History of Science 2220 Chapter Notes - Chapter 11: Secondary Sex Characteristic, Orthodox Judaism, Mikveh
2 May 2018
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Women in Medicine: Obstetrics and Gynecology
Perspectives of obstetrics and of women in medicine: traditional and critical
Birthing as Women’s Domain
- Because women could bear children, it set them apart in prehistoric societies
o Statues and paintings exaggerated its secondary sexual characteristics
- Bleeding could be dangerous making menstruation mystical
o The cycle signified and defined woman
o Some societies viewed it as a curse
o Orthodox Jewish culture
▪ Postmenstrual women ‘unclean’ until she has taken a ritual bath (mikveh)
o Christian tradition
▪ See a relationship between sexual characteristics and when women were
regarded as deities
▪ Very feminine tasks: agriculture, procreation, birth, rebirth, and healing.
o Ancient Egypt
▪ Hathor, a cow, the art mother who nourished the world
▪ Isis in charge over the fertile Nile and medicine
▪ Tauret, a hippopotamus, watched over childbirth
o Babylonia goddess Ishtar and the Greek Aphrodite were patrons of love
o Roman goddess Juno protected mother
- Birthing was the exclusive domain of women
o If males cared for women, special actions were made for gender interactions.
▪ Ex. 14thC. Chinese diagnostic dolls
• A modest distance between doctor and patient
o Would locate their symptoms on the doll, so that physician
did not see or touch her body
o Male professionals did not attend births in the west until the 17th and 18th C.
The Obstetrician’s View: Medicine for Women
- Doctors theorized about conception and birth even though women attendants were
dominant
- Some Hippocratic treatises focuses on women and premature births
o The wandering womb — an etiological hypothesis, explains many symptoms
o Treatments aimed at luring the uterus back into its proper
place.
- Aristotle – the seed of the child came from the father alone to be nurtured in the mother
- The medicalization of birth characterized by instrumentation to prevent, terminate, hasten
or relieve deliveries.
o Intervene (often doctors) vs attended (mostly, but not always, midwives)
o Those with the ability to end a log labour
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Caesarean Birth
- Originates in antiquity for when the mother was dying or already dead
- A post-mortem surgery ordered by a roman law (
lex caesaria
) to save the baby for the state
- Done without anesthesia, antisepsis, and without understanding of tissue planes and
suturing
o 13th C. Europe
▪ the Christian church urged doctors to operate post-maternal death to save
the infant’s soul by baptism
- François Rousset, 1581
o 15 cases of abdominal delivery while the mother was still alive, never performed the
operation himself.
o First woman to survive, spouse of a 16thC. Swiss Nufer. Delivered his child and
sewed up his wife
o Europe 1610, mother lived only a couple weeks.
- Not until late 19thC. that methods were created to achieve a safer maternal outcome.
Early Modern Midwifery
- 15thC. printing press led to ‘obstetrical’ literature
- birthing chair or stool:
o took advantage of gravity for the mother’s benefit while not preventing the view of
the attendant
- midwifery treatises
▪ who was the intended audience?
• Male doctors did not attend deliveries and midwives were rale
literate.
• May have served voyeurism of the educated elite
- Podalic version
o Used to deliver a fetus in transverse lie or some other unfavourable position
o Locates the baby’s foot, massages the mother’s belly, the child is turned and
delivered by gentle traction on the legs
- 17th C. still believe that the seed was male
- if children resemble their moms, it was the effect of gestational environment; babies were
the products of their fathers
- see the man-midwife appear
o new customs adopted like the modesty blanket.
o Trend may be due to the increasing acceptance of doctors in all aspects of health
- Midwife education was like of surgeons, an apprenticeship separate from physicians
Forceps
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