In fact, William L. Minkowski asserted that a male's reputation was negatively affected if he associated with or treated pregnant patients. [2] Resultantly, male physicians did not engage with pregnant patients, and women had a place in medicine as midwives.[2] Myriam Greilsammer notes that an additional opposition to men's involvement in childbearing was that men should not associate with female genitalia throughout the secret practices of childbearing.[4] The prevalence of this mindset allowed women to continue the practice of midwifery throughout most of the Medieval era with little or no male influence on their affairs. Minkowski writes that in Guy de Chauliac's fourteenth-century work Chirurgia magna, "he wrote that he was unwilling to discourse on midwifery because the field was dominated by women."[2] However, changing views of medicine caused the women's role as midwife to be pushed aside as the professionalization of medical practitioners began to rise.