Discourses on the function of the pelvis in childbearing from ancient times until the present day

This historical research traces evolving beliefs about the function of the pelvis in childbirth from ancient times until the present day. The female pelvis was considered facilitative of birth in ancient times, acquiring an increasingly negative image adjacent to developments in the study of anatomy and medicine. The ancient doctrine of humours highlighted constitutional differences between the sexes, which sixteenth-century anatomists refined down to the level of the pelvis. The idea that the female pelvis was perfect for childbearing was exalted as a natural reason for women's domestic and childrearing roles in society. Paradoxically, men midwives (now obstetricians) contended pelvic pathology often meant women failed miserably in this role. The pelvis was also harnessed by men midwives to demonstrate traditional midwives' ignorance of reproductive anatomy. The midwife authors discussed in this thesis were aware of this, and the need for all midwives to have a contemporary knowledge of the bony pelvis and female reproductive anatomy, in order to converse with doctors and maintain public confidence. Whilst forceps could overcome mild degrees of obstructed labour caused by a narrow pelvis, surgical techniques were employed to explore ways of widening or bypassing it, such as symphysiotomy or caesarean section. The foray into pelvic mensuration which began in the eighteenth century, continued unabated until the late twentieth century. Seemingly objective medical studies were also cultural markers which aimed to justify social differences between sex, race, and class. As maternal mortality declined in the late twentieth century, and the safety and versatility of the caesarean operation increased alongside developments in fetal medicine, concerns about the size and shape of the pelvis became of less consequence. Despite tremendous medical endeavour, the old adage, the fetal head is the best pelvimeter, continues to underpin practice to this day.