2013 saw the 500th anniversary of the production of the first popular book on midwifery, Der Swangern Frawen und Hebammen Rosengarten by Eucharius Roesslin, printed in Strasburg in 1513, and was celebrated by a display in the RCOG Library of copies of the book and related works held in the College’s Rare Book Collection.
The introduction of printing in about 1450 was to produce a revolution in the spread of scientific knowledge, including medicine, although at first this was limited to reproducing texts of ancient traditions. However, since midwifery was handled almost entirely by uneducated women, no progress in the art could be expected from the dissemination of knowledge through the textbooks which would follow on from Roesllin’s work in the 17th and 18th centuries.
Midwives at this time were likely to be married women with children of their own - their personal experience of childbirth was regarded as the most essential midwifery qualification. With no medical education, a midwife’s last resort during a difficult labour was in prayer with charms and incantations. Recognition of the status of midwives by the Church was only in connection of midwives baptising dying babies in an emergency, and the mother was always advised to make her confession before the onset of labour, in case she died in childbirth. If the baby was not baptised, it would be ‘shut out of heaven’ and could not be buried in consecrated ground.
Labour was a female family ritual excluding all men, with the mother-in-law usually organising events. Rest was considered the cornerstone of all treatment in the middle and upper classes, but female labourers continued with their tasks in fields and barns. Labour was a painful, hard business, made worse by the belief that pain was God’s punishment for Eve’s transgression in the Garden of Eden and a necessary part of childbirth. Consequently pain-relief was often disapproved of, and comprised herbal and floral treatments, such as opium seeds, chamomile ointment, mugwort tea, raspberry tea and mandrake. It has been estimated that 3% of women died in childbirth during the 15th century, compared to 7 in 100,000 now in the UK, and disease and poor-diet contributed to this number.
During the postnatal period, a woman had to remain in the home until she had been ‘churched’. Churching of women (a religious blessing) after childbirth took place when she was considered to be past ‘the unclean’ period brought on by labour: this was a happy occasion, often accompanied by a celebration of the woman’s return to society. She was also allowed to resume sexual activity at this time. Breastfeeding was the preferred diet for the child’s first two years, and had the advantage of providing immunological resistance in the baby against infection, and also in suppressing ovulation and so naturally reducing the birth rate.
Eucharius Roesslin (c.1470–1526)
Eucharius Rosslin was an apothecary at Freiburg in Germany before being elected physician to the city of Frankfurt on Main in 1506. He served as physician to the city of Worms in the service of Katherine, wife of Henry IV, Duke of Brunswick-Luneburg. His experience of examining and supervising the city’s midwives led him to the conclusion that the high infant mortality rates were due to the carelessness and substandard practices employed by them, and his book, Der Swangern Frawen und Hebammen Rosengarten (A Rose Garden for Pregnant Women and Midwives) was the result of these observations.The book was published in 1513 in Strasburg, in German, including engravings by Martin Caldenback, a pupil of Albrecht Furer. For the first time, images of the birth chair, the lying-in chamber and the position of the fetus in utero were shown. Together with his own observations on midwifery (in which he emphasised the importance of the role of men in reproduction and blamed midwives for destroying children through neglect), Roesslin included information from older writers such as Muscio and Soranus of Ephesus. It was instantly popular and had three editions in the same year.
The Birth of Mankind, 1540
The book was a success and was translated into English, appearing as the ‘Birth of Mankind’ by Thomas Raynald in 1540, based on a translation of the Latin version ‘De Partu Hominis’ by Richard Jonas. Three years earlier, Jane Seymour had died of puerperal fever after the birth of Edward VI, and this work was dedicated to Henry VIII’s new wife, Catherine Howard. The later physician, Thomas Raynaulde was responsible for the later editions from 1545, and the copies in the Library represent publications at a time when the stability of the book and its content and format were assured. Thomas Raynaulde was a physician who practised in the Old Churchyard at St Paul’s Cathedral in London, where most of the printing shops were concentrated. He travelled widely, and had books published in Venice.
Later editions included drawings of the ‘Sixteen unkind ways in which a child may come forth’ using anatomical abdominal figures from Vesalius’ ‘de Humani Corporis Fabrica’. The first part of the work covered anatomy, followed by a free translation of Roesslin’s book covering labour and delivery, and a third part on remedies for labour, breech deliveries and treatment of the newborn and diseases. By the late eighteenth century the theory and practice described in the text was not valued very highly, and the work should be seen as a compendium of the knowledge available during the 15th and 16th centuries.
College co-founder, Professor William Blair-Bell owned eight different editions of Birth of Mankind, and annotated his copy of Ballantyne’s review on the subject with a list of his copies and their cost, and these may be found in the Rare Book Collection of the RCOG.
The display of material in the College Library was available until the end of April 2013, and comprised the following items:
Earliest book on obstetrics
Ludovici Bonacioli Ferrariensis Medici Illustris, Enneas Muliebris [Ferrara, 1502] Latin
This volume comes accompanied by a note from Ernest Fahmy FRCOG, Edinburgh, eloquently describing the importance and contents of the book:
‘One of the earliest printed books entirely devoted to obstetrics. The author was professor of anatomy at the University of Ferrara at the beginning of the 16th century. The book is important as containing the first description of the nymphus and the clitoris and the first authentic discussion of the hymen. A treastise by Aristotle on conception and pregnancy is also incorporated in the volume. The book is dedicated to Lucrezia Borgia. This copy has one leaf in facsimile, a few underlinings and some contemporary manuscript notes. Bookplate of an 18th century doctor and of the Marquess of Crewe.’
The first popular book on midwifery
Eucharius Rosslin’s ‘Rosengarten’
Facsimile printed in Munich, 1910 of the 1513 volume and later editions, written in German.
This volume came from the library of the College’s co-founder, Professor William Blair-Bell, and bears his signature, dated March 1923. It includes illustrations of the book being presented to Catherine of Pomerania-Wolgast, use of the birthing chair, birthing positions, and examples of title pages from the different editions.
First anatomical, illustrated midwifery text
De Conceptu et Generatione Hominis, Jacobi Rueff [Zurich, 1554] Latin
Jacob Rueff (1500–1558) first published the popular De conceptu et generatione hominis in 1554. It was one of the first post-Vesalian, anatomically informed, illustrated midwifery texts popular with Latin, German, and English reading audiences and was recognised as a standard midwifery book for over a century following its publication. Initially printed in both Latin and German, De conceptu was translated into English in 1637 with the new title, The Expert Midwife or An Excellent and most necessary Treatise on the Generation and birth of Man.
Rueff, the City-Physician of Zurich, was officially responsible for educating and licensing city midwives, and his De conceptu combined practical information gathered from Zurich women with material borrowed from existing published works. In particular, Rueff adapted anatomical information from Andreas Vesalius’s recently published De humani corporis fabrica (1543) as well as from Eucharius Roesslin’s midwifery tract, Der Schwangern Frawen und Hebamen Rosengarten (1513).
This volume includes pictures of conception, anatomy, the reproductive system, disabilities, instruments including forceps, and birthing positions.
First popular book on midwifery
Schwangerer Frawen Rosengarten, edited by Gualtherum Ryffium [Frankfurt, 1569] German
This edition of Rossalin’s Rosengarten includes illustrations showing the production of medicines and the use of midwifery equipment, as well as the birthing positions.
This birthing scene is typical of the later editions of the ‘Rosengarten’; the instruments shown are early midwifery tools to aid delivery of the foetus.
First book on childbirth in Britain
The birth of mankynde, otherwise named the Womans Booke, Thomas Raynold [London, 1545] English
Rosengarten was a success and was translated into English, appearing as the Birth of Mankind by Thomas Raynald in 1540, based on a translation of the Latin version De Partu Hominis by Richard Jonas. Three years earlier, Jane Seymour had died of puerperal fever after the birth of Edward VI, and this work was dedicated to Henry VIII’s new wife, Catherine Howard. The later physician, Thomas Raynaulde was responsible for the later editions from 1545, and the copies in the RCOG Library represent publications at a time when the stability of the book and its content and format were assured. Thomas Raynalde was a physician who practised in the Old Churchyard at St Paul’s Cathedral in London, where most of the printing shops were concentrated. He travelled widely, and had books published in Venice.
This volume includes a loose plate showing this anatomical figure, and fixed plates of birthing positions and a birthing chair.
From the collection of Roy Dobbin FRCOG, enscribed by him in 1927.
The birth of mankynde, otherwise named the Womans Booke, Thomas Raynalde [London, 1598] English
This volume was presented to the RCOG by College President, Sir Eardley Holland, who purchased it at a price of £85.