A History of Childbirth

A historical-anthropological journey of the human birth.

By Royal Academy of Medicine of Spain

Real Academia de Medicina

Pregnancy and childbirth medical illustration (1822) by J.P. MaygrierRoyal Academy of Medicine of Spain

A History of Childbirth

The Spanish Royal National Academy of Medicine began 2016 with an exhibition organized by its Infanta Margarita Museum of Medicine, entitled "A History of Childbirth." It included important pieces documenting the historical and artistic aspects, as well as significant reference works chosen for their illustrative and artistic relevance. The exhibition was sponsored by Asisa (a Spanish healthcare provider), in collaboration with the Complutense University and Santa Cristina Hospital in Madrid, and was commissioned by professor and full member of the Academy, José Antonio Clavero Núñez. As a result, it charted the historical and anthropological course of human childbirth—one of the key moments in any human life.

Pregnancy and childbirth medical illustration (1822) by J.P. MaygrierRoyal Academy of Medicine of Spain

Female abdomen during pregnancy, in profile.
In its original state, and at the end of each of the three trimesters.

Pregnancy and childbirth medical illustration (1822) by J.P. MaygrierRoyal Academy of Medicine of Spain

Sequence showing the developmental stages of the embryo.

Early embryonic stages

"De partu hominis, et quae circa ipsum accidunt" (1532) by Eucharii RhodionisRoyal Academy of Medicine of Spain

Books on Childbirth

From very early on, the Academy's universal library of medicine was well stocked with specialist books. This is to be expected for a subject as tangible as pregnancy, with its direct culmination in childbirth—such a commonplace, natural event. To help readers understand their content, some of these books were wonderfully illustrated with precise images that, besides being beautifully drawn, clearly demonstrate the different techniques used in childbirth, including purely manual methods and those requiring tools. Well-preserved editions can be found on the best medical bookshelves, and much of their content is still fundamentally valid thanks to the keen clinical observations of their specialist authors.

"Preceptos generales sobre las operaciones de los partos", Joseph Ventura Pastor, 1789, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more
Book cover, Joseph Ventura Pastor, 1790, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more
Childbirth medical illustration, Joseph Ventura Pastor, 1790, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more
Pregnancy and childbirth medical illustration, J.P. Maygrier, 1822, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Pregnancy and childbirth medical illustration (1822) by J.P. MaygrierRoyal Academy of Medicine of Spain

Fetus in birth position.

Childbirth medical illustration (1790) by Joseph Ventura PastorRoyal Academy of Medicine of Spain

Helping Hands

Helping a woman through childbirth is one of the oldest healthcare interventions in history, thanks to midwives. They would share information among themselves about the best ways to intervene in difficult births, based on empirical evidence, thereby creating the earliest form of obstetrics. But it was not until after the Renaissance and the progress made in the field of anatomy that the role of obstetrician emerged and techniques were developed for dealing with obstructed labors. The discipline of obstetrics continued to develop, particularly in terms of care during pregnancy, for example in trying to prevent disorders such as the much-feared pre-eclampsia.

Pregnancy and childbirth medical illustration, J.P. Maygrier, 1822, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

For a long time, manual examinations were performed 'blind.'

Pregnancy and childbirth medical illustration, J.P. Maygrier, 1822, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Pregnancy and childbirth medical illustration (1822) by J.P. MaygrierRoyal Academy of Medicine of Spain

Forceps

This instrument was designed to help with the second stage of labor. Its origins are unknown, although it is mentioned in the Hippocratic Corpus and cited in writings by Soranus of Ephesus, Paul of Aegina, and Al-Zahrawi, seemingly with the purpose of removing a dead fetus. There were numerous attempts to use the tool, in its current guise, during the Renaissance and the 17th century. However, there is consensus on a single name: Chamberlen, which was the name of a French family who settled in England in the 16th century and were pioneers of the forceps' design and use. Over 100 different models were later developed, including those by Levret, Naegele, and Tarnier, but their use depends more on the preferences of each school rather than any proven advantage.

Pregnancy and childbirth medical illustration, J.P. Maygrier, 1822, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more
Pregnancy and childbirth medical illustration, J.P. Maygrier, 1822, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Childbirth medical illustration (1790) by Joseph Ventura PastorRoyal Academy of Medicine of Spain

Obstetric Surgery

Thanks to antibiotics, the cesarean section became not a risky alternative to death, but another surgical option within the field of obstetrics. From that point on, the life of the fetus was afforded greater value, and this evolved into the concept of it being "a patient along with its mother."

Pregnancy and childbirth medical illustration (1822) by J.P. MaygrierRoyal Academy of Medicine of Spain

Pregnancy and childbirth medical illustration, J.P. Maygrier, 1822, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Childbirth medical illustration (1790) by Joseph Ventura PastorRoyal Academy of Medicine of Spain

Neonatology

The fetus and neonate have garnered increasing importance, without the mother losing any of hers. This brought about the creation of neonatology, enabling newborns to be given medical care in the delivery room itself.

Childbirth medical illustration, Joseph Ventura Pastor, 1790, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more
Pregnancy and childbirth medical illustration, J.P. Maygrier, 1822, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Room of the exhibition "A History of Childbirth"Royal Academy of Medicine of Spain

Diverse Credentials

Scientific progress in the field currently known as obstetrics has been relentless, particularly since the mid-20th century, with a proliferation of excellent specialist teams based around gynecology and obstetrics professorships linked to university hospital services in these specialisms. However, the San Carlos Royal College of Medicine and Surgery in Madrid, for example, already had a "Birth Professorship" by the end of the 18th century. Throughout this long tradition, a wide range of professionals have been granted credentials: practitioners, obstetricians, and midwives, who worked predominantly in Spain after training at well-renowned schools. Until the mid-20th century, babies were rarely born anywhere other than at home, so the first face they would see would be that of the midwife.   The exhibition showcases many different credentials that have been used over the years, from a Royal License for midwives, dating from 1750, to door signs for the offices of midwives and physicians "specializing in births," and a credential for practitioners authorized for "normal births," under the School of Midwifery in Madrid, now Santa Cristina University Hospital.

Royal Decrée of Fernando VI (1750)Royal Academy of Medicine of Spain

“Royal license for midwifery and obstetrics exams”,
1750.

This was a valuable legal document that was created to regulate the care given during childbirth by a broad group of "minor health professionals," spread all across Spain. They were employed whenever there were insufficient doctors or surgeons to do the job. The latter would only attend to those who could afford to pay for their services, although the delicacy of the situation meant that their role was usually limited to mere observation, except in exceptional cases involving people of high regard, in the service of the Crown.
The document demonstrates how the law enacted by the Catholic Monarchs, which required a preliminary examination in order to access this kind of healthcare, was later annulled by King Philip II. The Royal Court of the Protomedicato heard evidence of abuses by those who were unskilled in the area and would intervene in other matters affecting the woman in labor, such as marital and inheritance issues. It was therefore decided that all obstetricians would have to pass an exam before the court in order to practice their profession.
According to the contents of this document, King Ferdinand VI re-established the authority for anyone who wished to work in the discipline of childbirth to be examined before the Court of the Protomedicato, then presided over by the top chamber physician, Dr Joseph Suñol.

Plaque of a midwife, Early twentieth century, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more
Plate of a birth doctor, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Obstetric Anatomical ModelsOriginal Source: Hospital Universitario Santa Cristina, Madrid

This didactic model presenting the fetus, from Santa Cristina University Hospital, is evidence of how midwives were taught to manage this crucial moment, common to the entire human race.

Room of the exhibition "A History of Childbirth"Royal Academy of Medicine of Spain

The clinical display includes a glass cabinet containing various models of Pinard horns, Fergusson specula, a pelvimeter, and an old scale for weighing babies. Beside this are two birthing chairs, one from the early 19th century and the other from the mid-20th century, transporting the visitor back to the time when women would give birth in these seats, known as “potros”

Birth attendance in primitive cultures by Carlos ViebaRoyal Academy of Medicine of Spain

Illustrations showing the different ways of giving birth in various primitive cultures.

Room 1 of the exhibition "A History of Childbirth"Royal Academy of Medicine of Spain

This cabinet contains an old doctor's case made by the legendary Parisian manufacturer Charriére. It contains all sorts of obstetric tools from the 19th century, along with a wax sculpture from the Javier Puerta Museum of Anatomy (part of the Complutense University), made under the direction of Ignacio Lacaba. It shows the appearance of the buttocks during birth.

Childbirth instruments set Childbirth instruments set (19th - 20th century) by Mon. Charriere CollinRoyal Academy of Medicine of Spain

Complete 19th-century obstetrician's case.

Room 2 of the exhibition "A History of Childbirth"Royal Academy of Medicine of Spain

A “protective” amulet

This protective amulet used during childbirth by central African tribes shows a different, unscientific view of the human being. The cabinet also displays an anthropomorphic image from the region of Popayán, illustrating the moment of birth, and a ceramic birthing chair from the south of Spain. The depiction of the moment of birth in different primitive tribes encourages reflection on the great scope of human ingenuity, beliefs, and science at this time of transcendental importance, not in the field of medicine, but anthropology.

Saint Raymond Nonnatus, 18th century, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Ever since ancient times, and particularly when uncertainty prevailed over what could reasonably be expected of the poor scientific and technical support available, people have placed great faith in their protectors. There are well-known Christian devotions for those suffering from pain in various organs, or who find themselves in perilous situations, including Our Lady of Good Childbirth (Nuestra Señora del Buen Parto), Our Lady of the Good Event (Nuestra Señora del Buen Suceso), or Saint Raymund Nonnatus—the patron saint of difficult births, who also has his own novena prayer. In pagan cultures, some tribes used—and some still use—protective amulets and icons to ensure a happy outcome in childbirth, as such an important and definitive life process.

Birth chair Birth chair, 19th century, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Impressive birthing chair, from the early 19th century, from the Infanta Margarita Museum of Medicine.

Ceramic birth chair, 2013, From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Simple ceramic birthing chair used in eastern and southern Spain. Mainly used in rural areas.

Room 2 of the exhibition "A History of Childbirth", From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

The cabinet contains half a dozen obstetric forceps from different periods, including Naegele and Tarnier models, and a basiotribe.

Room 1 of the exhibition "A History of Childbirth"Royal Academy of Medicine of Spain

Pure art: pregnancy and childbirth at the Faculty of Medicine.

In line with the times, medicine was taught with the help of iconographic materials to aid better understanding of the professor's explanations in the classroom, clinic, laboratory, or dissection room. In reference to human pregnancy and childbirth, the San Carlos Royal College of Medicine and Surgery went to great lengths to create these remarkable, multi-colored wax figures. They had already been drawn up by the end of the 18th century, under the direction of future professor of anatomy Ignacio Lacaba y Vila, by Juan Chaez, a sculptor to the Spanish Court, and the Italian Luigi Franceschi, a student of Felice Fontana. Just one glance shows you a definitive view of the different moments and positions as the fetus moves through the birth canal, as well as its relationship to neighboring structures. The framed plaster sculptures used for the same purpose, and to aid the correct use of obstetric forceps, are more recent. These splendid figures currently reside in the Javier Puerta Museum of Anatomy, in the Faculty of Medicine at the Complutense University of Madrid, and are part of a wonderful anatomical collection in keeping with the valuable heritage amassed by the oldest university in Madrid.

Obstetric Anatomical ModelsRoyal Academy of Medicine of Spain

Room 1 of the exhibition "A History of Childbirth", From the collection of: Royal Academy of Medicine of Spain
Show lessRead more

Glass cabinets displaying wax sculptures from the Javier Puerta Museum of Anatomy. These are some of the assets from the Complutense University of Madrid that were made under the direction of Ignacio Lacaba to help teach obstetrics to students at the San Carlos Royal College of Medicine and Surgery. They show two full-term births.

Obstetric Anatomical ModelsRoyal Academy of Medicine of Spain

Special Session "A History of Childbirth" (2016-02-24)Royal Academy of Medicine of Spain

Scientific Session

As is customary during exhibitions put on by the Infanta Margarita Museum of Medicine, a scientific session was held on February 24, 2016. Participants included full members of the Academy, José Antonio Clavero and Manuel Escudero, and Professor Juan Luis Arsuaga. It covered a broad range of topics such as the history of obstetrics, and a history of analgesia and anesthesia in childbirth, delivered respectively by the aforementioned Academy members (professors of obstetrics and gynecology). Arsuaga, a professor of paleontology, delivered a speech on the peculiarity of human childbirth compared to that of other mammals.

Prof. Juan Luis Arsuaga (2016-02-24)Royal Academy of Medicine of Spain

Professor Juan Luis Arsuaga is a Spanish paleontologist.

He has a Doctorate in Biological Sciences from the Complutense University of Madrid, and teaches paleontology at the Faculty of Geological Sciences at the same university. Since July 2013, he has been Scientific Director at the Museum of Human Evolution in Burgos.

Credits: Story

Real Academia Nacional de Medicina
Museo de Medicina Infanta Margarita
Biblioteca Real Academia Nacional de Medicina
Fundación Real Academia Nacional de Medicina
Asociación de Amigos del Museo de Medicina Infanta Margarita
Universidad Complutense de Madrid
Museo de Anatomía "Javier Puerta"
Hospital Universitario Santa Cristina
Diseño y montaje: Leona
Patrocinador: ASISA

Credits: All media
The story featured may in some cases have been created by an independent third party and may not always represent the views of the institutions, listed below, who have supplied the content.
Explore more
Related theme
Spain: A Crossroads of Culture
From sights to sounds to smells, experience Spanish culture in every sense
View theme
Google apps