Historians of Britain have long targeted the eighteenth century as the moment when male surgeons moved into the birthing room, beginning to deliver babies and supersede midwives. This transition has been attributed to a range of causes, from the technological (the development of obstetrical forceps) to the cultural (man-midwives becoming fashionable). This chapter problematizes these explanations, situates the change in the larger history of women’s work and views the British experience in the wider European context, as well as in British North America and the French Caribbean colony of Saint-Domingue, where men took a variety of roles. In Paris, for example, male surgeons had been crucial innovators in childbirth since the sixteenth century, while in Italy, a few schools for midwives, run by medical men, functioned from the late eighteenth century; even the German university lying-in hospitals trained female midwives as well as the male medical students for whom they were primarily designed. Seen in this pan-European context, the advent of man-midwives becomes, in part, an English version of the Enlightenment project to improve the life-chances of mothers and babies.