Birthing in Early America was solely the dominion of women, untrained but dedicated. As scientific knowledge advanced during the Enlightenment, medical events such as birthing began to gain recorded case histories. The French were largely responsible for early advances in midwifery practice. The phenomenon most responsible for the separation of women from midwifery was the invention and use of the forceps. Only the trained could use forceps, and the trained were only men. Not only the inferior position of women was responsible for their lack of training, but the extreme modesty imposed upon women by society kept them from seeking training. Astonishing diagnostic knowledge was accompanied by tragic and sometimes humerous treatment. There was an almost total lack of effective treatment methods.