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During the "Third Reich," the majority of German gynecologists and obstetricians did not hesitate to put themselves at the service of those in power. In 1933, many gynecologists initially only focused on the fact that the biopolitical objectives of the National Socialists matched their own long-standing demands for population policy measures and the early detection and prevention of cancer. In addition, cooperating with the Nazis promised the political advancement of the profession, personal advantages, and the honorary title of Volksgesundheitsführer (national health leaders). As a result, gynecologists exchanged resources with the regime and thus contributed significantly to the implementation of the criminal racial policies of the Nazis. At the congresses of the Deutsche Gesellschaft für Gynäkologie (German Society of Gynecology) "non-Aryan" members, mostly of Jewish descent, were excluded, the law on forced sterilization of 1933 (Gesetz zur Verhütung erbkranken Nachwuchses/Law for the Prevention of Offspring with Hereditary Diseases) was scientifically legitimized, its implementation was propagated, and relevant surgical techniques were discussed with regard to their "certainty of success." In the course of these forced sterilizations, existing pregnancies were also terminated and the victims were misused for illegal scientific examinations or experiments. Drawing upon racial and utilitarian considerations, gynecologists did not even shy away from carrying out late abortions on forced laborers from the East during the Second World War, which were strictly prohibited even under the laws of the time. Some gynecologists carried out cruel experiments on humans in concentration camps, which primarily served their own careers and the biopolitical goals of those in power. The few times gynecologists did protest or resist was when the very interests of their profession seemed threatened, as in the dispute over home births and the rights of midwives. Social gynecological initiatives from the Weimar Republic, which were mainly supported and carried out by gynecologists persecuted for their Jewish descent since 1933, were either converted into National Socialist "education programs" or simply came to an end due to the exclusion of their initiators. German gynecologists had hoped for a large-scale promotion of the early detection of malignant diseases of the uterus and breasts, to which they had already made important contributions since the beginning of the 20th century. But even though the fight against cancer was allegedly one of the priorities of the Nazis, no comprehensive measures were taken. Still, a few locally limited initiatives to this end proved to be successful until well into the Second World War. In addition, German gynecologists established the modern concept of prenatal care and continued to advance endocrinological research and sterility therapy. After the end of the Nazi dictatorship, the historical guilt piled up during this period was suppressed and denied for decades. Its revision and processing only began in the 1990s., (© 2021 S. Karger AG, Basel.)

Medical men, turning to midwifery in the eighteenth century, claimed that they were able to save the lives of mothers and children, jeopardized by "ignorant" midwives. Consequentially, modern scholars have tried to assess the progress of obstetrics and the merits of lying-in hospitals on the basis of maternal and, more rarely, perinatal mortality rates. The data and methodological problems involved, however, have been largely ignored. Here they are discussed in the light of a micro-study based on detailed archival evidence from Göttingen University's lying-in hospital, founded in 1751. Its mortality data are analyzed in comparison to those from other German and some foreign maternity hospitals. In a further step, perinatal and maternal mortality in hospitals is compared to that in normal home deliveries, attended by female midwives. By linking the findings to the eighteenth- and nineteenth-century debates about the pros and cons of lying-in hospitals, further questions are raised.

Albert Döderlein and his son Gustav had as professors in Munich and Jena a formative influence on the German gynecology in the first half of the 20(th) century. Albert Döderlein discovered the lactobacillus named after him and its function, he was one of the first who employed radiotherapeutics in cancer therapy and introduced the rubber glove in obstetrics and gynecology. But he also wrote the gynecologic text to the "Bill for prevention of progeny suffering from an inherited disease dated 14(th) June 1933". After his time at the university hospital Charité, between 1936 and 1945 he was medical superintendent of the department of gynecology and obstetrics at the Police Hospital in Berlin. He can be regarded as the founder of antenatal care in Germany. Both scientific and historic aspects of the biographies of these two professors are critically looked right past.

In recent years, historians of eighteenth- and nineteenth-century European midwifery have drawn attention to the great differences between midwives' experiences in England and the United States, where obstetricians succeeded by and large in displacing female practitioners, and midwives' experiences on the continent, where their fate was far more varied. While some countries witnessed the decline of midwives, in many others they were licensed and integrated into a government-sanctioned medical hierarchy. Scholars have disagreed, however, on how to evaluate the government's role in regulating midwives. Some have been critical, portraying midwives as victims of an alliance between the State and elite physicians who sought to place all other practitioners under their control. Others have cast midwives as beneficiaries of the State's protectionist policies, emphasizing their success in withstanding physicians' attempts to eliminate them entirely. Whilst these different interpretative models may reflect some regional variations, this article suggests that, in many cases, midwives both lost and won simultaneously: as State employees they lost much of their independence, but in exchange they gained protection not only from elite physicians, but also from unlicensed practitioners, who posed every bit as much of a threat.

In 1946 the share of clinic deliveries in the Soviet occupation zone amounted to 27 %, 1970 the given share of clinic deliveries in the GDR come to 99 %. From the beginning of the seventies home deliveries were not listed any more in the official statistics. After that neither the home obstetrics nor the family orientated clinical obstetrics took a larger space in the scientific discussions in the specialist public of the GDR. The following will show the development of the extraclinical obstetrics on the territory of the GDR as well as describe and discuss its medical and social context from the end of the forties until 1989. Usually in the (critical) reflections of the revival of home resp. extraclinical obstetrics in the eighties and nineties only the development in the "old" Federal Republic is taken into consideration. A description of the medicohistorical development in the former GDR in order to complete the all-German way of looking at this phenomenon was still due until now.

Hundred years ago, on 12 January 1903 the gynaecologist Max Sänger (1853-1903) died. He was one of the most well-known German gynaecologists at the end of the 19th century, and during the 20 years he practiced in Leipzig, he achieved an international reputation. His scientific work covered almost the whole field of contemporary obstetrics and gynaecology, and he is still remembered for his modification of the Caesarean operation, which substantially reduced maternal mortality. Sänger was closely linked to Norway, both professionally and personally. This paper describes his work as gynaecologist and his relationship to Norway, especially his friendship with Nina and Edvard Grieg.

The maternity hospital in Göttingen, founded in 1751, is considered to be the first in the world which was part of a university. Its main purpose was to train male medical students. Secondary aims were to instruct female midwives and to provide a haven for poor pregnant and lying-in women. The hospital was open to all women, without discriminating against foreigners, or any religion or race. Almost all patients were not married, and the overwhelming majority were servants. This article makes use of printed as well as archival material, mainly from the period when Professor Friedrich Benjamin Osiander was the hospital's director, i. e. 1792-1822, in order to show how the patients were used for developing and teaching 'scientific' obstetrics and man-midwifery.

After the detection of yeasts in 1839, German speaking mycology was first performed in obstetrics to find out the source of neonatal thrush. The authors are Berg (1846), Mayer (1862), Martin (1856), Winckel (1866), Haussmann (1870), Kehrer (1883), Epstein (1924), Rüther, Rieth and Koch (1958), Malicke (1963), Blaschke-Hellmessen (1968) and Schnell (1981) and others. In the gynecological field yeasts, vaginal mycoses and therapeutic problems had been investigated by the gynecologists Döderlein (1892), Spitzbart (1960), Lachenicht and Potel (1971), Neumann and Kaben (1971), Müller and Nold (1981) and Mendling (1987, 1995). Many gynecological papers, however, had also been written by dermatologists and microbiologists.

The present article deals with the standing and the tasks of midwives in 19th century Württemberg. After outlining the legal framework of obstetrics, special emphasis was given to the education and activities of contemporary midwives, and to their numbers. At the beginning of the 18th century, obstetrics was almost exclusively in the hands of women. After 1800, a growing number of barber-surgeons and physicians began to practise obstetrics. At the same time, vocational training and qualification of women-obstetricians increased considerably. Schools for midwives and lying-in hospitals were founded. In these schools a limited number of midwives were trained by physicians. Finally a hierarchy of different groups of obstetricians developed: first physicians, then barber-surgeons, midwives and folk healers. Although midwives were more or less excluded from operative obstetrics and high-risk-pregnancies, care and supervision of uncomplicated pregnancies, and of women in childbed remained their responsibility. It could be shown that in 19th century Württemberg more than 90 percent of pregnancies ran a safe course, and neither physicians nor barber-surgeons took a special interest in the care of normal births. Thus there was no dramatic transfer of obstetric care from the hands of the midwives to those of academically trained men. The high social status of the university-bred physicians separated them from most of the patients, as did the doctors' high fees. A certain indolence, and a remarkable sense of shame on the part of the pregnant women prevented much demand for academic obstetricians.

This article analyzes the behavior of the renowned professor of obstetrics Friedrich Osiander towards his Jewish former student, the private lecturer Joseph Jacob Gumprecht. In a public academic debate between the two of them, Osiander made use of anti-Semitic arguments. He did so even though his medical ideas and practice were based on concepts of Enlightenment and especially religious tolerance. An analysis of Osiander's behavior shows that his denunciations were hardly emotional outbursts against Gumprecht. Rather, they were sober pedagogic attempts to cleanse Gumprecht from what Osiander saw as his "Jewishness", thereby helping him on his climb into bourgeois academic society. This interpretation fits well with the German "etatistic" version of Jewish emancipation: Jews were able to gain equal standing, but only under the condition of moral "improvement", or ridding themselves of all "Jewish attitudes." Thus, "Enlightened" ideas of Jewish emancipation were partly based on beliefs in Jewish moral inferiority. It is significant that the example under investigation happened in a medical faculty, since this was a prime location for acculturated Jews to meet Gentile scholars who represented the Enlightenment-influenced ideas of the times.

Hildegard of Bingen (1098-1179), the famous priestess of South-Germany, wrote an outstanding work including theological books, a composers work, a large correspondence and a medical book named "the book about the subtilities in the different natures of the creatures": "Liber subtilitatum diversarum naturarum creaturarum". This work has later been splitted in two or three books, the "Physica", the "Causae et curae" and the "Berliner Fragmente", perhaps a part of the "Causae et curae". Until today not all handwritings are critically edited. 25 plants can be found in gynecological or obstetrical indication in her writings. Regarded under modern aspects most of them could be used in minor gynecological problems. Some are almost unknown today, others are regarded as too dangerous. Finally the medical work of Hildegard of Bingen can be estimated as a threshhold of experience, but it should not be transferred into the modern medicine without a detailed analysis.

Major advances taught by the German gynaecologist and obstetrician Carl Siegmund Franz Credé were the manual expression of the placenta and the prophylaxis of the gonoblennorrhoea. Under his supervision, as head of the obstetrical department of the Berlin Charité, the first exclusively gynaecological unit was founded in Europe. In 1856, he was elected head of the Department of Obstetrics of the University of Leipzig. Credé was the editor of the first 42 volumes of "Archiv für Gynäkologie". He died on March 14th, 1892, from prostatic carcinoma.

The process of institutionalization of obstetrics in the German universities is investigated on the basis of contemporary accounts and archival documents. The inauguration of the "school for midwives" by Johann Jakob Fried at Strasbourg (1728) was followed after 1750 by the foundation of numerous other obstetric departments and lying-in hospitals, in which midwives and medical students could attend a regular and systematic bedside-teaching for the first time. As to the architectural types, four basic structures have to be distinguished: Whereas in big cities the teaching centres were integrated in pre-existing hospitals (type A), the setting up of lying-in hospitals in regional universities took place in decaying old buildings (type B). The organizing of an obstetric ward in the former "clinicum" together with the medical and surgical department (type C) was rather seldom. Before 1850 the construction of expensive new buildings for lying-in hospitals (type D) was only realized at few places. In conclusion the emphasis is put on the political intentions and tendencies of the enlightenment philosophy which influenced considerably the creation and the development of the first teaching centres for obstetrics.

There have always been controversies on the pros and cons of home delivery and childbirth in a hospital. During the Nazi regime, the official "health command" policy monitored by the Nazi party promoted home delivery under midwife supervision, both by pertinacious propaganda and partly also by decrees and ordinances. The official line of argument against clinical obstetrics consisted of a queer and highly questionable mélange of ideology and distored facts brought forward by the so-called "Reichsgesundheitsführer" Dr. Leonardo Conti and his mother, Mrs Nanna Conti as head of the Party-sponsored Midwives Association. The "Midwives Law" was promulgated on 21 December 1938 prescribing compulsory consultation of a midwife for every delivery. By the end of 1939 gynaecologists eventually rallied in protest against legislative measures to restrict clinical obstetrics, by means of a memorandum penned by the German Association for Gynaecology. This memorandum was scheduled for circulation among all the members of the association. The pressure exercised by this memorandum resulted in tough negotiations amounting to a tug-of-war between representatives of the German Association for Gynaecology and Dr. Conti. This led eventually not only to an abandonment of the attacks against clinical obstetrics but also to an official and unreserved recognition of its achievements. In addition, the "Reichsgesundheitsführer" issued "Directives for regulating obstetrics procedures" in 1940/41 in which it was laid down that it would be left to the decision of the expectant mother to choose where she would prefer to deliver her child.