C-Sections Before Anesthesia

By Holly Tucker

C-sections were the surgery of very last resort and rarely performed until the mid-to-late eighteenth century. While they were not common, this does not mean that the procedure did not take up good-sized sections of obstetrics texts. In fact, the more difficult and horrific the procedure...the more often you'll get to read about it in early manuals.

You have here an inventory of the tools required for a caesarean section in the very early eighteenth century. This is taken from Pierre Dionis's Course on Surgical Operations [Cours d'Operation de Chirurgie], published in 1708.

Dionis (pronounced Dee-oh-nees) was an innovator in surgical instruction and ushered in a new emphasis on formal training of surgeons. He began his professional life as a surgical and anatomical demonstrator at the Jardin du Roi--now the Paris Jardin des Plantes. Open-air dissections were performed at the gardens and usually drew a large crowd of spectators.

Dionis later became a court surgeon. He documents the work he did at court and describes the demonstrations that he performed at the request of Queen Maria Theresa (Louis XIV's wife). One that sticks in my mind is the dissection that he did following the death of a pregnant woman. The Queen requested that he give her a lesson on the anatomy of the womb and specifically demanded that he bring in specimens from the newly dissected corpse.

More on early c-sections

More on the history of anesthesia

Stephanie Snow on anesthesia's dark side

Image: Wellcome Library for the History of Medicine, London

Midwives and Witches

by Bronwyn Backstrom (Vanderbilt University)

The ideas of witches and witchcraft have been around for centuries and were hot topics. Witches were typically identified as older single women of lower class. Throughout history, there has been a stereotype that only women, specifically midwives and other women-healers, were witches. Women were targets because of the tradition of misogyny; women's participation in folk-healing; and changes in the awareness of female nature, their family and economic roles, and ideas of women's social behavior.

Female witches were accused of three main things: female sexuality (this included every sexual crime against men), organization, and having magical powers (both good and bad) that affected one's health. Witchcraft was considered to go against the Catholic Church. It was considered a threat to God's holy order because it was not based on scripture or religion. In addition, all witchcraft was considered based off of carnal lust, or strong sexual desires, with evil spirits.

The Malleus Maleficarum, meaning "Hammer of Witches," was written in 1484 by two reverends: Heinrich Kramer and James Sprenger. This book contains everything one needs to know about witches and witchcraft at the time, from what defines a witch and how they become one, to the sentences they would receive because of their participation in witchcraft. It also contains information on witch-midwives.

According to Malleus Maleficarum, witch-midwives were considered the most wicked and dangerous witches, who inflicted the greatest injuries. This is because they dealt with the health of others and had easy access to newborn children, who were used in offerings for the evil spirits. Witch-midwives were accused of causing miscarriages; however, if they allowed a child to be born, they would allegedly either feast on the child or offer it to the evil spirits, allowing the witches to infect the child and turn it into a witch.

The evil spirits called the witch-midwives to offer them newborn children for several reasons. One was for their pride. Another was to disguise the act of infidelity as a virtue. By associating children with the evil spirits, the witches drew in more innocent people, making it easier for them to turn into witches. Finally, they used the children to fill their ranks. When the evil spirits infected children at an early age, turning them to witches, they could set them aside to be used in the future as needed.

There was a decline in accusations against women as witches between the 17th and 18th centuries because of the increase in male midwives. Men began to replace women, resulting in fewer women in the field who could be accused of witchcraft.

Image: Heinrich Kramer and James Sprenger. Malleus Maleficarum, 1669. (Courtesy of Wellcome Library, London.)

References:

Brauner, Sigrid. Fearless Wives and Frightened Shrews: The Construction of the Witch in Early Modern Germany. Amherst: University of Massachusetts Press, 1995.

Ehrenreich, Barbara, and Deirdre English. Witches, Midwives, and Nurses: A History of Women Healers. Old Westbury: Feminist Press, 1973.

Kramer, Heinrich, and James Sprenger. Malleus Maleficarum. Trans. Reverend Montague Summers. Manchester: University of Manchester Press, 2007.

Food for Thought

Here's a tidbit for any Wonders and Marvels readers out there who may be thinking about starting a family.

Until the late seventeenth century, Galenic notions of the body as a complex system of fluids (humors) dominated. In the sport of baby-making, the end goal was to mix male and female "seed" in just the right quantity and quality to make a boy. So this meant that the hotter the better.

Men were considered hot and dry in humoralist models. So, if the seed mix was hot, a boy would be born.

So, here are a few seventeenth-century tips for all of you out there. If you want a girl, stick with those cold foods like fruit and lettuce. If you want a boy, head straight for foods that early-modern physicians classified as hot: wine, meat, arugula.

I'm not so sure about the recipe for dried stag testicles, though. If it works for you, let us know. Early doctors recommend that you sprinkle them liberally onto your food.

Imagine this: "Excuse me, Sire. But could pass the salt and testicles?"

For more eclectic musings on embryology, childbirth, chastity belts, brothel madams, you name it...
take a peek here.

Book of the Week: Keepers of the Keys of Heaven

By Holly Tucker

Here is an assignment that would send deep panic through my writerly self: Please write, in 500 pages or less, a history of Popes from the beginning to the present day.

Roger Collins has risen to the task magnificently! Written with clarity and verve, Keeps of the Keys of Heaven: A History of the Papacy is an approachable and deeply satisfying read on the big History (big H) of Popes that is interwoven with lots of intriguing behind-the-scenes history (little h).

For example, who knew that a woman named Donna Olimpia was the first and only woman ever permitted to address the secret-shrouded conclave following the death of Pope Innocent X, in 1655?

Donna Olimpia was the pope's sister-in-law and had been rumored to be his mistress. She was a formidable business woman who shepherded the family fortune, while also making time to take over the licensing of brothels in Rome. Brothels, it seems, were regulated by the papal administration until Olimpia made the case that this was an activity completely unbecoming of God's church. Makes sense.

My guess is that there was also a little bit of financial incentive for her work. In fact, as Collins explains, the licenses that appeared over the doorways of houses of ill-repute soon bore her family arms. Thus giving her then nickname of La Pimpessa.

Ever curious, I have an email out to my colleagues who teach Italian for the full 17th century vocabularies of Italian Madams. I'm so curious about the play on words between Pimpessa and Papessa--which were, it seems, Olimpia's nicknames.

Professor Collins will also be here on Thursday to talk about Popes and booze. Amen.

And for those of you who can't get enough of Church trivia, you might take a peek at this gem about the Virgin's fertility belt.

Sacred Relic or Heavenly Accessory

Miracles of Prato

Childbirth as a Spectator Sport

By Catherine Delors

At Versailles, not only the Queen, but princesses of the royal blood were required to give birth in public. Why? To prevent any substitution of the infant in case he was destined to reign. I say “he” by design, because France’s unwritten constitution prevented women to step unto the throne in their own right, though they could, and often did govern the Kingdom as Regents.

In the case of Marie-Antoinette, her first laying-in was all the more eagerly awaited that she had been married for eight years without presenting her husband with an heir. For a Queen, this was a glaring failure. Her sister-in-law, the Comtesse d’Artois, married to the King’s youngest brother, had already been delivered of two healthy little boys. Marie-Antoinette had attended the deliveries, as required by the etiquette, and deeply felt the political and personal humiliation of her own childlessness.

Now at long last she herself was pregnant. The stakes could not be higher: if the child were stillborn, or a girl, the heir to the throne would remain the Comte de Provence, another brother of Louis XVI. The Comte de Provence was cunning, ambitious, and probably the most dangerous enemy of the royal couple. Every year that passed without Marie-Antoinette giving birth to a Dauphin brought him closer to the throne (to which he would eventually ascend, decades later, under the name of Louis XVIII.)

Let us listen to what Madame Campan, First Chambermaid to Marie-Antoinette, tells us in her irreplaceable Memoirs: “The Queen’s laying-in approached; Te Deums were sung and prayers offered up in all the cathedrals. On December 11, 1778, the royal family, the Princes of the royal blood, and the Great Officers of State spent the night in the rooms adjoining the Queen's Bedchamber.” This, by the way, was days ahead of time because the child would not be born until the 19th of December.

Finally, before noon, it became certain that the birth was imminent. “The etiquette,” continues Madame Campan, “allowing all persons indiscriminately to enter at the moment of the delivery of a queen was observed with such exaggeration that when the obstetrician said aloud: “The Queen is going to give birth!” the persons who poured into the chamber were so numerous that the rush nearly killed the Queen. During the night the King had taken the precaution to have the enormous tapestry screens which surrounded Her Majesty’s bed secured with cords; but for this they certainly would have been thrown down upon her. It was impossible to move about the chamber, which was filled with so motley a crowd that one might have fancied himself in some place of public amusement. Two chimney-sweeps climbed upon the furniture for a better sight of the Queen.”

Marie-Antoinette fainted. Was it simply pain? The body heat created by the crowd packed in the bechamber? The feeling of being exposed to strange eyes in a circus scene? Or the pressure to give birth to a boy? Apparently Marie-Antoinette and her friend the Princesse de Lamballe, Head of the Queen’s Household and member of the royal family, had agreed on a sign the Princesse would make to inform Marie-Antoinette of the child’s gender as soon as it became apparent. Normally that announcement would have been made more formally minutes later, and Marie-Antoinette wanted to know right away. And the child turned out to be a girl! Maybe the disappointment was enough to make the Queen lose consciousness.

The obstetrician decided that the patient needed to be bled (indeed what patient wasn’t in need of a good bloodletting in the 18th century?). More sensibly by modern standards, he called for the windows to be opened wide.

The King sprung to action. The windows had been stopped up (Versailles has always been notoriously drafty) and he rushed to force them open. Let us not forget that Louis XVI was a man of unusual height and strength.

The Court’s head surgeon then seized his lancet and bled the Queen. Whether thanks to his ministrations or more likely the rush of fresh air in the stifling room, she opened her eyes. At this moment the Princesse de Lamballe, who was much given to what was then called “nervous spasms,” added to the general confusion by fainting herself. She had to be carried through the crowd “in a state of insensibility.” Only then was it deemed necessary to empty the room of all idle onlookers. “The valets,” writes Madame Campan, “dragged out by the collar such inconsiderate persons as would not leave the room.”

“This cruel custom,” continues Madame Campan, “was abolished afterwards. The Princes of the family, the Princes of the blood, the Chancellor, and the ministers are surely sufficient to attest the legitimacy of a prince.”

Certainly it was an improvement, but that still left a few dozen people to attend every royal birth...

Catherine Delors is author of Mistress of the Revolution. She also keeps a fascinating blog on all things royal during the eighteenth century.

Sacred Relic or Heavenly Accessory?

By Laurie Albanese and Laura Morowitz

Since the beginning of time women have understood the importance of a well-chosen accessory. Think Cleopatra’s asp, Jackie Kennedy’s pearls, Coco Channel’s hat. Even the Mother of God, it seems, was not immune to the accessory’s allure.

Indeed, the Sacred Belt of the Blessed Virgin may be the only fashion accessory in history to have been venerated by Pope John Paul II, housed in a locked chapel in Italy, and stolen under threat of death. This simple gold and green woven silk sash has inspired frescoes, altarpieces, poetry and prose, and countless prayers. Lovely as they are, it’s hard to imagine Candace Bushnell’s Manolo Blahniks arousing similar decades of devotion from the likes of Saint Francis, Saint Bernard, or Maria de’Medici, all of whom communed with the relic.

Purportedly passed from the Blessed Mother to Saint (“Doubting”) Thomas at the moment of her assumption, the Sacred Belt is ascribed with the miraculous properties of aiding conception, gestation, and protecting women in childbirth. Since the 13th Century the belt has been housed in Prato, Italy, where it was carefully guarded by a merchant who brought it from Jerusalem as part of his wife’s dowry. The man slept with the belt under his pillow, but after his death it was passed to the safe keep of the church. When it was ‘miraculously’ recovered after a theft in 1312, a gated chapel was built in Santo Stefano Cathedral , where the belt remains under lock and key surrounded by colorful frescos depicting its illustrious history.

Today, as it has for centuries, the Sacred Belt draws hundreds of visitors to the small Tuscan city of Prato each September 8th to celebrate the Feast of the Blessed Virgin. It is on this date in 1456 that bad-boy Renaissance painter Fra Filippo Lippi is reported to have snatched the novice Lucrezia Buti from the streets of Prato, and taken her to live in his workshop. This scandal, along with the legend of the Sacred Belt, play an important part in our novel, The Miracles of Prato.

About the authors:
Laurie [Lico] Albanese’s books include Blue Suburbia: Almost a Memoir, Lynelle By the Sea, and The Miracles of Prato , co-written with Laura Morowitz. She has written for The New York Times, the Chicago Tribune, Mothering magazine, and many other periodicals. She is the recipient of a New Jersey State Council in the Arts Fellowship in Fiction Writing, and a Catherine R. Dodge Foundation Fellowship. Visit her website at www.laurielicoalbanese.com.

Laura Morowitz is Professor of Art History at Wagner College in New York. She is the author of numerous articles, reviews and publications on European and American art, and on popular culture. Her pieces have appeared in The Art Bulletin, The Oxford Art Review, The Art Journal, The Journal of the History of Collecting and The Journal of Popular Film and Television. The Miracles of Prato is her first novel.

About the image

A 19th Century Abortionist

By Beverly Swerling

It’s tempting to think the abortion wars started with Roe v. Wade, but it’s not true.

In the early eighteenth century abortionists advertised in New York City broadsheets offering “guaranteed cures” for “female problems,” code for an unwanted pregnancy. The cures took the form of a variety of purges and placebos, and the non-sterile, non-anaesthetized version of what we’d now call a dilation and curettage when performed by a doctor, or a back-alley coat hangar special at the hands of an unqualified abortionist.

Just as the title quack was not a pejorative in colonial times – quackery was defended as natural and ‘homely’ – abortion was considered perfectly acceptable if performed before the end of the fourth month, the usual time for the child to “quicken.” The popular notion was that until then the fetus was not human, not ensouled, as the clergy said. By 1828, however, doctors were beginning to develop the specialties of gynecology and obstetrics. To eliminate the competition they lobbied for a law that said a person performing an abortion after quickening could be charged with manslaughter, fined $100, and sentenced to a year in prison. Their pleas were reinforced by a journalist, George W. Dixon, who saw himself as the keeper of public morality and apparently believed that if they could be sure of ending an illicit pregnancy, women would all become adulteresses and prostitutes. Under such circumstances no man could be sure of the virtue of his wife or his daughters.

None of this stopped the most famous abortionist of her day, a woman who called herself Madame Restell, from building a thriving business. On the one occasion when Madam Restell was imprisoned, the men who relied on her to look after their mistresses if needed, (philandering was fine, creating a scandal was not) paid her jailer to provide a featherbed and “delicate” food. While she was in prison the American Female Moral Reform Society visited and tried to persuade her to convert to Christianity. They were not successful. She made even more money after she was released. Enough so she built herself a Fifth Avenue mansion (on the corner of 52^nd Street) and bought a splendid coach and four with a liveried driver who took her up and down Broadway every afternoon.

For more, see Edward G. Burrows and Mike Wallace, Gotham: A History of New York City to 1898. Oxford University Press.

Beverly Swerling is author of City of God: A Novel of Passion and Wonder in Old New York.
Image: National Police Gazette, March 13, 1847

Witches and Midwives

Throughout the Middle Ages and into the early seventeenth century, which witch hunts had reached their height, midwives were often depicted as witches who communed with the devil. While there may be questions regarding the exact nature of prosecution/persecution of midwives between 1500 and 1700, description of the demonic works of the midwife-witch nonetheless abound in lay and learned writings through the early-modern era. Kramer and Sprenger's influential witchcraft book Malleus Maleficarum, first published in 1486 and reprinted no fewer than thirty times between 1487 and 1669, contains frequent reveries on witch-midwives and their horrific acts toward new mothers and their offspring. This book of witchcraft reports a woman's allegations that she was punished after she refused to allow a midwife with a "bad reputation"to assist her in her pregnancy. Soon after she went into labor, the rejected midwife went into her room, paralyzed her so that she could not speak, and vowed to avenge herself. The midwife-witch then put thorns, bones, and bits of wood in her entrails so that, six months later, the new mother would be "tortured"with unbearable pain.

From Pregnant Fictions: Childbirth and the Fairy Tale in Early Modern France
(p. 64). Author? yours truly.

Witches and Midwives

by Bronwyn Backstrom (Vanderbilt University)

The ideas of witches and witchcraft have been around for centuries and were hot topics. Witches were typically identified as older single women of lower class. Throughout history, there has been a stereotype that only women, specifically midwives and other women-healers, were witches. Women were targets because of the tradition of misogyny; women's participation in folk-healing; and changes in the awareness of female nature, their family and economic roles, and ideas of women's social behavior.

Female witches were accused of three main things: female sexuality (this included every sexual crime against men), organization, and having magical powers (both good and bad) that affected one's health. Witchcraft was considered to go against the Catholic Church. It was considered a threat to God's holy order because it was not based on scripture or religion. In addition, all witchcraft was considered based off of carnal lust, or strong sexual desires, with evil spirits.

The Malleus Maleficarum, meaning "Hammer of Witches," was written in 1484 by two reverends: Heinrich Kramer and James Sprenger. This book contains everything one needs to know about witches and witchcraft at the time, from what defines a witch and how they become one, to the sentences they would receive because of their participation in witchcraft. It also contains information on witch-midwives.

According to Malleus Maleficarum, witch-midwives were considered the most wicked and dangerous witches, who inflicted the greatest injuries. This is because they dealt with the health of others and had easy access to newborn children, who were used in offerings for the evil spirits. Witch-midwives were accused of causing miscarriages; however, if they allowed a child to be born, they would allegedly either feast on the child or offer it to the evil spirits, allowing the witches to infect the child and turn it into a witch.

The evil spirits called the witch-midwives to offer them newborn children for several reasons. One was for their pride. Another was to disguise the act of infidelity as a virtue. By associating children with the evil spirits, the witches drew in more innocent people, making it easier for them to turn into witches. Finally, they used the children to fill their ranks. When the evil spirits infected children at an early age, turning them to witches, they could set them aside to be used in the future as needed.

There was a decline in accusations against women as witches between the 17th and 18th centuries because of the increase in male midwives. Men began to replace women, resulting in fewer women in the field who could be accused of witchcraft.

Image: Heinrich Kramer and James Sprenger. Malleus Maleficarum, 1669. (Courtesy of Wellcome Library, London.)

References:

Brauner, Sigrid. Fearless Wives and Frightened Shrews: The Construction of the Witch in Early Modern Germany. Amherst: University of Massachusetts Press, 1995.

Ehrenreich, Barbara, and Deirdre English. Witches, Midwives, and Nurses: A History of Women Healers. Old Westbury: Feminist Press, 1973.

Kramer, Heinrich, and James Sprenger. Malleus Maleficarum. Trans. Reverend Montague Summers. Manchester: University of Manchester Press, 2007.

Men and Women in Midwifery

by Allison Nelson (Vanderbilt University)

In the early modern period, midwifery began to change from a female art into a male occupation. The shift was not a smooth one. Indeed, it began in 1522, when Dr. Wertt of Hamburg dressed up as a woman in order to observe midwives and learn about childbirth. When he was discovered as a man, Wertt was burned alive. Later in the mid-sixteenth century, however, the renowned surgeon Pare laid a more solid foundation for men's work in the birthing room; he did this by aiding in delivery by pulling babies out of the womb by their feet during difficult births.

A contributing factor in this shift of gender roles was Louis XIV's use of male midwives to deliver his illegitimate children. As men delivered his mistresses babies, male midwives gained popularity. A rapid population boom in Europe further encouraged these social changes; as the population grew and universities increased their study of reproduction and anatomy, childbirth became a medicalized and, thus, masculinized domain. Case studies, rather than oral tradition, became the preferred method for educating individuals about childbirth (1).

There existed three recognized distinctions between male and female midwives. First, the men held a monopoly over medical tools, which women were disallowed from owning. Second, the male midwives were more formally educated in universities; there they dissected bodies, read case-studies, and learned about classical theories. Women, on the other hand, were taught through experience; they apprenticed and learned through women's household manuals. Third, male and female midwives viewed patients differently. While women's manuals emphasize individual relationships and take a maternal tone, men's manuals stressed quantitative practices and medical causality (2).

Even as male midwives gained popularity, their acceptance was not unanimous. Some people believed that men did not belong in the birthing room; since men could never experience childbirth, some believed it was beyond the realm of male expertise. Such critics often cited the Bible, claiming the absence of men at recorded births. Other critics viewed male midwives as interlopers into other men's domestic territory. In a space where the husband or father was absent, the male midwife's presence stood out as inappropriate; it raised questions about the male midwives' potentially inappropriate behavior toward vulnerable female bodies. Thus issues of female modesty and male property emerged, and opponents called upon husbands to bar male midwives from their homes (3).

While gender issues caused debate, so too did suspicion about scientific instruments and their over-use in the birthing room. Frequently, male midwives used tools even in "normal" births that might not necessitate them -- and the tools posed additional risks. Not only did the tools threaten additional infections, but their misuse could harm the baby or its mother. Renowned female midwife Sarah Stone, for example, claimed that in her career she had only seen four cases that could have been safer through the use of tools (4).

Image: Fores, Samuel William. "A Man-Mid-Wife." From Man-Midwifery Dissected. London, 1793. (Wellcome Library, London)

(1) Schnorrenberg. "Is Childbirth Any Place for a Woman? The Decline of Midwifery in Eighteenth-Century England." Studies in Eighteenth Century Culture (10) 1981: 393.

(2)Fife, Ernelle. "Gender and Professionalism in Eighteenth-Century Culture." Women's Writing (11:2) 2004: 185-200.

(3)Blunt, John. "Man-Midwifery Dissected: or, The Obstetric Family Instructor." 1793.

(4) Stone, Sarah. "A Complete Practice of Midwifery." 1737.

Syphilis in Early Modern Europe

by Jamie Whittenberg (Vanderbilt University)

Syphilis, a highly infectious sexually transmitted disease, sparked fear among the early Europeans. And for good reason.

Syphilis has three stages, the last being deadly and untreatable if advanced enough. First recognized as an outbreak in 1494 in Naples among the French mercenary troops, it quickly spread to all parts of Europe. Faced with such a contagious and disfiguring disease, the early Europeans quickly blamed one another or attributed it to external forces such as interspecies sex, the planets, or witchcraft (1).

Often, the men were most often depicted as victims of syphilis. The course of the disease: a woman, the carrier of death. The case of Bellina Loredana exemplifies this attitude. She was accused of inflicting the disease on a prostitute through witchcraft, until she was (partly) exonerated due to the prostitute's obviously promiscuous behavior. Still, the idea that women spread the disease by seducing men was prevalent (2).

As the disease spread, early modern Europeans began to turn to more naturalistic causes for syphilis. This evolved into two theories: Pre-Columbian and Post-Columbian. The former operated on the belief that syphilis was always present in Europe, possibly misdiagnosed as leprosy. Although the surge may have been noticed after contact with the New World, this theory states that it is just a coincidence. The Post-Columbian theory suggests that syphilis was a disease brought over from the Indians and that no European country was to blame, no matter how much they bickered among each other (1).

No consensus was reached on who was correct in this matter. Many seemed to offer contradictory views on the subject, such as John Smith. He at once called syphilis the "French pockes" as well as the "Indian disease" within one sentence. Both theories are present in his statement. Even looking retrospectively, bio-archaeologists have found it impossible to determine which theory is correct. They studied for syphilitic lesions on the bones in pre-contact Europe and America (1). Although they did find evidence of syphilis in early America, it does not have the characteristic dental pathology that is typical with syphilis. Therefore, it is still undetermined to this day whether syphilis came over from the New World, or if syphilis exploded into a potent form during the siege in Naples in 1494 (1).

Image: Gilman, Sander L. "AIDS and Syphilis: The Iconography of Disease." October (1987): (43) 87-107.

(1) Qualitiere, Louis F. & William Slights. "Contagion and Blame in Early Modern England: The Case of the French Pox." Literature and Medicine (2003): (22) 1, 1-24.

(2) McGough, Laura J. "Demons, Nature, or God? Witchcraft Accusations and the French Disease in Early Modern Venice." Bulletin of the History of Medicine (2006): (80) 2, 219-246.

The Chamberlen Family Secret

by Lani Goodman (Vanderbilt University)

In the 17th century, forceps were a new tool in obstetrics that were, interestingly enough, kept a secret for over 100 years by the Chamberlens, who invented them.

There were eight Chamberlen men, divided into five generations. Some speculate that William Chamberlen (first generation) was the family member to first develop the forceps during his stay in Amsterdam, while others consider his son, Peter Chamberlen II, to be the inventor. In either case, all following members of the Chamberlen family practiced obstetrics, attended to the Royal Family of England, and used their secret instruments in cases of difficult deliveries.

The forceps were revolutionary instruments in that they significantly reduced the mortality rate for women and their fetuses in difficult deliveries by changing the position of the fetus in the uterus, making the delivery safer and easier. Before the invention of forceps, difficult deliveries generally ended with an abortion of the baby, or the death of both mother and fetus. In very rare cases, Caesarian-sections were performed, which typically meant death for the mother.

In order to preserve their secret, the Chamberlens adopted a very particular method of delivering babies. They would arrive with a beautifully carved, extremely heavy wooden box that encased the secret instruments. Once entering the patient’s room, the Chamberlen would ask that everyone leave, so that only he and the pregnant mother were left. He then blindfolded her, and she would remain blindfolded throughout the delivery to guarantee she would never see the forceps. After delivering the baby, he would clean the instruments, replace them in the box, and only then could family and friends enter the room to see the baby.

It is unknown exactly which of the Chamberlens was the first to leak the family secret, but it is generally thought to be a member of either the fourth or fifth generation. Another theory is that one of the craftsmen who constructed the forceps for the family was the person to let the secret out.

Prioleau, William H. "The Chamberlen Family and the Introduction of Obstetrical Instruments." Proceedings of the Huguenot Society of Great Britain & Ireland 27.5 (2002): 705-714.

Rushen, Joyce. "The Secret 'Iron Tongs' of Midwifery." Historian (1991): 12-14.

Dunn, P. M. "The Chamberlen Family (1560-1728) and Obstetric Forceps." Archives of Disease in Childhood : the Journal of the British Paediatric Association : Fetal and Neonatal Edition. 81.3 (1999): F232-F234.

Richardson, Ruth. "Chamberlen's Forceps." From the medical museum. Lancet 358.9289 (2001): 1279.

Colonial Midwifery

by Heather Whaley (Vanderbilt University)

Colonial Midwifery began with the Mayflower's journey in 1620. Bridget Lee Fuller delivered three babies during the two months long voyage and continued practice as a midwife in Plymouth for 44 years until her death in 1664. In addition, it is documented that one birth took place aboard the Arabella by a midwife that was brought on board from the Jewel. (1)

Among the many women pioneers in Colonial Midwifery a handful stand out. Anne Hutchinson was both a pioneer in civil liberty and religious toleration and a well respected midwife. One of her students, Jane Hawkins, delivered a "monster" baby and was suspected to worship the devil and practice witchcraft. Jane was later exiled along with Anne who was ultimately massacred by Native Americans. (2)

Many less known midwives were highly respected by their communities and their services were greatly appreciated. Ann Eliot was not known for anything new or controversial; however, she birthed over 3,000 children and garnered the respect of her community resulting in eight families making her the executor to their estates as they felt so indebted to her. Her epitaph reads "be ye blessing of God,…brought into this world above three thousand children." (3)

The first to employ a town midwife was New Amsterdam in 1660. The midwife was paid 100 guilders per year for attending the poor. In the south, plantations usually had a slave that acted as a midwife to both black and white mothers. As time went on, in the south, the majority of midwives were black. The further north, the more white midwives there were serving both the upper and lower classes. If she was a paid community employee she was given a house but could not refuse to help anyone who called upon her. (1)

Many of the midwives in early America acted under the supervision of Protestant bishops. This was considered important with the high infant mortality rate of over 50% in order to baptize the infant before its passing. Complications with childbirth were quite common and survival with some was rare. Puerperal fever was the most common, and became increasingly common as men entered into Obstetrics. This was because men employed more interventions and vaginal exams. In a time before the germ theory this was the cause of great infection. In the 18^th century the only relationship that was made was that hemorrhage led to the Childbed fever. This was in fact happening as materials that were not clean were used to stop the bleeding. Another common complication, "milk leg," was swelling in the leg of the mother that happened on the third of fourth day and was thought to be caused by "bad" milk coming in; as women were confined to bed for up to weeks after their birth they were actually developing clots in the legs that caused them to swell.

Going into the 19^th century, midwifery was dominated by men in America. In the late 18^th century William Shippen established the first lying-in hospital in America in Philadelphia. He also participated in the founding of the University of Pennsylvania School Of Medicine, becoming their first professor of anatomy, surgery and midwifery, quite a mix!

The beginning of formal instruction geared towards men led to the swift demise of women in midwifery and the dawning of a more scientific era in healthcare. (4)

Image: John Ashton, Chap-books of the Eighteenth Century (1882). Prints and Photographs Division, Library of Congress.

¹ Chaney, Judith A. "Birthing in Early America". Journal of Nurse-Midwifery March/April 1980: 25(2) p. 5-13.

² Litoff, Judy B. American Midwives. Westport: Greenwood Press, 1978

³ Packard, Francis. History of Medicine in the United States. New York: 1931.

⁴ Donegan, J. Women & Men Midwives. Westport: Greenwood Press, 1978.

Childbirth Mortality Rates

This was a guest column that I did over at Catherine Delors' Versailles and More. Just in case you didn't see it, I'll boldly repost.

Early-modern obstetrical manuals contained a detailed inventory of the many things that could go wrong in the birth room. And for good reason. It is estimated that one of ten women could expect to die from childbirth related causes in the Old Regime. A married women would become pregnant, on average, five or six times.Given that up to 10% of the labors were fatal, this means a woman had a 50% to 60% chance of dying during her reproductive life.

Of course, these are estimates. It is very hard to estimate death rates with precision because fertility and mortality were variable across regions and socioeconomic groups. The statistics I cite here are from Jacques Gélis et al., Entrer dans la vie: Naissances et enfances dans la France traditionnelle (95). If you’re interested in knowing more, you might take a peek at Dobie and Wilmott’s An Attempt to Estimate the True Rate of Maternal Mortality, Sixteenth to Eighteenth Centuries. Medical History 26.1 (1982): 79-90.

Another favorite of mine is by Lianne McTavish, Childbirth and the Display of Authority in Early Modern France.

Girls will be...boys?

Well, this one will certainly test the sensibilities of our gentle Wonders and Marvels readership! Remember: It's important to look history straight in the eye.

Or in this case, the private parts.

From Antiquity and well into the late eighteenth century, humoralist modes of anderstanding dominated medical practice and anatomical theory. Humoralism was associated with Galen, a second-century ACE Greek physician who lived in Rome. His work was substantially influenced by his predecessor Hippocrates.

Galen held that the body was governed by a system of fluids, of "humors": blood, phlegm, yellow bile, black bile. Each body had a "complexion" that was specific to the individual--and reflected a greater tendency toward one of the four humors. Men had a humoral complexion that tended toward "hot and dry." Women considered humorally "cold and wet." They were also seen as defective version of a more perfect male body.

Because a man’s body was hotter, his reproductive organs stayed more comfortably outside his body. Colder, female reproductive organs were instead tucked inside the body to maintain warmth. The vagina was therefore often represented an inverted penis and the ovaries as "female testicles" or "stones" in early medical illustrations.

For more on humoralism and the facts of life, be sure to head over to this post.

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Thomas Laqueur wrote the seminal work (I couldn't resist) on the One-Sex Model: Making Sex: Body and Gender from the Greeks to Freud.

But academics love a good fight. And the reception of Laqueur's book started one of the best professorial boxing matches around about whether the one-sex model was as dominant as Laqueur claimed. So be sure to take a look at these:

Michael Stolberg, "A Woman Down to Her Bones: The Anatomy of Sexual Difference in the Sixteenth and Early Seventeenth Centuries." Isis 94 (2003): 274-299.

Winfried Schleiner, "Early Modern Controversies about the One-Sex Model Renaissance Quarterly 53 (2000): 180-191.

And Laqueur's response...

"Sex in the Flesh." Isis 94 (2003): 300-306.

Image: Andreas Vesalius, De Humani corporis fabrica, 1543 (courtesy of the Wellcome Library, London).

Midwives and Witches, oh my!

Witches can be nasty creatures...and doubly so anywhere near newborns. Just think about the evil fairies in Sleeping Beauty or Snow White. Nothing to trifle with!

If witches and mean fairies seem to be circling baptisms and childbeds in fairy tales, it has a lot to do with the fact that--according to popular legends--they were in need of supplies for their devilish rituals.

According to early-modern writers like Jean Bodin, Cardano, and Della Porta, the fat of newborns was a vital ingredient in magical flying potions. Witches were also said to make candles from an infant's umbilical cord.

Other byproducts of labor were also reported to have great mystical properties. The placenta was considered by some to be an aphrodisiac and, if eaten, could be used to treat infertility, a practice that the church condemned.

These and other concerns regarding what the midwife-witch might do with human flesh and body fluids motivated regulations in German (Wurzburg, 1555) that clearly specified how the midwife was to dispose of all biological bi-products during the delivery. Morever, frequent laws were passed in France that dictated that only woman of good Catholic faith could help a birthing mother.

Lifted from my Pregnant Fictions: Childbirth and the Fairy Tale in Early-Modern France
(p. 67)

Image: The History of Witches and Wizards (1720)

18th Century Contraception: Catherine Delors

As Holly noted in her guest post on my blog, married women, in the 17th and 18th centuries, would become pregnant on average five or six times. This is far less than “natural” fecundity. So what was happening?

For one thing, people married relatively late. In 1789 France, the average age of first-time couples was 26.5 for brides and 28.5 for grooms. True, nobles married much earlier, generally as teenagers, but they represented only about 1% of the population, a tiny minority. For most French people, at least 10 years of reproductive life were thus “lost” to late marriages. The tremendous social stigma attached to out-of-wedlock births made them accidents to be avoided at all costs.

Once women married and gave birth to children, the most widely available birth control technique was breastfeeding. Peasant women in particular nursed their children--and served as wetnurse to others--well into toddlerhood, which allowed them to space out their pregnancies. Rousseau, for reasons independent from contraception, strongly advocated breastfeeding in his very influential Emile (published 1761) and the practice soon became fashionable among upper-class women as well.

Even the illiterate knew empirically about the contraceptive effect of breastfeeding. Other techniques, however, required an advanced understanding of conception. This was reserved to the more educated segments of the population. Pornographic novels (a thriving genre in pre-revolutionary France) extolled the virtues of the withdrawal method, and barrier devices like sealskin condoms and sponges dipped in an acidic liquid such as vinegar.

Catherine Delors is author of The Mistress of the Revolution. She connects with readers via Versailles and More.

The Chicken or the Egg

Open an introduction to genetics textbook, and you'll find a few preliminary pages on preformationist theory. The underlying message is: Look here, look how far we've come. Look at how silly early embryological theory was.

The fact of the matter is that preformationism made perfect sense at the time--and it was a theory that dominated the embryological landscape for well over 100 years. Ovism (the idea that preformed humans existed in eggs) is what made the most sense to early-modern philosophers. It would take Kant and Blumenbach's theories in the 1780s for theorists to be able to imagine the idea of something coming from nothing, that an organism can form from disorganized matter.

So here's the question: How will history judge us in a few hundred years? What do we know for sure, right now, that is destined for the joke books of the future?

Image: Wellcome Library for the History of Medicine

Little Men in Sperm

Speaking of seeing what you want to see..

Something major happened during the scientific "revolution" of the seventeenth- and eighteenth-centuries. Telescopes, barometers, blood circulation, air pumps, vacuums, early calculating devices, discovery of planetary systems...yes, yes, we know all about that.

The discovery of the egg and the sperm in 1672 and 1677 changed the way people understood babies--and how. Heated debates took place about whether possibly, just possibly, humans existed preformed in either the egg or the sperm. Animaculists argued that shrinky-dink-sized beings lay wait in the head of each sperm.

Ovists argued that tiny humans sat in each egg. At the end of the day, the ovists won out. One of the most difficult aspects of spermist theory to reconcile was the knowledge that there are millions of sperm in a single ejaculation. Surely God would not allow the genocide of all of those beings in a single embrace! And imagine what they had to say about going solo...

The best study out there on preformation is, without a doubt, Clara Pinto-Correia's The Ovary of Eve: The Egg and the Sperm and Preformation.

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IMAGE: Antonio Vallisnieri, Histoire della generazione dell'uomo e degli animali