DOROTHY C. WERTZ
Until the mid-nineteenth century, birth was a women's event attended by midwives. Ninety-five percent of the time, both mother and child survived. Some colonial midwives delivered 3,000 to 4,000 babies in the United States without a fatality, but when something went wrong, midwives had few technologies. They could reposition a breech birth and deliver the child feet first (a maneuver called podalic version). By the eighteenth century, if their techniques failed, midwives called a male barber-surgeon (a tradesman without formal education) to dismember the fetus to save the mother's life. Typically, the few men who witnessed birth saw it as a flawed, disastrous process needing improvement.
The forceps, the first instrument that could deliver a live baby, probably evolved from midwives' attempts to deliver impacted babies by placing spoons on either side of the head. When men began to take an interest in birth, in the early seventeenth century, the English barber-surgeon Peter Chamberlen developed a lock to hold the spoons together. Like many medical entrepreneurs, the Chamberlen family kept the new instrument a family secret for over a century and became accouchers (male midwives) to the royal family. Forceps may have taken more lives than they saved before Pasteur's bacteriological discoveries of the 1860s. Early models had no curves to fit the birth canal or the baby's head, often tore the mother's soft tissue, and were not disinfected or even washed. Sources of infection were unknown and infections were usually blamed on patients.