A history of Dutch obstetrics

1
A history of Dutchobstetrics

• o.p.bleker, AMC

2
Famous names in Dutch obstetrics

• Hendrik van Roonhuyse (1625-1672)
• Frederik Ruijsch (1638-1731)
• Hendrik van Deventer (1651-1724)
• Jan Palfijn (1650-1730)
• Petrus Camper (1722-1789)
• Paulus de Wind (1714-1771)
• Hector Treub (1856-1920)
• Gerrit Jan Kloosterman (1915-2004)

3
Willemtje Cloppenburg, midwife in 17,18 th.
century Amsterdam

o.p.bleker
The ten joys of marriage, by Hippolytus de Vrye
(Hieronymus Sweerts). Hyronymus Sweerts,
Amsterdam 1678 plaat VII, detail. UB Amsterdam
4
Role of the midwife only starts at the
onset of labour and delivery.
De tien delicatessen des huwelyks, of de
wederlegging van de tien veramkelykheden des
huwelijks. P de Vernoegde Getroude (pseudoniem
van Hieronymus Sweerts). Timotheus Hoorn,
Amsterdam, 1678.
5
Collegium Medicum or Medical College

• 1638 founded by the
• burgomasters of Amsterdam
• 4 doctors in medicine
• and 2 pharmacists
• supervision of doctors, pharmacists, and midwives
• meetings every tuesday
• 11.30 am tot 2.00 pm

6
Frederik Ruijsch professor anatomy barber-surgeon
s guild
Inspectors of the Collegium Medicum in
1683 Adriaan Backer, Amsterdams Historical Museum
7

• After a second request of Ruijsch
• the gentlemen of justice have decided that
  all midwives of this town, before admission, will
  be examined by the inspectors of the Collegium
  Medicum and the professor anatomy of the
  barber/surgeons guild (Frederik Ruijsch).
• Dagelijksche notulen van Burgemeesteren Bd.
  III folio I,
• den 6 Februari 1668 (Gemeentearchief
  Amsterdam).

Delft 1656
8
Ordinance of 1668 arrested 31 januari by the
gentlemen of justice published 7 march Effective
31 may.
9
List of midwives, who passed their exams 1668
1715 Gemeente Archief, Col. Med. 27, 75.
10
First page from the book List of
miwives, who took their exams, In
1668 134 midwives were admitted, the years
after, a mean of 5,4 each year.


Gemeente Archief Col. Med. 27, 75.
11
Obstetrical care in Amsterdam around 1668

• 200.000 inhabitants
• 6000 deliveries per year
• 120-140 midwives and
• some (6-10?) barber-surgeons, specialized in
  obstetrics obstetricians

Geyl. De geschiedenis van het Roonhuysiaans
geheim, Rotterdam, 1905 Nieuwenhuis,T.
Vroedemeesters, vroedbrouwen en verloskunde in
Amsterdam in1746-1805. Het Spinhuis, Amsterdam
1995, p.21 en 91, noot 13. MHD van Leeuwen en JE
Oeppen. Reconstructing the demographic regime of
Amsterdam 1681- 1920. In Economic and Social
History in the Netherlands V , 1993 blz. 61-102.
12
Examination of barber-surgeons Question one of
the aspects of surgery is to take away what is
abundant or should not be there give some
examples. Answer , to remove stones from the
bladder, fish bones from the throat,and the
trapped child (afhalen der vrucht).
Titelprent uit t Nieuwe Examen der chirurgie van
B. de Bout, 1694, UB Adam.
13
13 maart 1697 Willemtje Cloppenburg wife of
Arend Cramer (mother of six children) passed her
exam of midwifery before the Inspectors of
the Medical College and the professor in
Surgery Frederick Ruijsch
14

Examination of midwives, possibly from
1700 (Gemeente Archief, Amsterdam) The questions
are still actual today and give a good impression
of what was teached to midwives in those
times. C.R. Post. De Amsterdamse vroedvrouw uit
de 18e eeuw. NTVG 1956 100 (I,3) 1-8. , UB
Amsterdam.
15
Examination of midwives 1700

• 3. the child is a mole or abortion
• 6. ..in labour, how to position the woman
• 8. what to do in case of non-vertex position
• of the child
• 9. when and how to improve
• the forces of labour

16
Examination of midwives 1700

• Question 10.
• .and lack of progression of labour and
• delivery, what to do
• Amsterdam
• 6000 deliveries per year
• and very likely 100 trapped
• foetal heads 1,7 .

Nieuwenhuis,T. Vroedemeesters, vroedbrouwen en
verloskunde in Amsterdam in1746-1805. Het
Spinhuis, Amsterdam 1995, p.21 en 91, noot 13.
17
the obstetrician well covered, sat down before
the woman, and after short time there was
an undamaged living child, while the mother, to
his (Hovius) astonishment had not suffered
much. Van Dieden citeert Hovius in een brief
van 28 augustus 1748 aan Paulus de Wind. De
Wind. tGeklemd hoofd geredt, 1751, blz. 13.
Van Solingen. Manuele opeartien der chirurgie
etc. Amsterdam, 1684, UB.
18
Roonhuysiaans secret

• Secret instrument of Hendrik van Roonhuysen,
  about 1695
• Rogier van Roonhuysen (son of Hendrik) and
  Frederik Ruijsch know the secret as well

Roonhuysiaans geheim, bij Mauriceau 1759, UB
Amsterdam
19
21 maart 1709 Ruijsch and Rogier
Roonhuijsen promise to teach Boekelman, Plaatman
en de Bruyn, obstetricians in Amsterdam, to
assist and help women in obstructed labour by
skills and instruments, however what is teached
will remain a secret for others.
A. van de Laar, Schets der gehele
verloskunde. SGravenhage, 1777.
20
List of instruments prescribed to the rural
obstetricians in 1818.
F.van Soeren. Doctores Meesters Apothecars en
Artsen. 1990, blz. 41.
21
Examination of midwives 1700

• 11.
• without rupture of membranes abundant blood
  loss shows, and at the end the general condition
  of the woman detoriates, what to do..

Placenta praevia laterialis en centralis
22
C.G.Schrader. Memorybook of the Wife Notebook of
a Frisian midwife, on the years 1693 1745 6
cases of total placenta praevia in about 3000
deliveries 2 per 1000. 2 women died from
bloodloss, and 4 women survived.

Kloosterman GJ. Verloskundige kanttekeningen bij
vrouw Schraders menoryboeck. In C.G.Schraders
Memoryboeck Van de Vrouwens. MJ van Lieburg en GJ
Kloosterman. Rodopi, Amsterdam, 1984, blz. 62-63.
23
Examination of midwifes 1700

• 12. how to know wether the child is alive or
• dead
• 14. how to get the afterbirth
• 18. wether one may expect more than one
• child
• 19. what to do in case of a
• dead child

Manuele placentaverwijdering, Fabre. Précis
dObstétrique. Balliére et fils, Paris, 1910,
blz.374.
24
Ruijsch on the placenta

• .just waiting is the sole and best attitude
  with respect to the birth of the placenta

Ruijsch.
Ontleedkundige verhandelingen 1725, p. 29-54.
25
that the placenta, after being a longer time in
the womb, may increase very much and even may
change into a bundle of vesicles.. XXXIII
Aanmerking Verzamelde werken blz. 77.
mole
26
The city was devided in 18 districts. City
midwives were prescribed to live in their own
district, to hang out an announcement with their
name, the number of the district and
City-midwife, on it.
27
Willempje Cloppenburg, midwife aks the
burgomasters of Amsterdam to be promoted to
city-midwife. 1705 ??
28
1674 Request of Ruijsch

• Relevant knowledge of anatomy through
  preparations and through anatomical demonstration
  on female corpses from the hospital, for midwives
  and their trainees
• Courses in midwifery from 3 towards 4 years
• In order to prevent problems during labour and
  delivery

29
14 january 1712 Willempje (Willemijntje)
Cloppenburg takes a trainee for midwifery
Gertruij Harmens. Vroedvrouwenboek 1712 1753,
Gemeente Archief, Col. Med. 27, 72.
30
The anatomical theatre in the weighhouse at the
new market, where Ruijsch held public lessons and
lectures. On 15 and 16 november 1712 Ruijsch gave
a public lesson for the midwives.
Jan de Beijer, De Nieuwmarkt met de Waag, 1756,
De Verzameling van Eeghen, cat.nr. 103, Gemeente
Archief, Amsterdam.
31
List of all midwives, present at the anatomic
lesson from Frederik Ruijsch at anatomical
theatre, on 15 and 16 november 1712. The first
day 87 midwives and pupils were present, the
second day 53, of which 48 also on the first day.
32
15 november 1712 Willemtie Kloppenburgh and
her pupil Getruy Harmens
33
On the second day of the Anatomy, four
midwives did not show up, but were uyt
roeyen, which means gone out for rowing.
34
Anthonie van Borssum, Volewijk. 1664 peoples
region Rijksprentenkabinet, Rijksmuseum
35
Rotterdam, printed by T.J.Wijnhoven Hendriksen,
Book Plate printer at the Hoogstraat
Amsterdam printed by the heirs H Reynders Second
Tuindwarsstraat
36
De tien vermakelikheden des houwelyks, door
Hippolytus de Vrye (pseudoniem van
Hieronymus Sweerts. Hyronymus Sweerts, Amsterdam
1678, plaat VII.
37
To conclude

• Dutch midwives were responsible for, the
  overwhelming majority of all labours and
  deliveries.
• Their results (Vrouw Schrader) were good.
• Doctors and obstetricians were only asked to
  assist in case of trouble.
• Knowledge, skills, hygiene, general health etc.
  may have changed, the independent position in the
  lead of primary obstetrical care has not.