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  • Midwifery is what a midwife does - it's the branch of nursing that helps with childbirth.
  • Obstetrics is the branch of medicine that covers childbirth - so it includes midwifery.
  • Gynaecology is the branch of medicine that deals with problems specific to women, but not including obstetrics. It covers things such as infertility and menstrual problems.
  • The early Islamic Arabs had female doctors who assisted in obstetrics and gynaecology.
  • In the Christian West midwives developed an apprenticeship approach to training, which was completely separate from the training of doctors in the developing universities. There was little connection between the two until the 16th century.
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Slow Progress

  • Ambroise Pare (1510 - 1590), who is most famous for his work on gunshot wounds and amputations, also covered pregnancy in his book on surgery - however, he did record 35 live children from one pregnancy so it may have been inaccurate! Eucharius Rosslin wrote the earliest surviving book on midwifery in 1513.
  • The French Chamberlans family invented specialised obstetric forceps. They brought them to England when they fled religious persecution in 16th century France.
  • Male midwives (accoucheurs) became fashionable amongst the elite in 17th century France - the majority of people stook with the more traditional option of women though.
  • The medical profession became more interested in obstetrics in the 18th century and the first British school of midwifery opened in 1725. William Smellie published 'The Theory and Practice of Midwifery'. Traditional midwives were sceptical of his writings.
  • Childbirth was a very dangerous activity. Gravestones and registers of deaths during the Renaissance period and onwards show how many women died in their twenties during or soon after pregnancy.
  • There were primitive condoms in the 17th century and earlier, but the lack of effective, widely available contraception before the 19th century made chastity the only effective family planning.
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Population Growth

  • The industrial age saw a huge rise in population growth.
  • This was despite the poor conditions in cities, which made women less likely to survive a normal pregnancy. Lack of exercise, pollution-related diseases and deficiency diseases like rickets all weakened people, as did epidemcs of smallpox, tuberculosis and cholera.
  • Some people raised religious objections to using anaesthetics in childbirth. They thought that a line in the Bible said women were meant to suffer pain during childbirth. These ideas were onky really defeated when Queen Victoria asked for chloroform during the birth of Prince Leopold.
  • The development of antiseptics did a lot to reduce the deaths of women following childbirth - especially Semmelweis's use of chloride of lime to control post-natal puerperal fever.
  • Gynaecology as a separate branch of surgery dates from the mid-1800s, with much of the pioneering work being done in America. J.M. Simms opened the first gynaecological hospital in New York in the 1850s.
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Family Planning

  • In 1798 Thomas Robert Malthus was the first to suggest that the human species might increase in numbers beyond its ability to feed itself.
  • The reduction of deaths in childbirth meant an increased rate of population growth and a greater need for family planning.
  • Clinics providing barrier and chemical forms of contraception and family planning advice were pioneered in the 1920s - by Marie Stopes in Britain and Margaret Sanger in America.
  • Contraceptive pills were first available in the early 1960s. For a while the pill and effective antibiotics seemed to offer security from unwanted pregnancy and STDs. This helped fuel the sexual revolution of the 1960s. HIV changed that. The World Health Organisation and the UN Population Fund have been working to bring effective family planning to the developing world.
  • Recently new infertility treatments have been developed.
  • Most famous is IVF (in vitro fertilisation - or test-tube babies). The external fertilisation of an egg before implantation in the uterus was first done for humans in 1977.
  • Eggs, semens or even embryos can also be frozen and stored for a long time before being allowed to develop into babies. This can be useful - e.g. healthy sperm might be stored before a treatment that could leave a patient infertile.
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