In 1920, Joseph Bolivar DeLee published the article, “The Prophylactic Forceps Operation,” in which he describes how physicians can manually remove a neonate from a laboring woman’s vagina with the use of sedating drugs and forceps. The procedure, according to DeLee, resulted in decreased rates of complications and mortality for both the woman and neonate. DeLee claimed the procedure could reduce damage to the woman such as prolapse, or when internal pelvic organs push down and sometimes protrude from the vagina, and fatal infant brain bleeding. He also suggested that physicians make an incision from the woman’s anus to vagina to accommodate the use of forceps, a procedure later known as an episiotomy. In “The Prophylactic Forceps Operation,” DeLee proposed the technique and use of his procedure, adding to the growing debate in the early twentieth century on the best way to medically assist women during delivery.
Joseph Bolivar DeLee was an obstetrician in the US between the nineteenth and twentieth centuries who advocated for the specialized teaching of medical students in the field of obstetrics to address problems occurring during pregnancy. He claimed obstetricians maintained a wider skillset than midwives, and founded the Chicago Lying-In Hospital to provide affordable obstetric care to women in Chicago, Illinois. According to Carolyn Herbst Lewis, critics of DeLee’s practices often cite his 1920 article, “The Prophylactic Forceps Operation,” as catalyzing a cultural shift toward overly clinical birthing practices. However, rather than solely advocating for its use, he had cautioned against the extreme use of forceps during delivery, and emphasized that obstetricians needed to know the information in the case it could ever save a woman’s life. Though some of DeLee’s philosophies were controversial, such as his disapproval of midwifery, he provided the emerging specialization of obstetrics with new technologies and interventions, cleanliness standards, and the introduction of film as a teaching method.
A vaginal speculum is a medical device that allows physicians and health providers to better view a woman’s cervix and vagina during pelvic exams. Most specula are made of metal and plastic, and physicians insert a portion of the speculum into the patient’s vagina to separate the vaginal walls. Physicians have used devices to view inside a woman’s vagina for centuries, but physicians did not begin using what is known as a speculum in the twenty-first century until the 1800s. Prior to the invention of the modern speculum, health specialists struggled to find a way to view the cervix and vaginal walls. Because of that, health specialists could not accurately diagnose medical problems that were occurring in those tissues. Therefore, the speculum has enabled healthcare professionals to provide women with better gynecological diagnoses and care.