An exploration of the development of the profession, from its origins in the 1600s, to the foundation of the Institute of Obstetricians and Gynaecologists in 1968, examining key achievements to the present day.
The publication of 'The Birth of Mankinde' was a significant moment in the field of midwifery. Written by Eucharius Rösslin in 1513, it was originally published in German and was translated into English in 1545. It opened up and formalised the secretive world of midwifery and provided information on fertility, pregnancy, birth and infant care, as well as up-to-date anatomical description.
The year after Wolveridge's text, an English Midwife Jane Sharp published 'The Compleat Midwive’s Companion'. She drew on her 40 years of experience, as well as extensive reading, to produce a guide for women. Sharp criticises man-midwives as expensive and unnecessary, dedicating her text to her ‘sisters’ the ‘celebrated midwives of Great Britain and Ireland’.
In 1742, Bartholomew Mosse received the College’s Licence in Midwifery, having studied in continental Europe. Horrified by the conditions of Dublin’s poor, Mosse established a Lying-in hospital for poor women. It opened on 15 March 1745 on George’s Lane; the first hospital of its kind in the British Isles. In 1757 it moved to its current location as the Rotunda Hospital.
Mosse raised funds for his hospital in a variety of ways, from lotteries to concerts, plays and charitable bequests. The hospital’s new location included a pleasure garden, with a charge for admittance to raise funds. It was not until 1785 that an annual government provision was made for the hospital, based on a tax on private sedan chairs in Dublin city.
Fielding Ould succeeded Mosse at the Rotunda. Ould was granted the College’s Licentiate in Midwifery in 1738 and described as "singularly well qualified". In 1743 he dedicated his 'Treatise on Midwifery' to the College. However, in 1756 Ould attacked the College, who had refused him a Licentiate in Medicine, as they believed it not ‘consistent with the dignity of their body’ for a man to hold both Licentiates.
In the 1750s, obstetric teaching was developing in England, but a proposal to introduce teaching at the Rotunda was opposed. Trinity College thought it was their preserve, and the governors feared ‘the patients ... were to be subjected to all sorts of indignities in order to afford instruction to a parcel of Brats of Boys’. It would be 1774 before the first lectures were delivered by Dr David MacBride.
Francis Hopkins was elected President of the College five times between 1785 and 1816, and devoted much time to the College. His later terms of office coincided with his seven years as Master of the Rotunda. He also served the College as Dun’s Librarian, in the year before his death in 1819, and donated a number of early medical books to the College's collection.
For centuries, puerperal fever was a serious risk in childbirth. In maternity hospitals, death rates could reach 100% during epidemics. Robert Collins correctly believed puerperal sepsis was a contagious disease, implementing the cleaning of wards, ventilation control and hand washing, with his work being greatly admired by Ignaz Semmelweis, pioneer of antiseptic procedures. In Collins' last 3 years as Master of the Rotunda there were no puerperal sepsis deaths.
Evory Kennedy succeeded Collins as Master of the Rotunda and College President. He continued Collins’ work, and also helped to introduce the stethoscope to obstetrics. In 1838 Kennedy gave the inaugural address to the new Dublin Obstetrical Society, concluding that ‘the accoucheur is as much in repute, as formerly he was the reverse’.
In 1826, Mrs Margaret Boyle left £100 to establish maternity services in the Coombe area. In 1829, a hospital, founded a few years earlier by Dr John Kirby, was purchased and became the Coombe Lying-in Hospital.
Outside Dublin, the ﬁrst Lying‐in hospital opened in Belfast in 1794, followed, 4 years later by Cork, and in 1812 one opened in Limerick. In Galway, maternity provision primarily came from nursing homes and the workhouse, but by 1942 the Central Hospital provided midwifery care.
Training for female midwives was slow to develop. In 1856, Fleetwood Churchill lamented ‘the merest rudimentary knowledge’ of many midwives. He published a manual in which he ‘endeavoured to teach as much as a midwife need know’. The lack of trained midwives was a concern to the Masters of the maternity hospital, who instituted programmes of reform and education.
For nearly twenty years the College engaged in the debate on midwives' registration. During this period, several obstetricians served as President, including Lombe Atthill and Andrew Horne who took leading roles in the debate. The College supported the idea of registration, as long as Irish qualifications were recognised. The Midwives (Ireland) Bill was eventually passed in 1918.
Medical Registration was introduced by the Medical Act of 1858, but obstetrical training was not included until the 1888 Amendment Act. Training was limited to a short rotation in a Maternity Hospital, including a stint 'on the district', carrying out deliveries in the home. Despite obstetrics being central to their practice, rural GPs could qualify having attended at only a dozen uncomplicated births.
He was knighted in 1913, wearing this hat, sword and shoe buckles . Horne is also reputed to have thrown James Joyce, then a medical student, out of Holles Street for making an offensive remark about the hospital's patients. As a result, Horne is said not to have read 'Ulysses' due to his dislike of Joyce.
Solomons is believed to have been the inspiration for Dr Michael McMurrough in Signe Toksvig’s 'Eve’s Doctor'. The book describes a handsome gynaecologist who ‘walked ... the street enveloped in quick warm darting glances and brought secretive smiles that made every husband want to remonstrate with his spouse about her behaviour’. Toksvig and Solomons are believed to have had an affair.
Heaney’s poem 'Out of the Doctor’s Bag' celebrates the role of the rural GP in childbirth. It focuses on Dr Joseph Kerlin, a GP based in Magherafelt, Co. Derry, who delivered Heaney and his siblings. Heaney creates an evocative image of Kerlin arriving for each delivery in his ‘fur‐lined coat’, surrounded by the tools of his trade, ‘a whiff of disinfectant … highlights on the forceps’.
With only 52 obstetricians and gynaecologists in Ireland in the 1960s, it was felt impractical to found an Irish College. The group looked instead to found a Faculty within one of the existing Colleges. It was decided that RCPI was most suitable, given ‘the medical nature of much of the work’. The first meeting, attended by 31 doctors, was held on 11 October 1968.
Over the past 50 years the Institute has developed as the professional body for Obstetricians and Gynaecologists, and sets standards in education though the MRCPI in Obstetrics and Gynaecology and the Diploma in Obstetrics and Women’s Health. Today, there are 228 Members and Associate Members of the Institute, and 157 doctors on the Institute’s training programmes.
The profession has, to some extent, come full circle. 350 years ago, a female dominated profession was taken over by the rise of the Man-Midwife. Today, 75% of the trainees on the Obstetrics and Gynaecology programme are women. In 2018, for the first time, two of the three Dublin Maternity Hospitals had Female Masters, the same year as the Institute appointed its first female Chair.
Curation: Dr Michael O’Dowd, Claire Ó Nualláin, Harriet Wheelock
Images: Bobby Studios
Audio: Peter Flood, Gary Killeen, Joe McGurk and Alexandra St John
This exhibition was a joint project of the RCPI Heritage Centre and the Institute of Obstetricians & Gynaecologists, to mark the 50th anniversary of the founding of the Institute.
We would like to thank all those who helped in the creation of the exhibition, especially Dr Peter Boylan, Dr Conor Carr, Edel Hynes, Dr John Murphy, Dr Cliona Murphy, Dr Maeve Eogan and Dr Sorca O'Brien