Condition - in case of multiple birth, get a penalty of 5 x the number of babies. The roll is made and cumulative by order of child prioritised, so if triplets are born, milk for the first baby is rolled regularly; for the second baby it's rolled at -10; for the third baby, at -15.

• Success and critical success - Adequate milk is available.

• Failure - There is milk for a month. Afterwards, roll again.

• Critical failure - The mother doesn't have enough milk.

In case the mother doesn't have enough milk, a wet nurse needs to be found, typically a mother whose own child hasn't survived.

For every period, an infant mortality roll must be made. There are 6:

• Roll at birth for survival of the first day.

• Roll on day 2 for survival of the first 10 days.

• Roll on day 11 for survival of the first month (up to day 30).

• Roll on day 31 for survival of the first 3 months (up to day 90).

• Roll on day 91 for survival of the rest of the first year (up to day 360).

• Roll on day 361 for survival of the second year (up to day 720).

After that, the child is subject to the same conditions as adults, such as plagues.

Both roll the mother's Condition. Healthy babies roll at +10, unhealthy at -10, and add a further +10 if the child has been weaned. Modify it further by standard of living: +15 Ostentatious, +10 Quite Wealthy, +0 Reasonably Comfortable, -10 Low Income, and -20 Poorest of the Poor.

• Critical success - Infant seems healthy throughout the period.

• Success - Infant not in jeopardy (though there may be an illness scare, but they'll pull through)

• Failure - Infant gets sick with a moderate disease.

• Critical failure - Infant gets sick with a grave disease.

As all diseases are spirits, "moderate" and "grave" refers to the power of the spirit, how hard it is to exorcise, and how deadly it is.

Herb Lore

A lot of this comes from the HârnMaster supplement "herblore", but I don't remember how much of it I changed - not a lot, I think. Once more: these are untested suggestions.

Herb Knowledge

Players start with knowledge of the herbs that the Old Midwife knew, so mainly the herbs relating to childbirth and blood pressure. To figure out new stuff about it you gotta:

• Find a teacher who knows

• Read about it in a book

• Test it yourself

So you go to the field, find a new herb, and now you gotta either look up its appearance on a book, ask around, or test it.

• Herbs that are very common or common in an area will likely suffice asking a local herbalist. Otherwise, you'll need a proper professional.

Also, written works increase the skill as such:

Oral information - Modify search by -5.

Scroll or oral information - Talks only about 1 herb. Modify search by -5, increase skill by 1d3.

Tract - Examines several herbs of the same group in detail. Modify search by -10, increase skill by 1d6.

Tome - Herbariums and other "dictionary of herbs", contains many but not very detailed, and rarely have illustrations. Modify search by -15, increase skill by 1d10.

Herb Gathering

General Search: If you just go up to a place and gather whatever plants look nice, the DM just rolls regularly on the list and sees what you get.

Special Search: If you got a specific herb in mind, roll herblore modified by rarity, applied to the skill modifier, and then apply the modifier by where you know the herb from:

• Very common +1

• Common 0

• Uncommon -1

• Rare -2

• Very rare -3

Each roll takes 1 watch.

Bad habitat: Some habitats are bad, marked per plant. In these cases, multiply the supply by 0.8x (reduced by 20%).

Effect and Risk: Each herb has a % of how likely it is for the effect to take place or a risk. These are then modified by stuff, such as:

• Different habitat: If not found on its Best Habitat, chance of both is decreased by 15.

• Lack of replenishment: If you use less than the recommended dosage, the chance of both decreases proportionally. That is, if the dosage is 5 blooms and you use 4, the chance of both is reduced by 20% (4 is 20% less than 5).

• Inferior recipe: Recipes marked with 0 have no reduction, marked with 1 has a -10, marked with 2 has a -20. If the recipe is not listed at all, the effect is decreased by -30 and the risk is increased by +30.

• Old herb: The effect and risk decay at a rate dependant on used part:

  • Roots lose -5 per month

  • Twigs, spears, and stems lose -5 every 10 days

  • Leaves lose -1 per day

  • Blooms and petals lose -2 per day

Recipes

To produce remedies you roll Herblore too with the production modifier, but Alchemy can also be used. The level of success affects the chance of effect and risk:

• CS +10

• S +0

• F -20

• CF Production failed

Also, each production type keeps for a certain time, rolled in secret.

If the dosage for a recipe isn't mentioned, it's enough for 1 treatment.

Decoction: Putting a small spoon of crushed herbs into a pot of cold water and then boiling it for 10 min, letting it steep, then sifting it with a colander, to make a kind of tea.

• Production Modifier +0

• Keeps for less than a day. Must be drank immediately.

Herbal wine: Hackled herbs are put into a vessel filled with white wine, then closed and left undisturbed in a dark place for 3 weeks. Then the fluid is distilled into another (preferably opaque) vessel, which should be closed with a cork. The normal dosage is 3 small spoons a day, and half a pint has liquid for approximately 40 treatments - aka 13 days.

• Production Modifier -10 (+5 if using Alchemy)

• Keeps for 1d7+5 months.

Maceration: A spoonful of herbs is inserted into cold water and then steeped overnight. In the morning the ater is strained and heated slowly, then drunk.

• Production Modifier -5

• Keeps for 1d2 days

Ointments and salves: To make one it requires 1/8 of a goblet of vegetable oil and 1 dram of beeswax. They're mixed and heated until the wax has completely dissolved. Afterwards, the ointment is taken off the fire and cooled down until hand-hot, and then the herb ingredients are added and the ointment is stirred carefully. There's 32 drams in a vessel, it takes 1 dram for a Minor Cut / Tear; 2 or 3 for Serious ones; and 4 or 5 more for Grievous ones.

• Production Modifier -15

• Keeps for 1d2+2 months

Pills (10): Usually prepared by mixing pulverized herbs with a tiny bit of syrup, jelly, gum, resin, and / or honey and heated until it forms to a thick paste. The paste is then formed into small balls that are coated with a thin layer of wax.

• Production Modifier -15

• Keeps for 1d3+5 months

Pure: Just applied directly, either eating the blooms and leaves, or added to bandages.

• Production Modifier +10

• Keeps for variable time

Syrup: Mix bruised herbs with honeyed water, wine, barley water, or fruit must. This is boiled for several hours. Eventually the mixture is removed from the heat, strained, and cooled. One preparation has enough syrup for 75 treatments.

• Production Modifier -10

• Keeps for 1d5+7 months

Tea: A spoonful of leaves or blooms is put on a cup and then doused with boiled water, then steeped for 10 min and strained.

• Production Modifier 0

• Keeps for 1d7+5 hours

Tincture: The gathered herbs are cut into very small pieces that are then put into a vessel filled with brandy (or another spirit) until all leaves are covered. The closed vessel is left for 10 days in good sunlight with occasional shaking. Then the fluid is strained into another vessel (preferably opaque) for a few hours, closed with a cork. A normal dosage is about 30 drops 3 times a day. A regular tincture has liquid for approximately 100 treatments (33 days).

• Production Modifier -10 (0 with Alchemy)

• Keeps for 1d2 years

I then intended to do a hugely long list of herbs but didn't get around to it. I was going to adapt the ones in HerbLore and include new ones.

Interesting Events

General interesting things for the campaign:

• One of the maids is pregnant and no one can admit it's the lord's son but he's also tremendously curious and involved in the whole process despite having no qualifications and being more of a hindrance than a help, and also the maid loves him and wants him to acknowledge the child as his, but his parents will drum all involved in any acknowledgement out of the manor.
• Choosing whom to help, such as a wounded knight who shows up and is a known enemy of the lord, or a teen girl who wants an abortion but knows if their parents find out she's cooked
• Being there for a bad situation and having to testify in court about the virginity of a woman without full information
• "Janie's having a baby, but the bridge that leads to Babytown is blown out, someone has to ford the river a week upstream to get medicine from Babytown and get back before Janie goes into labor"
• figuring out how a couple where the man is sterile can surreptitiously have a child
• helping a woman who is having an illegitimate child to disguise the fact
• this time the city you're all in is under siege
• the woman goes into labour in bandit-infested woods in winter when her coach breaks down
• two noble families are at war and one of them tries to secretly poison her so she loses the child but actually gets almost all of you and the family with the same soup serving
• It happens in winter and there needs to cross a frozen river
• Bread riots as plague ravages the land
• Crusade

And this was my thinkboard with assorted nonsense, thoughts, errant ideas, annotations, half-formed sentences, etc - I think quite a few of these were ideas said by Retired Adventurer and other people at one point or another that I ravenly brought to my nest:

• We need a map of the biomes, along with how far they are, routes to get there with strategic choices balancing time and risk. Food and gear are of no import, assume they're always staying at an inn.

• Multiple pregnancies might happen at once, and the herbalist needs to be prepared with her herbs, making tinctures and oils and stuff. At game start there are probably some remaining resources in the old midwife's house, but after a while they'll need to manage the resources along with the time it takes to make the tinctures, forage it, and be taking care of different pregnancies at once.

• Lots of stuff related to food and dieting

• Hypertension and arrythmia

• You'd chart out each woman's pregnancy, identify a few key factors / complications and timeframes to resolve them, and vary the amount of time PCs have to get there and then help deliver the child successfully.

• Chart out complications, then determine how they're diagnosed, and you may need to adventure to get some of the supplies you need. Plus, getting there faster and having more time with the pregnant woman means you can monitor the situation and prevent the accumulation of failed checks / complications that she's building up. Basically like a sustained test in a game with a decent skill system. Plus PC problem solving.

• I think you could prepare a simple handout labelling potential issues, and then since you're the same midwife each time, a player could come to learn the specific likely complications of this family as well.

• I think you want to avoid a situation where there are eight midwifery skills a PC needs to pick and choose between, without going to a set up where it's "roll to win" either.

• Probably some sort of herbalism / alchemy skill to make curatives, a medicine skill for various injuries and the like, and then maybe one other skill. Pulling this off would mean giving the other PCs stuff to do as well, so you'd have situations where the baron's wife is stuck on a carriage that's broken down, and the midwife's, IDK, carpenter husband needs to get the axle fixed so everyone can get home because there are wolves in the forest the carriage is in, and there can be one wizard but his skills will be mostly irrelevant to the problems the PCs are actually facing so he'll be the trap option for the guy who always needs to play a wizard. I figure somewhere between 6-12 births would be fun to do. Probably a mix of pregens and custom chars if someone really wanted to play a particular concept like wizard, ninja, mercenary knight, but no concessions to the latter in terms of subject focus. You'd need a map, a pregnancy chart, a weather chart, a calendar, a list of PCs, a list of NPCs, and then some challenges and problems for each episode.

• The room itself needs to be nice

• "The whole point of the Great Midwife Campaign is that one PC starts off as a young midwife who needs to go and help the local lord's wife give birth to her first child, and then you follow the fortunes of the noble family as they rise in power and prominence and keep having more children, moving further and further from the rural manor where the PCs live, but insisting on having the same midwife giving birth to all of their children. So it's a multi-generational campaign for the NPCs, and the midwife gets older and wiser but also has her stats fade over time, and the rest of the PCs are like, her wheelman, a guard, etc. who enable her to get there in time, and then you use the pregnancy and descent mechanics to deal with how the birth goes"

• So the risk comes not from like, orcs chopping off your penis while you try to steal their pocket change, but from trying to prevent an amniotic tear from causing premature birth, or figuring out how a couple where the man is sterile can surreptitiously have a child, or helping a woman who is having an illegitimate child to disguise the fact, or dealing with a twin situation where they're going to have low birth weight, but also you put exciting stuff in the background.

• the campaign follows the midwife and her team as the noble family marries, breeds, etc. moving closer and closer to the capital while only trusting this one midwife to deliver their children, plus the situations grow increasingly more complex over time

• Midwife in medieval Europe is a relatively privileged position. It's typically done by widows, for pay, using expert knowledge, and midwives with good reputations were highly in demand and were essentially the top tier of the medical profession for women

• One guy starts off as a carter with a cart, he's the wheelman who has to get everyone there in time, and back up muscle. Another person could be the priest who has to christen the child and can provide minor magical support if shit goes off the rails, someone else can be a guard or a guide or both to help them get where they're going, etc.

• But yeah, the core of the GMC is that you're taking the typical elements of the overland adventure and social problem solving, and foregrounding those in a context where the goal isn't to punch anyone out, but there's still a mechanical challenge of similar complexity sitting at the end of that

• e.g. the woman might be traveling in a coach that crashes and go into an early labour, and the muscle guys have to lift everyone out of the coach and shift it out of the way, and someone else might have to control the scene so the distraught husband doesn't interfere, and so on

• Each birth should be the high point of the adventure, so you want the situation to be spiralling out of control and putting pressure on everyone before the PCs even get there, and then of course the birth lines up with the resolution or abatement of the larger crisis, whatever it should be

  • So the rioters are throwing chairs through the windows of the urban manse and marching in the streets sacking places, and the muscle guy has to hold the door closed to the chamber where the woman is giving birth, with the midwife and maybe the priest inside to help out, and the manor guards are running around screaming outside and the lord firing his pistol or shooting arrows wildly at anything that moves, etc.
  • Some can also just be endogenous to the challenge, like a breech birth or twins or two members of the family pregnant at the same time or whatever and everyone standing around trying to help but being mechanically useless except for the midwife and the pregnant woman, which is also accurate to the stressful situations of birth

• You can also do stuff like "the lord will be unhappy if I don't have a son" or "I'm having trouble conceiving" with the midwife tasked with figuring shit out

• Don't forget because you're dealing with nobles you need a wet nurse, which means you're either trying to find a lactating women whose kid has just died who isn't herself a troublemaker or else a woman who is willing and able to nurse both

  • You're the midwife, your job is to sort shit out
  • That's what they're paying you the big bucks for

• Yeah, even outside of stuff like the medieval equivalent of a car crash or difficult births because two twins are breeching or whatever, you have all the social politics around births, and it's a moment in life where women's social influence is particularly high

  • So Baronness So-and-So fucking hates Lady Such-and-Such, your client, and is going to ratfuck the whole situation so that it's as miserable as possible, and since you're the family's midwife, taking you out is the fast route to making that happen

• Your last job, you're an 100 year old woman with your own apprentices (who can be PCs!) with crazy skills but terrible physical stats.

• By the thirteenth century there were books, not yet wholly devoted to the bringing up of young children but offering advice on the matter among their other concerns. Aristotle himself, a chief classical author studied in medieval universities alluded to babies and their care in the seventh book of the Politics. Their diet should be based on milky food, not wine which leads to disease. Crying and screaming should be tolerated, since they strengthen the body, and not impeded as Plato recommended in the Laws. Older children should be allowed to move freely, kept amused and accustomed to the cold from their earliest years to harden them for war. Giles of Rome repeated these precepts in about the 1270s, but he misunderstood Aristotle's opinion on crying and quoted him as saying that it should be discouraged because it weakened the spirits. The fullest account of baby-care which circulated in medieval England was that of Bartholomew Glanville in his encyclopaedia. Bartholomew gives a whole chapter to the care of the infant and another to the duties of the nurse, both evidently reflecting what was done as well as advising what ought to be. The nurse bathes the baby, and should do so frequently. She anoints it with oil of myrtles or roses. She feeds it first from the breast and later with food, chewed in her mouth and pushed with her fingers into the mouth of the baby. She swaths the child in sheets and cloths, with the limbs stretched out and tied with cradle bonds, lest they should grow deformed. She dances the child up and down and rocks it in the cradle. She talks to it and lisps her words in baby-talk. She lulls the child with cradle-songs and, says Bartholomew, should put it to sleep in a dark place lest its eyes be dazzled with bright lights. Sleep is important for children because it concentrates their warmth in their inner parts and helps them to digest. Walter of Bibbesworth adds to this some observations on children as they grow older. They start to crawl as soon as they can use their feet. Directly this happens they cover themselves with dirt, and a boy or girl should be assigned to follow them round and see that they do not stumble or fall. A dribbling mouth should be wiped with a cloth, called in English a "slavering clout". When a child stretches out its hand in the morning for bread, it should be given a lump or a slice. At dinner time it is good to open an egg, taking off the shell and the white and giving the child the yolk, or to cut up an apple and give it the flesh after paring the core and peel. Later on it should be encouraged to dress itself and learn how to do up its buttons. Neither Bartholomew nor Walter had much space to give to nursery life, but they both perceived its interest and importance, and recorded many little details for which we are grateful now. For this they have an honourable place in the history of childcare.[

• One element to think about as well is that a medieval woman who can afford a midwife is probably going to have a bunch of kids, not just one or two, and so one element of mechanisation could be "Do you trade off things that will make this birth easier or resolve complications straightforwardly with making future births more difficult?" and vice versa. For example, if the mother experiences fissuring during birth (fairly common), you'll need to suture her fissure shut for proper healing (this is a bit ahistorical, since sutures were really only reintroduced to European medical practice in the 16th century IIRC). A tight suture will be more effective at reducing bleeding than a looser one would, and will heal faster, but will also potentially produce a scar that threatens to retear open on future births, increasing the risk of future fissuring.

#advice and aids #gameable content #the great midwife campaign