Giving birth in the 16th century was always risky. And if the infant needed serious help to escape the womb, both mother and baby鈥檚 chances of survival were slim. An instrument to haul the baby out, alive and intact, would have been a godsend. Towards the end of the century a certain Peter Chamberlen cobbled together just such a device. Did he tell the world what it was and how it worked? Hardly. Without the benefit of patent protection, revealing the design of his new instrument would have lost the family business a valuable asset. Instead, Chamberlen and his relatives kept their invention a secret. They smuggled it into the labour room, did the business, then smuggled it out. For well over a century no one could figure out how they managed to emerge triumphant from so many difficult deliveries.
INSTRUMENTS for use during birth have been around for at least 2000 years. But most were crude and destructive-helpful in removing a baby from the womb, but only at the price of injuring or killing it. Until the 16th century, anyone dealing with a labour that had gone badly wrong could choose to save the mother or the infant, but not both.
The medical profession hadn鈥檛 yet claimed childbirth as part of its territory. Only when matters became desperate would a surgeon get involved. The women who attended births were mostly ill trained and uneducated. They relied mainly on folklore in the execution-an apt word-of their craft. If they used equipment of any kind, it was likely to be something from the kitchen.
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It was around this time that male midwives began to arrive on the scene. The Chamberlen family formed an obstetric dynasty. William, the head of the family, was a Huguenot who arrived in England in 1569 after fleeing persecution by French Catholics. He had one daughter and four sons, two of them confusingly named Peter. Peter the Younger produced eight children, one of whom-also called Peter-became a doctor. 鈥淒r Peter鈥� as he was known, fathered a child called Hugh (Hugh senior) who in turn had a son, Hugh junior. All three Peters and both Hughs, together with various other relatives, practised midwifery.
It was probably Peter the Elder who invented the forceps. Having realised what an edge this gave them over their competitors, the Chamberlens were in no hurry to lose their advantage. They were said by some to carry their instruments to the birth room in a special box, which they would open only once all bystanders had left the room and the woman herself had been blindfolded. More likely they simply concealed the forceps in a coat pocket.
To preserve modesty, all procedures were carried out by touch with the woman鈥檚 body concealed beneath a blanket. This would have made it easy to remove the forceps from an inside pocket, deliver the child, and then hide them away without anyone seeing what was happening.
Subterfuge and sharp practice were nothing new to the Chamberlens. Two of the Peters (Elder and Younger) had trained as barber surgeons, a profession that grew out of a long-standing tradition that the man who shaved you would also perform any minor surgery you might need. This group was barred from prescribing medicines-then the prerogative of the university-educated physician. But Peter the Elder flouted this so blatantly that the College of Physicians had him jailed. Only his good relations with King James I鈥檚 wife, Queen Anne-whose confinements he had attended-got him out.
Like their modern counterparts, the forceps resembled a large pair of scissors, but with curved and flattened blades designed for grasping rather than cutting. Each blade had a large window in it to minimise pressure on the baby鈥檚 head. In the first version, the two blades were articulated with a fixed rivet. This would have made it difficult to manoeuvre them into position around the baby. Mark two had blades that could be inserted separately and then connected by slipping a pin on one through a hole in the other. The third and fourth versions were even more adaptable. They had holes in both blades. Once they were in place the two could be linked by slipping a thread through the holes and tying them together.
How the Chamberlens鈥� secret got out-if it got out at all-is a matter of speculation. According to Bryan Hibbard, an authority on the history of obstetrics, Hugh senior went to Paris in 1670 to meet a celebrated accoucheur-a male obstetrician-called Jules Clement, and offered to sell the design of the family鈥檚 instrument for 10,000 crowns.
Clement naturally wanted some proof that he wasn鈥檛 buying a pig in a poke. Guided by the equally celebrated physician Fran莽ois Mauriceau, the accoucheur set a demanding test of the vendor鈥檚 equipment. In fact it was not so much demanding as impossible. Hugh Chamberlen was asked to deliver a woman suffering from dwarfism made worse by physical deformities, who had already been in labour for eight days. After three hours, Hugh admitted defeat. The woman died.
By the early to mid-18th century, forceps of some kind seem to have been in use in at least two towns in Holland. Hugh senior had settled in Amsterdam at the end of the 1600s. This fostered a suspicion that he may have made a second and more successful attempt to capitalise on the secret by selling it to another obstetric family, the van Roonhuysens. But the evidence is thin: the design of their forceps shows little sign of it.
The family home of Dr Peter and his son Hugh senior was Woodham Mortimer Hall in Essex. It was here that the Chamberlens鈥� original instruments were hidden for some 150 years. In 1813, the mother-in-law of a subsequent owner ventured into the attic and found various mementoes that had been placed there by Dr Peter鈥檚 wife. They included a testament, a pair of gloves, one of Peter鈥檚 teeth and four pairs of the original forceps.
Why any woman would place her husband鈥檚 medical instruments among a bundle of otherwise rather personal keepsakes is hard to say. But it seems entirely in keeping with the rest of the family鈥檚 odd history. The forceps ended up in the London base of the Royal College of Obstetricians and Gynaecologists, where they are on display along with the rest of the instruments discovered at Woodham Mortimer Hall. They provide a reminder that medicine has often been an entrepreneurial as well as a healing profession.