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The topic of reproductive care is debated heavily today, but this is by no means an unprecedented trend. Women’s reproductive health has been a focus of concern for millennia. However, it was not until the mid-18th century that the fields of gynecology and obstetrics as we know them today began to emerge.

Prior to this time, women’s reproductive health was largely consigned not to the domain of science but to the realm of superstition. 

The Age of Enlightenment and the Turn Toward Science

In the 1700s, pregnancy and childbirth fell principally under the purview of religious authorities. Most births occurred in the home with the aid of female midwives — women who typically had little or no formal medical training. Rather, midwifery at this time was controlled largely by church authorities.

 

In much of Europe, midwives were required to be licensed by church officials to prevent the practice of witchcraft during the highly vulnerable neonatal period. Religious licensure in midwifery also often included the authority to perform baptisms and last rites in emergency situations. Nevertheless, midwifery remained very much a practice shrouded in superstition, folklore, and tradition.

 

By the mid-century, however, the growing influence of the Age of the Enlightenment inaugurated a gradual but profound shift toward scientific rationalism. Males, many of whom were trained physicians, began to dominate the ranks of midwifery.

 

These male midwives frequently received advanced training in anatomy and surgery and soon were attending to women of all social classes, from the impoverished to the elite. Male midwives, or accoucheurs, learned to perform pelvic exams on expectant women and to anticipate and prepare for potential complications during childbirth.

 

At this time, new medical innovations were introduced to facilitate births, including the development of forceps to safely assist in the delivery of the fetus.

 

Resuscitation techniques were also being developed at this time. William Smellie, a pioneer in the emergence of the field of obstetrics, is reported to have performed the first successful resuscitation of an infant by using catheterization to inflate the neonate’s lungs. So rapid was the medicalization of reproductive health by the mid-18th century that the first medical colleges in the United States offered specialized training in obstetrics and gynecology.

Comfortably Numb?

Despite the 18th century’s significant advancements in the field of obstetrics/gynecology, much remained unknown and misconceptions were common. Perhaps the most obvious example is the ubiquity of opium-based nostrums that could be readily procured at any general store or apothecary shop.

 

Purported curatives came in many forms, from laudanum tinctures and elixirs made of alcohol and opium to tampons laced with cocaine. These opioid products were purported to ease menstrual pain, regulate women’s menstrual cycles, and relieve the myriad conditions thought to be associated with “womb disorders,” which could include anything from headaches to “hysteria.”

Infection Prevention

Although reproductive healthcare made enormous strides in the 18th century, death rates for women and infants remained appallingly high. Most maternal deaths were associated with puerperal or childbed fever — a frequently fatal infection acquired by the mother during childbirth.

 

The prevalence of birth-related infections speaks to the still rudimentary understanding of infectious diseases during this period. Even the most well-trained of physicians likely had only a rudimentary understanding of bacterial and viral spread or of infection prevention.

 

Miasma theory, or the belief that many serious illnesses were caused by “bad” air, prevailed. Clinicians had no understanding of the threat that one human could pose to another, of the reality that human beings are far more infectious than mosquitoes or rodents, the most virulent of other species.

Birth Control

Not surprisingly, birth control was also a concerning “lady cure” of yesteryear. In the 18th and early 19th centuries, a host of products were introduced that purported to prevent pregnancy and induce miscarriages in expectant women.

 

However, most purveyors opted to couch the true function of abortifacient compounds, those designed to induce abortion, in obscure language to implicitly rather than explicitly signal to consumers their actual function. Nevertheless, these so-called “women’s pills'' were a popular, if largely ineffective, birth control product.

 

These easy-to-come-by pills “allowed” women to choose what was called the “quickening.” The medicine was comprised of naturally occurring substances that were thought to induce miscarriages, but often the ingredients weren’t actually capable of doing so and surgical procedures were offered instead. Unfortunately, dangerous birth control and abortifacient methods didn’t stop after the 18th century. Many quasi-cures were touted, including “bleach douches” that were not only ineffective but sometimes resulted in fatalities.

The Takeaway

Reproductive health is a concern that is perhaps as old as human history itself. In the 18th century, though, human reproduction migrated from the domain of superstition to the domain of science. The practice of facilitating childbirth began to leave the provenance of female midwives and move into the domain of male accoucheurs and medically trained physicians. Advancements in the understanding of anatomy and innovations in medical technology increased the safety of labor and delivery for mothers and infants alike.

 

Despite this enormous progress, however, many dangerous myths and dubious practices prevailed, including the reliance on opium to relieve gynecological pain and the lack of proper infection prevention. The end result of these challenges was appallingly high rates of substance dependency among women as well as an overwhelming number of women and children lost to infections acquired during childbirth.

 

Now, these types of pills and procedures are heavily regulated and studied for side effects and efficacy. However, much debate still remains surrounding the ethical implications and the involvement of church and state in the rights of women to use such methods. We have come a long way since the days of superstitious reproductive care, but we need to stay vigilant in learning all we can about how to provide the best reproductive care for women.

 

About the Author:

Frankie Wallace contributes to a wide variety of blogs and writes about many different topics, including politics and the environment. Wallace currently resides in Boise, Idaho, and is a recent graduate of the University of Montana.