"A shocking spectacle": a medical and social history of craniotomy in nineteenth century British obstetrics

At the beginning of the nineteenth century the gruesome procedure craniotomy, the surgical destruction of the foetus to facilitate delivery, was widely accepted in British obstetric practice. It was the traditional means of saving women's lives in labours that would otherwise eventuate in their death. During the nineteenth century, however, there was a profound change in British attitudes towards the practice of craniotomy. It became the centre of heated discussions, debates and anxieties that saw it move from acceptance to rejection by the end of the century. This thesis examines this transformation. Craniotomy was understood to be about saving lives. However, with a growing concern over mortality in childbirth, significant misgivings were raised about just how successful it was in doing so. As a result, craniotomy became the focus of considerable interest and intense discussion. Based on archival research of medical literature, doctor and student’s notebooks and hospital records, this thesis offers a detailed textual analysis of the documents produced by obstetricians. It traces various explanations, discussions and debates regarding this procedure. It was this dialogue that contributed to the heightened anxiety experienced by the doctor and mother about the known dangers of craniotomy. These discussion and on-going anxieties were influenced by changing medical knowledge, existing and shifting attitudes to craniotomy, and the relative value placed upon the mother and child. This led to the foetus becoming a topic of increasing medical interest, while simultaneously, validating and legitimising the place of obstetrics. Through a critical study of the complexities around this shift, this thesis seeks to provide a new understanding of craniotomy and, most importantly, to make a unique and valuable contribution to the knowledge of the histories of obstetrics, childbirth and women’s bodies.