Jürgen Schlumbohm and Claudia Wiesemann (eds), Die Entstehung der Geburtsklinik in Deutschland 1751–1850: Göttingen, Kassel, Braunschweig, Göttingen, Wallstein Verlag, 2004, pp. 144, illus., €19.00 (paperback 3-89244-711-X).

Abstract

The first academic lying-in hospital in Europe was opened in Gottingen in 1751. This collection of essays commemorates the event while putting it into a German perspective. Claudia Wiesemann states quite rightly in her introduction that there can be no doubt that the medicalization of birth had its origin in the establishment of lying-in hospitals in the second half of the eighteenth century. The small university town of Gottingen in northern Germany took the lead. The founding of a lying-in hospital there was part of a policy of the kingdom of Hanover, on the one hand, to attract medical students to its new university while competing with Prussian universities, on the other, to provide care for unmarried pregnant women, thus reducing the number of infanticides. Teaching young doctors in obstetrics was just another aspect of bedside teaching which characterized the reform of medical education in the age of Enlightenment, as Isabelle von Bueltzingsloewen shows in her survey of the development of bedside teaching at German universities in the eighteenth century. The only lacuna of this otherwise concise overview by a French medical historian is that the seminal book by Christian Probst (Der Weg des arztlichen Erkennens am Krankenbett: Hermann Boerhaave und die altere Wiener medizinische Schule, Stuttgart, 1973) is not mentioned in the bibliography. Jurgen Schlumbohm, who can be considered the expert on the social history of the famous lying-in hospital in Gottingen, provides yet another stimulating essay on the teaching practices and the everyday life in this “total” institution. The second director of this lying-in hospital, Friedrich Benjamin Osiander (1759–1822) was one of the leading obstetricians of his time, admired by his colleagues and feared by his female patients because of his strong liking for the forceps. Forceps deliveries amounted to 40 per cent in this clinic. In other contemporary lying-in hospitals the rate was much lower. In Vienna, for example, it was 4 per cent of all births. Osiander and his successor were also collectors of embryological specimens and obstetrical instruments, as Christine Loytved describes in an essay which gives not only a brief history of this important collection of artefacts but also attempts to find out more about the use of these historical instruments. This includes the interesting question whether it is possible to trace emotions in the history of perinatal history. Christina Vanja provides a comparative view on the history of lying-in hospitals in Germany by shedding light on the history of the Accouchierhaus in Kassel founded in 1763. She raises an interesting point claiming that the female patients in such institutions had motives other than just to escape the usual punishment for fornication. The lying-in hospital was particularly attractive to unmarried pregnant women because it had a foundling hospital attached to it. Vanja's essay is an example of a recent trend in the social history of medicine which pays particular attention to the demand for medical services. Those who have been regarded as victims or objects of medicalization were not totally powerless; they had in fact their own strategies of getting what they wanted out of a system intended to control and discipline them. The final essay in this volume shows that not every lying-in hospital founded in the second half of the eighteenth century was a model institution. The case of Braunschweig makes clear that the success (e.g. low infant mortality rates) depended largely on the academic infrastructure and on the professional interest of those persons in charge of such innovative clinics.