Technological Object: Midwifery Manikin

“This was a wooden statue, representing a woman with child, whose belly was of leather, in which a bladder full, perhaps, of small beer, represented the uterus,” quipped the English midwife Elizabeth Nihell in reference to the teaching manikin used by the Scottish man-midwife William Smellie to demonstrate birthing manoeuvres in his courses. “This bladder was stopped with a cork,” added Nihell, “to which was fastened a string of packthread to tap it, occasionally, and demonstrate in a palpable manner the flowing of the red-coloured waters [and] in the middle of the bladder was a wax-doll, to which were given various positions.”

Birthing “statues” like Smellie’s made their way into midwifery classrooms across Enlightenment Europe and served as simulative tools on which aspiring midwives put their skills to the test. These handcrafted “machines” served as stand-ins for expecting mothers and reflected on how eighteenth-century modes of midwifery training embraced a mechanistic view of the body which pervaded the culture of birthing technology. The availability and popularity of these machines owes as much to this mechanistic viewpoint as to the technical achievements of engineers like Frenchman Jacques de Vaucanson, who perfected self-moving androids that included a flute player and the famous “defecating duck.” Medical practitioners shared an interest in harnessing mechanics to develop technologies for the benefit of their patients and the period saw the emergence of novel machinery like mechanical beds for paralytics.

The popularisation of the teaching “manikin” was the understandable outgrowth of this mechanistic turn in medical technology. By mid-century, these machines were widely adopted by pedagogues to illustrate the geometry of the female pelvis and various birthing positions to eager students. These life-size representations were typically composed of leather, wood, wicker, wax, textiles, plaster, metal, and even human bone. An ivory miniature variant known as the “anatomical Venus” represented a pregnant women with dainty mobile limbs and removable parts resting on a plush pillow and presented in a richly decorated wooden or glass case. In this model, the infant was attached to its mother by a string posing as an umbilical cord. Miniatures were used for diagnostic purposes in Eastern and Western medical traditions, but also for teaching purposes, as is evidenced by a wax Venus for sale that was advertised to midwives by an H. Wessels in London.

Like their miniature counterparts, life-size models of pregnant women were accompanied by infant dolls. These models were described as “phantoms” “manikins,” “(doll-)machines,” “mock-women,” and “dummies.” The sheer number of designations highlights the ambiguity surrounding their construction, use, and relationship to real bodies. The French word “mannequin” derived from the Dutch term “little man” came into use around 1730. It designated an artist’s or tailor’s lay figure employed in textiles and its use in referring to these models underscores their doll- and toy-manufacturing origins. Terms like “automaton” and “machine” depicted the models as mechanical reconstitutions of living prototypes, while “doll-machine” matched the model’s manufacturing history with its mechanistic design. Finally, “phantom” and “mock-woman” revealed questions concerning the ontological and moral status of these models.

For all the ways to describe them, these dummies were never mistaken by their makers or users for “real,” animate women. This did not mean that that their life-like effects, such as mobility in the skull joints of the foetus, were unappreciated. Their artificial status in fact rendered these machines particularly virtuous for the trials and errors of classroom learning: detachable organs and the mechanical touches which mimicked birthing waters offered all the advantages of real-life situations without the mess and unpredictability. What is more, the lifelikeness of the models could easily be adapted or compromised to achieve particular pedagogical aims. The result was that virtually no models featured faces, few had breasts, thigh stumps replaced full legs, and many featured the gravid uterus at the expense of surrounding organs.

The utility and increasing availability of these manikins meant that they became a staple in midwifery classrooms across Europe by mid-century. As they gained in popularity, the finished products exhibited greater naturalism and virtuosity thanks to ongoing design modifications. The German man-midwife G.F. Mohr may have been one of the first to use such teaching aids. He refers to the wood and cardboard pelvises he fashioned as alternatives to natural ones when Church sanctions prevented him from retrieving skeletons from cemeteries. Similarly rudimentary models were described by William Smellie when he travelled in 1739 to Paris to apprentice under the father and son Grégoire whose machine was “no other than a piece of basket-work, containing a real Pelvis covered with black leather, upon which he could not clearly explain the difficulties that occur in turning children.” Another male apprentice offered a comic description of what was probably also the Grégoire model: “Madam is a Piece of Basket-work, covered with a Kind of Silk, in Imitation of her Skin, and appears in her Buff.”

These men were part of a generation of “man-midwives” who were introduced to birthing techniques on doll-machines. Smellie’s Scottish compatriot, the anatomist William Hunter, likewise owed much of his skill in birthing to the time he sojourned in Paris as a medical apprentice. After establishing his practice in London, Hunter commissioned the construction of an iron cast of a full-term uterus as part of a more ambitious multi-media project, which began in 1771 when a heavily pregnant woman perished and her body became available for study. Following its dissection, Hunter ordered a body cast and chalk drawings of the corpse, and engravings were made to illustrate his medical atlas, The Anatomy of the Human Gravid Uterus (1774) (below). The restored original plaster and lead cast depicting “[t]he Child in the womb in its natural situation” is currently on display at the Hunterian Museum in Glasgow, where portions of Hunter’s collections were transported in 1807.

Plaster and lead were unusual materials for machines intended for day-to-day classroom use. More typical materials are represented in an Italian wooden box-like model with upholstered components that typically featured in French teaching dummies. The distribution of textile-based machines across rural France was achieved largely thanks to the tireless efforts of Mme du Coudray, who was appointed King Louis XVI’s midwife in 1759. During her nearly twenty five year “mission,” she trained over four thousand female and male midwives using what she called the “machine” she had perfected (below). The English woman of letters Ann Thicknesse applauded this “femme artificiel, this ingenious invention” and the Paris Royal Academy of Surgery invited her to present her machine to its members in 1746. Mme du Coudray also left her mark on the towns she had toured by depositing a model and illustrative textbook with local authorities, in the hopes that her former pupils would share their hard-won skills with new cohorts of midwifery trainees.

Midwifery manikins achieved new degrees of technical and pedagogical virtuosity within the cultures of eighteenth-century medical technology and pedagogy. Yet the history of this birthing hardware is much more – and less – than an uninterrupted trajectory of technical innovation culminating in the models’s classroom authority. Instead, it is the story of how such experts developed teaching tools on a largely pragmatic basis, with the aim of arming midwives with the expertise required to oversee both routine and difficult births in the lying-in chamber. Along the way, they encountered many challenges and some practitioners even came to question the mechanistic conception of the human body which the machines embodied, turning their gaze instead to the possibility of training midwives with real women in labour in hospital environments. Others continued to invest their energies in improving these manikins and it remains as no surprise that they have found their way into midwifery classrooms today.

—Margaret Carlyle

(all images © the author)

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