Pregnancy Loss
Mothers of Monsters

Mothers of Monsters


I am looking at an infant boy suspended in a jar of liquid. The preservative fluid has kept the boy’s body looking much as it did when he was born over two hundred years ago here in Amsterdam. The crown of his head protrudes upward several inches, giving his head an odd shape and swollen features. The boy either didn’t survive his birth or didn’t survive long thereafter, and so the man-midwife brought the boy’s strange body to the Dutch anatomist Willem Vrolik, whose museum I am now in. Vrolik described the boy on Plate 35 of the catalog of his collection published in 1849, the Tabulae. He thanked the man-midwife for bringing him the body. He described the boy’s anatomy and diagnosed him with hydrocephaly, or fluid retention in the head.1 Vrolik also gave details about a figure in the boy’s case who was rendered invisible in the physical preparation of his body: his mother.

This boy is one of hundreds of human fetuses at Amsterdam’s Museum Vrolik, most of whom bear major congenital abnormalities such as cyclopia,2 anencephaly,3 or siromenelia.4 Willem Vrolik (1801-63) was among the first teratologists, scientific men who sought to classify types of congenital abnormality and, through classification, understand what caused them.5 This was a science of bodies, a search for immaterial causes within organic material. Yet in every jar, there is not only a body but an event, a moment of loss: a miscarriage, a stillbirth, a shortly-lived infant. Mothers appear in physical fragments like a translucent amniotic sac, or the flesh around an ectopic pregnancy, or a uterus enveloping an eternally-unborn fetus.

An infant boy suspended in a jar of liquid. The crown of his head protrudes upward several inches.
A preserved three-month-old fetus with placenta prepared by Frederik Ruysch in the 17th century. (Frederik Ruysch/The Kunstkamera Collection)

Maternal experience is more present in textual accounts of the bodies, such as Vrolik’s Tabulae. So as I am looking at the boy’s protruding crown and his swollen features, I know his mother was thirty years old and suffered “extreme violence” in the fourth month of her pregnancy, which included heavy blows to her shoulder, hip, and abdomen. After this, her pregnancy was torturously painful until the birth. Vrolik noted that the child was born “feet first,” a breech delivery.6

Fetal anomalies, historically called “monstrous births,” are common features of eighteenth- and nineteenth-century anatomy collections. Walking into Museum Vrolik today, it is obvious that Willem saw the body as an important source of evidence in his research into the cause of congenital abnormality. But the striking visuals of Vrolik’s collection and others like it obscure the event of birth in favor of the body birthed. So let me tell you about these bodies as objects: who collected them and what people learned from them. And in doing so, let’s look for pregnant women and consider their role in this story of scientific collection and research.

In seventeenth-century Amsterdam, Frederik Ruysch figured out how to preserve a human body. Using a technique of wax injection and spirit preservation, the anatomist was able to create artistic objects out of human bodies and their parts. Fetuses appear frequently in Ruysch’s preparations although there are few abnormalities. Instead, Ruysch made preparations of those bodies he felt best exemplified God’s design.7 The preparations are incredible: a four-month fetus resting atop a human foot whose amputation is hidden by a lace cuff, or a uterus dissected to show the three-month fetus tucked inside.8 Amazing as they are, however, one might reasonably ask: where did Ruysch get all these tiny bodies?

One of Ruysch’s many job titles was the examiner of Amsterdam’s city midwives. These city midwives– called stadsvroedvrouwen — were educated in practical and theoretical obstetrics, examined, and licensed for practice. Once licensed, a stadsvroedvrouw was given a city district and paid by the municipality to deliver the women within her zone. The idea was to equalize access to care: poor women and their babies were dying because they couldn’t pay the midwife or prevent her from being tempted away by wealthier patrons.9 By 1700, Dutch cities began establishing stadsvroedvrouwen systems to help stem the disproportionate mortality. Ruysch oversaw Amsterdam’s midwives in the decades around 1700, and he helped establish the system in other cities around the Netherlands.

Stadsvroedvrouwen were given the same type of obstetrical instruction provided to male surgeons, including the dissection of a female body to study the reproductive system. A stadsvroedvrouw was an autonomous practitioner except in cases where she was required to call the man-midwife: stillbirths, “unnatural” births, and deliveries requiring forceps. The fetuses who became preparations — by Ruysch and, a century later, by Vrolik — tend to reflect those categories for which a man-midwife or surgeon would have been called. This snapshot of the stadsvroedvrouw system tells us not only the medical network women gave birth within, but also shows us whose hands were involved in moving a fetal body from the birthing bed to the anatomist’s jar.10

The boy from Plate 35 was brought to Willem Vrolik by a vroedmeester, or man-midwife. Vrolik described the boy’s mother as suffering great pain until her delivery, but he used a word — verlossing — which implies delivery by forceps. In the details, we see the pregnancy and its end in glimpses: a married woman being tended to by a stadsvroedvrouw who, upon realizing it was a breech pregnancy, followed protocol and brought in the man-midwife who delivered the child using forceps. We don’t know why the mother let the man-midwife take the boy’s body, whether she was pressured or ambivalent. Perhaps she wondered what caused the boy’s strange appearance. Whatever her thoughts may have been, the vroedmeester knew an anatomist who would be interested in the unique infant, and so he brought the body across Amsterdam to Vrolik’s home.

Pencil drawing of a three-month-old male fetus with an elongated head.
Willem Vrolik, “Plate 35,” in De Vrucht van Den Mensch En van de Zoogdieren, Afgebeeld En Beschreven in Hare Regelmatige En Onregelmatige Ontwikkeling (Amsterdam: G.M.P. Londonck, 1849), 165.

Willem Vrolik explained embryological development through vormkracht: the forming force. In the century separating Ruysch and Vrolik, scientific understandings of gestation had changed dramatically due, in part, to the way anatomical preparations had opened up the womb to medical observation. Preparations of fetuses at varying gestational ages seemed to show the body emerging in stages from an unformed blob into an organized body. This observational knowledge depended on pregnancy losses: miscarriages, ectopic pregnancies, stillbirths. These provided a physical map of how the body came to be.

Yet, as with the boy in Plate 35, sometimes the body came to be different than expected. Vrolik believed that vormkracht guided the development of all living bodies according to natural laws. And he believed “monstrous” bodies were rare but not at all outside the normal course of nature: instead, they could be grouped into types, each caused by a specific disruption to vormkracht during development.11 Classification required collection, and so Willem Vrolik collected monsters.

The body told Vrolik what type of abnormality a particular case was, but it did not tell him why; for this, he needed mothers. The violence that Plate 35’s mother experienced marked the beginning of her pregnancy’s difficulty. Vrolik specified that it was a breech delivery for reasons beyond explaining the use of forceps; he noted that many of Tabulae’s hydrocephalic infants were breech deliveries, hypothesizing that this position was characteristic of “the type.” In the case of Plate 35, Vrolik was confident that “the violence was responsible” for the boy’s position and, thus, his abnormality.12

About half of Tabulae’s entries refer to the mother’s experience, and these tell us what Vrolik suspected could disrupt vormkracht and produce abnormality. He noted maternal illness, injury, and sexual violence. Sometimes, the mother had given birth to other children with the same abnormality. He tracked pain and cramping in order to isolate moments of change. Sometimes, the mother had felt the baby move only a few days before it was born still and strange.

Vrolik was not the first anatomist to collect this information about abnormal births. In fact, these details appear consistently in accounts of abnormal births dating to the sixteenth century. Yet unlike older accounts, Vrolik wasn’t explaining away a single strange occurrence or assigning blame.13 Instead, he was connecting cases to show that they weren’t single strange occurrences at all. Anatomy itself could classify abnormal bodies into types, but maternal testimony allowed Vrolik to identify common themes in how those types of bodies came to be not just once, but as a rule.

Visitors to anatomy museums like the Vrolik are fascinated by fetal preparations. They peer into jars revealing the developmental march from formless mass to full-term infant. They are often especially struck by the small bodies that serve as examples of the abnormal. In the museum, these bodies are conditions, syndromes, developmental stages, diagnoses. Yet each embodies a real moment of loss to a woman who, aside from the fruit of her womb, faded into history and appears in textual glimpses, if at all. This information is often unavailable or incomplete. But considering pregnancy loss as a necessary fact to the museum’s creation and its original scientific enterprise foregrounds the humanness of the space– not only in its content but in its origins.

Notes

  1. Willem Vrolik, De Vrucht van Den Mensch En van de Zoogdieren, Afgebeeld En Beschreven in Hare Regelmatige En Onregelmatige Ontwikkeling (Amsterdam: G.M.P. Londonck, 1849), 165. Return to text.
  2. Cyclopia is a rare condition where the orbits of the eye do not separate into two cavities, resulting in single eye and a probiscus in place of a functional nose. This results in a stillbirth or miscarriage and is non-survivable. Return to text.
  3. Anencephaly is the absence of most of the brain. Infants with anencephaly rarely survive more than a few hours after birth. Return to text.
  4. Sirenomelia is a fusion of the lower limbs. 50% of cases result in stillbirth, and the remainder do not survive more than a few days. There are very few modern cases of longer survival with early surgical intervention. Return to text.
  5. Laurens de Rooy, Forces of Form (Amsterdam: Academic Medical Center – Vossiuspers UvA, 2009), 64. Return to text.
  6. Vrolik, De Vrucht van Den Mensch En van de Zoogdieren, Afgebeeld En Beschreven in Hare Regelmatige En Onregelmatige Ontwikkeling, 165. Return to text.
  7. Julie V. Hansen, “Resurrecting Death: Anatomical Art in the Cabinet of Dr. Frederik Ruysch,” The Art Bulletin 78, no. 4 (1996): 673. Return to text.
  8. Frederik Ruysch’s Anatomic Collection,” Online Museum Collection, The Kunstkamera Collections Online. Return to text.
  9. Hilary Marland, “The ‘Burgerlijke’ Midwife- the Stadsvroedvrouw of Eighteenth-Century Holland,” in The Art of Midwifery: Early Modern Midwives in Europe (New York: Routledge, 1993), 192–213. Return to text.
  10. Hansen, “Resurrecting Death: Anatomical Art in the Cabinet of Dr. Frederik Ruysch,” 672. Return to text.
  11. de Rooy, Forces of Form, 63. See also Vrolik, De Vrucht van Den Mensch En van de Zoogdieren, Afgebeeld En Beschreven in Hare Regelmatige En Onregelmatige Ontwikkeling, vii. Return to text.
  12. Vrolik, De Vrucht van Den Mensch En van de Zoogdieren, Afgebeeld En Beschreven in Hare Regelmatige En Onregelmatige Ontwikkeling, 165. Return to text.
  13. For more about earlier published scientific accounts of abnormal births, see: Anita Guerrini, “The Creativity of God and the Order of Nature: Anatomizing Monsters in the Early Eighteenth Century,” in Monsters & Philosophy, (London: College Publications, 2005), 153-168. Return to text.

Featured image caption: Human fetus in the Nemo Science Museum in Amsterdam. (Courtesy Marek Bereza/Flickr)

Sara Ray is a doctoral candidate in the History and Sociology of Science at the University of Pennsylvania. Her work explores monstrous births as an intersection between embryology, natural history, medicine, and disability between 1697 and 1849. Sara's research has been supported by the Fulbright Program, the Science History Institute, and the Council for European Studies.

3 thoughts on “Mothers of Monsters

    • Author gravatar

      Nice essay! Glad to see you’re doing this research and asking the questions about the pregnant women who produced the “monsters” and embryos for science. fyi: shannon Withycombe’s, Lost, shows how MDs were able to collect these fetal bodies from women. Also, I have a chapter on the history of “monstrous births” into 21st c in the new edited collection by Rembis, Kudlick, and Nielsen, The Oxford Handbook of Disability History.

      • Author gravatar

        Dr. Reagan, thanks for these comments! I cannot wait to read “Lost,” Dr. Withycombe’s work has already been a great resource for me. I will look up your chapter about monstrous births to read right now. Thanks for your comment!

    • Author gravatar

      Very thoughtful post…curators often report the fascination of women visiting medical museums who visit these collections especially to understand their own pregnancy loss. Wonderful that you can shed some light on the women of the past and what they had experienced.

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