King Louis XIV, The Obstetrician And The Lithotomist

King Louis was born in France in 1638. His reign lasted 72 years and, to date, he is the longest ruling sovereign monarch in European history. He was the classic symbol of absolutism. He died at the age of 76 after fathering over 20 children.

It is believed that King Louis was the organiser of what is now the most common way women give birth, lying down. However, that claim cannot be verified for certain, Francois Mauriceau, an Obstetrician, promoted the ‘French Birthing Position’, a reclining arrangement that allowed the doctor the ability to inspect and complete procedures with greater effectiveness.

The earliest records of childbirth depict women maintaining a sitting, squatting or standing attitude whilst in labour. It is known that the lying down method was not standard practice traditionally. Prior to the 17th century, upright birth postures were widely used – those that relayed on a birthing stool or chair for the delivery. These utensils date back to Babylonia, 2000 – 1600 BC. History illustrates that Cleopatra kneeled to give birth.

Rather than viewing pregnancy as innate for many women, Francois saw childbearing as an illness, “a tumour of the belly”. This perception, the view that birth and babies were ‘medical problems’ allowed inferior practitioners of surgery such as barbers to enter the territory, pushing midwives out. Prior to 1550, midwives were the only audience at births, in Europe. The Mauriceau maneuverer, also referred to as the Mauriceau-Smellie-Veit maneuvere is named after the French obstetrician, it is an emergency medical maneuvere used in cases of breech delivery.

King Louis XIV may have played a part in promoting this new approach. Many medical and historical articles report that the monarch enjoyed the activity of childbirth however found displeasure in the upright positions as they interfered with his view. It is believed that knowing that the king was admirer of this new process, the rest of society started to embrace the new practice. The ‘semi-recumbent’ position is most often used today, not only as it is comfortable, but it also allows for the woman to place her legs in a position that help open the pelvis. This position is also used for patients undergoing a lithotomy. The change in state also reflects our current lifestyles, we spent less time squatting and sitting than those in the past. We can determine that midwives play an important role in childbirth, especially during the second stage of labour as correct positions are important for a safe vaginal birth.

It is also known the King Louis XIV took an interest in French lithotomist, Frere Jacques, who also went under the name Jacques De Beaulieu. Though not accepted by the medical staff at Hotel Dieu, he obtained a licence to practise from the King. It is suggested that the use of the lithotomy position in labour and the expanded practice of the lithotomy operations occurred at equal times and locations in 17th century France. It is also indicated that this method continues in use today as it is believed to prevent loss of blood during childbirth.

Despite all the historical and medical articles available, not one person can be held responsible for the change in birthing positions or method as there are many factors to consider and an abundance of opinions. The shift may have been caused by the Sun King who viewed himself as symbol of God, who held absolute power; and his friendship with nursery rhyme namesake, Frere Jacques, which may have been named after the problematic lithotomist. Then again, it could have been the influence of Mauriceau, who perceived childbearing to be an illness.