It is suggested that most midwives came from the lower classes and were illiterate.[2] More specifically, Monica H. Green notes that midwives were not required to be literate, and therefore many midwives were not.[5] This suggests that the field of midwifery did not require prior formal education. Additionally, Green asserts that midwives differed from female surgeons and barbers because their spouses were not typically men who practiced medicine.[5] During the late Middle Ages a few books were written for teaching midwifery for both women and men. Prior to this point, midwife manuals contained outdated information and were written by individuals who studied medical theory without physician influence.[1]