Birth: a changing scene. Part I: Images of home birth in the Wellcome Library

Library Assistant Anna Ostrowska shares with us some of her research for her recent Wellcome Library Insight Session.

With current home birth rate in the UK standing at meagre 2.39%, it is easy to forget that less than a hundred years ago most British births took place at home. The figure was around 80% in the 1920s and dropped to 35% only in 1957, after hospital birth became both safe (sulpha drugs had proved effective against puerperal fever since the 1930s) and affordable.

The promotion of hospital birth as the only safe and reasonable option was confirmed by the Department of Health’s ‘Peel Report’ in 1970, which asserted:

“We consider that the resources of modern medicine should be available to all mothers and babies, and we think that sufficient facilities should be provided to allow for 100% hospital delivery. The greater safety of hospital confinement for mother and child justifies this objective.”

“The greater safety of hospital confinement” has not been supported by conclusive research and no-one asked the mothers where they would like to go into labour.

There is an abundance of representations of home birth in the Wellcome Library, both historical and contemporary, and among other things they tell the story of changing attitudes towards pregnancy and birth.

This image from Jakob Rueff’s De conceptu et generatione hominis…, published in 1554, is a typical sixteenth century lying-in scene with a bath and cradle. It depicts a ‘natural birth’: one given at home and normally in the company only of other women, traditionally seen as having special understanding of this female ‘mystery’. The women were mothers themselves and this experience legitimated their presence: having survived childbirth, they could provide both psychological and practical support to the woman in labour.

The female midwife orchestrated the ceremony with considerable authority. Let’s make no mistake about it, some of the midwives could be quite bossy! You can read a previous Wellcome Library blog post on one contemporary depiction of a triumphant midwife here.

That birth was indeed a women-only affair found its reflection in language. Until the seventeenth century no word existed to signify a male birth attendant and the modern word ‘obstetrician’ (first used in English in 1828) comes from the Latin word for a midwife, obstetrix. Perhaps not that surprisingly, when used as an adjective from the seventeenth century onwards, ’obstetrical’ was normally a metaphor pertaining to men ‘delivering’ ideas, texts or lectures.

The frontispiece of another sixteenth century book, edited by Walther Ryff, Frawen Rosengarten. Von vilfaltigen sorglichen Zufällen und gebrechen der Mütter und Kinder... also reinforces the perception of birth as women-only event. We can see a woman giving birth on a birth stool, assisted by the midwife, as well as another one lying in bed after delivery with a newborn baby on her side with curtains tucked back so we can see; in the front attendants are enjoying the meal; there is another child in a walker. On a closer inspection, this well-populated scene includes thirteen women, a newborn infant, four small children and no grown-up men. Interestingly enough, even today some midwives and mothers-to-be opt for removal of all men from the birth chamber.

Hard work as it was, attending birth included elements of leisure too: the English word ‘gossip’ comes from ‘godsiblings’ or ‘god-parents’, originally signifying female friends and relatives invited to help a woman in labour. The beautiful delicate watercolour by an unidentified seventeenth century Netherlandish painter, possibly a woman, A kraamkamer (birth-room), shows one of the women handing round sweetmeats to gossips, a custom which still exists in the Netherlands to mark the baptism of a baby. Today the sweetmeats are ‘beschuit met muisjes’ (rusk with mousse, the mousse being aniseed with a sweet coating - pink for a girl and blue for a boy).

Despite apparent total feminisation, our holdings show that the birth scene was not always men-free. This eighteenth century French etching shows a Breton woman relaxing after giving birth, with her husband present among female gossips.

A husband attending birth could even prove useful, such in this engraving where he holds his wife in a position on an obstetrical stool, with a midwife awaiting the appearance of a newborn and another female attendant dressing the first baby.

A similar formation is pictured in this oil painting, probably by a French painter from the beginning of the nineteenth century, currently on display in Wellcome Collection's Medicine Man gallery. In this case the rendition is both much more visceral (note the graphic depiction of the mother’s genitals and blood) and more allegorical (the maid is possibly a personification of Hygiene).

However, aside from husbands, male medical practitioners - as early as the second century AD - attended births. Unlike female midwives, whose job was to assist ‘nature taking its course’, they were present only at complicated births, especially when the child didn’t present head-first. A surgeon could perform a Caesarian section after a mother's death or to remove a dead foetus, while physicians prescribed medicines.  Male practitioners were thus associated with death or difficulty at births.

This perception changed with the onset of the ‘obstetric revolution’ in the seventeenth century and the appearance of the unseemly figure of the man-midwife.

Author: Anna Ostrowska

Images:
- Jakob Rueff, De conceptu et generatione hominis, 1554 (Wellcome Library, EPB / B 5611/B)
- Walther Ryff, Frawen Rosengarten. Von vilfaltigen sorglichen Zufällen und gebrechen der Mütter und Kinder, so inen vor, inn, unnd nach der Geburt begegnen mögenn. Dabei auch aller Bericht der Pflege unnd Wartung, Frawen, Jungfrawen, und Kindern dienlich und von nöten. New ann Tag geben, 1545 (Wellcome Library, EPB / D, 7099/D)
- A kraamkamer (birth-room), 16-- (Wellcome Library no. 44688i)
- A Breton woman relaxing in a cupboard-bed after giving birth, she is surrounded by a group of Breton women and her husband. Etching, 17-- (Wellcome Library no. 17353i)
- A seated Greek woman on an obstetrical stool being held in position by her husband whilst giving birth aided by a midwife, another attendant dresses the first baby. Line engraving by A. Tardieu after N. Maréchal (Wellcome Library no. 16911i)
- A mother giving birth to a baby. Oil painting, 1800 (Wellcome Library no. 44694i)