New life, but also pain and death: the history of childbirth in our country and in the world

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The earliest birth history

We can only speculate about how our ancestors handled childbirth at the dawn of humanity. Probably though mothers of that time gave birth to children in the presence of the older women of the tribe. Some prehistoric figurines then indicate that the people of that time believed in their magical power, which was supposed to protect the mother during childbirth.

In ancient times, a number of civilizations already described their rituals, as well as expert knowledge about obstetrics. Many of these springs have survived to this day. We know, for example, that at the time of the Mycenaean civilization, a goddess of childbirth named Eileithya was worshipped, which subsequently also penetrated to Olympus. The ancient Romans also had goddesses of childbirth. In these ancient civilizations, it was practically always the case that childbirth was a purely female affair. Other women were present with the mother at the time of delivery, who advised and helped her.

Photo: Metropolitan Museum of Art, CC0, via Wikimedia Commons

A sculpture from 300 – 30 BC found in Cyprus depicting a woman in labor

However, there were exceptions. One of them is sure Soranos of Ephesus. He wrote the first truly professional publication on the topic of obstetrics, and in it we also find such things as instructions for performing an abortion, or instructions for a special touch to turn the fetus if it is oriented upside down in the uterus. It was knowledge that Europe was rediscovering with difficulty in the 15th and 16th centuries.

The Middle Ages was one of the worst periods in terms of childbirth. Christianity, especially at this time, placed women in a secondary position. And not only that the doctors of that time hardly dealt with obstetrics, but even in the middle of the 11th century even women who died during childbirth were not entitled to a standard burial.

Women had to help each other again. There were “professional women” among them, that is midwives. For example, we know from the chronicles that one such was present in 1176 at the birth of the later founder of the Czech monasteries, Blessed Hroznaty. Also King Wenceslas II. mentions that his nanny was also a midwife. Around the time when the aforementioned Hroznata was born in Bohemia, an exceptional Italian doctor known as Trota from Salerno several treatises on obstetrics and women’s medicine. These were practically the best and almost the only texts on this subject throughout the Middle Ages.

Despite all this, a unique event is also connected with the Middle Ages, specifically with the year 1337, when it seems that a the first caesarean section in history in which both mother and child survived. It was about Beatrix of Bourbon, the second wife of John of Luxembourg and the king’s son Wenceslas, i.e. half-brother of Charles IV. Today’s doctors agree that their predecessors at that time did a completely professional job worthy of admiration, although it was not a planned caesarean section, but a response to an acute problem.

Births in the modern age

In 1519, a book called “Message and teaching to pregnant women and midwives”. It was a translation of a book by the German doctor Roeslin from 1513. Obstetrics began to find its way into the light of day. In principle, however, births still took place in the same way and represented a great risk for both the woman and the child. It must be remembered that we are talking about a time when malnutrition was quite common, especially among the poorer inhabitants, and the level of hygiene was also at a very low level. The expertise of midwives was given only by their own experience, there was no formal education, and the idea that midwives would read the writings of ancient authors is of course nonsensical. All this increased the risk of complications.

Women in our country had to wait until the eighteenth century for the first significant change in the care of pregnant women. Empress Maria Theresa, herself a mother of sixteen, began to introduce the first reforms of the healthcare system, which were further developed by her son, Emperor Joseph II. The most significant change was that from 1746, midwives had to complete a course and then pass an exam. In 1753, supervision over the entire health care system, including midwives, was reorganized through the so-called “General Health Regulations of the Kingdom of Bohemia”. In 1786, the regional midwife’s office was even established. In the same year, obstetrics also became part of the curriculum at the Faculty of Medicine.

History of maternity hospitals in the Czech Republic

It is also associated with the 18th century establishment of the first maternity hospitals in the Habsburg Monarchy. The very first one was opened in 1776 in Soukenická street in Nové mesto. As early as 1609, however, the so-called Wallachian Hospital was operating in Prague, which focused on pregnant women and children, although it was not a classic maternity hospital at all. An interesting feature of the Máří Magdalena maternity hospital in Soukenická Street was the fact that women who had a certificate of poverty from the parish priest could give birth here for free. Respectively, the obstetrician only asked them to breastfeed motherless children or those whose mothers could not breastfeed for some reason.

Photo: RZFang, CC BY-SA 4.0 , via Wikimedia Commons

Modern delivery room

From the beginning of the 19th century, professional publications began to multiply relatively quickly, and doctors became more and more skilled and knowledgeable in childbirth. The discovery of the doctor Ignác Filip Semmelweis, working in the middle of the 19th century in a Viennese maternity hospital, that poor hygiene is the cause of infections became absolutely essential for increasing safety. This absolutely groundbreaking discovery subsequently dramatically reduced maternal mortality during childbirth.

However, births in maternity hospitals were rather exceptional. The vast majority of women gave birth at home in the 19th century. After all, it was also true for the first half of the 20th century and during the First Republic. An interesting fact is that maternity hospitals at that time were not the privilege of the rich, but rather the opposite, mainly women without a family background and moving on the fringes of society gave birth in them.

Likewise, it cannot be assumed that indeed all midwives were properly trained. Especially in remote areas, this activity was still carried out by women without formal education.

Neonatology

A major change was brought about by the National Insurance Act of 1948, which helped definitively establish so-called institutional births. In the second half of the 20th century, the goal of doctors was not only to ensure the safety of mother and child during childbirth, but neonatology also began to develop. Doctors were increasingly able to save premature babies who would not have had a chance of survival until recently.

However, the main thing was not happening here, but across the ocean. The first incubators already existed in the middle of the 19th century in France, England, Tsarist Russia, or the USA. At that time, they were heated, for example, by roof tiles heated on stoves. The great development of incubators took place in the United States in the 1930s.

The main credit for this goes to the Polish emigrant Martin Arthur Couney, who operated a facility equipped with incubators heated by warm air heated by boilers of boiling water. The whole system was designed so that in the incubator space, the air had a temperature corresponding to that prevailing in the womb. In addition, the air was filtered through gauze in an antiseptic solution.

There are two interesting things about Martin Couney. He very likely never studied medicine in the first place. He offered the services of his facility to all children free of charge, and earned money for the operation by showing the children in the incubators to visitors for an entrance fee, as in a museum. In the USA, incubators began to move to standard hospitals in the early 1940s. In the Czech ones, some of the first appeared just after the Second World War, when they were donated to us by the UNICEF fund as part of post-war development aid. Nowadays, there are almost a hundred maternity hospitals in the Czech Republic, and the health care system provides women in labor with maximum care and support.

The article is in Czech

Tags: life pain death history childbirth country world

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