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For many centuries, the practice of Obstetrics was beneath the dignity of physicians, and indeed of surgeon-barbers. Anatomic studies date back over a millennium with Leonardo da Vinci's depiction of an intrauterine pregnancy, one of his most famous works (1,2). Other artists followed, turning their attention to anatomy in print and wax media, among others (3-6).

Impropriety and the Obstetric Exam

A number of social customs through out the ages have always made physical diagnosis a bit awkward, keeping the physician's sight and ear away from his patient (7,8). In the orient, female patients would point out their physical problems by way of an ivory "doctor's lady" rather than perform a closer physical exam (9).

Transition to the Mainstream

Midwives, frequently untrained, aided in deliveries and it was not until the middle of the 17th century that Ambrose Pare established the first school for midwives in Paris (10,11). William Smellie (1697-1763) is considered the father of English Obstetrics and tried to bridge the gap between medicine and modesty as he delivered babies under sheets that extended from the mothers' shoulders to his.

1,2) Early Works

The first is a 9th century depiction of fetal presentations in "Gnyaikeia", a manuscript by Soranus, now in the Royal Library, Brussels. Leonardo da Vinci's artistic technique was far ahead of medical practice at the time. This is one of da Vinci's most famous sketches and was drawn primarily as a guide for other artists.

3-6) Obstetric Medical Illustration

Female anatomy is beautifully illustrated by Bourgery in "Traite de L'Anatomie de L'Homme" (1866-1871), while an intrauterine pregnancy is nicely illustrated by Dr. William Hunter in his famous "Anatomia Uteri Humani Gravidi", 1774. Another fine illustration is in JP Maygrier's 1822 work, "Nouvelles Demonstrations D'Accouchmen". An 18th century wax model of a twin pregnancy can be seen at the Specola in Florence, Italy.

7,8) Impropriety and the Obstetric Exam

Dr. Maygrier demonstrates a GYN examination in the 19th century when social custom tended to favor midwives for the care of pregnant woman. This short turned wood stethoscope was made for an obstetric examination and was invented for reasons of propriety.

9) Ivory Doctor's Lady

This hand carved example probably was from the turn of the century and sits on an ebony base. Note the lady's bound feet which were considered very attractive into the 20th century. The pillow under the figure is unusual.

10,11) The Delivery

Note the lack of sterile technique demonstrated in this delivery by Dr. JP Maygrier, 1822. Delivery chairs like the one pictured have been used into the 20th century.

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2) Embryo, da Vinci

4) Gravid Uterus by Hunter

6) Twins at the Specola

8) OB Stethoscope

9) Doctor's Lady

10) Delivery, Maygrier