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Obstetric Tables: a collaborative approach to an unusual Georgian midwifery guidebook

It’s International Women’s Day and Ceri in the Visitor Engagement Team highlights a project by Dr Rebecca Whiteley, Shreeve Fellow in the History of Medicine, for its collaborative and engaging approach to research. Rebecca’s interest in the visual culture of pregnancy and midwifery of the 1800s has led her to investigate the Library’s extraordinary medical collection. Join us on a whistle-stop tour of the project!

The Obstetric Tables, discussed in this post, contain medical imagery which reflects the medical and visual culture of the era in which it was created.

Flap-books, many of us cheerfully reminded of childhood wonder and discovery: ‘is the playful dog hidden under the rug, or peeking out from a basket?‘. For many they herald a first encounter with the printed book, yet we may not relate them to historical medical scholarship.

At the cusp of the Georgian era, artist and male midwife George Spratt published his first edition of Obstetric Tables; a unique guide for students of midwifery. With an artist’s creative vision, Spratt devised colourful and intricate mobile flaps to give students a layer-by-layer demonstration of pregnancy and common medical interventions.

The print held within the University’s Special Collections is the subject of Rebecca’s article published in this February’s issue of British Arts Studies.

3D-imaging enables midwives of today to visually track fetal development and record the first treasured milestones for those expecting.  Historically, midwives could refer to guidebooks with detailed anatomical drawings that were informed by dissection room observations.  This video, created by the University of Manchester’s Imaging Team as part of Dr Rebecca Whiteley’s research reveals a pregnancy at full term, as tissues and membranes are lifted.

The beginnings of a collaborative project

Rebecca’s research with the Medical Archives held at The John Rylands Research Institute and Library has been generously supported by Dr David Shreeve. The Research Institute were instrumental in connecting Rebecca with specialists across conservation and imaging, enabling Rebecca to share discoveries with a wide audience.

Dr Rebecca Whiteley writes:
The book on obstetrics by George Spratt is rather special in its production of flap constructions to describe the pregnant, labouring and foetal bodies. In my research, I was particularly interested in the extent to which the target audience (young male medical students), as well as other kinds of viewer, would find these flap images useful.  
Did their mobility allow them to communicate material qualities of the body more effectively? Or perhaps the body in movement and process?  As I pursued these questions, I came to feel that elements of the flap images – the sometimes violent medical interventions, the descriptions of naked bodies – would have triggered quite emotional responses in nineteenth-century viewers. These might have ranged from curiosity and interest to horror.

Making Obstetric Tables accessible

Rebecca had to think creatively about how she could communicate the tactile aspects of the book to remote audiences: what might the illustrations evoke for viewers of today? Before imaging could take place, the book’s condition had to be assessed.


At the Rylands, conservation specialists Elaine Sheldon and Janay Laudat were tasked with the challenge of assessing Obstetric Tables: could it safely be displayed, handled and digitised without causing damage to the delicate illustrations?  They evaluated the materials, mechanism, inks and paper. Eager to hear their experience studying the work’s material qualities, we reached out to them.    

Janay Laudat writes:

Some of the illustrations have a delicate layer of transparent tissue hinged underneath the printed paper flaps, possibly used to illustrate an amniotic sac or protect hand colouring on the paper beneath. This use of delicate transparent tissue and moving parts lies in contrast to many of the graphic and often forceful images, such as the use of forceps. As I peeled back layers of the flaps and tissue, it reminded me of peeling away skin. This added to a sense of intimacy with the book while also being unsettling.


With the good news that Obstetric Tables was stable for imaging, Rebecca could progress with making the volumes accessible to wider audiences.  Gwen Riley Jones, manager of the experienced Imaging Team at the Rylands, facilitated a comprehensive digitisation of the work with each page and flap expertly photographed and compiled into a digital copy, available to discover at Manchester Digital Collections.   To demonstrate the mobility of the illustrations, a series of video clips was also produced, accessible to the interested public and researchers alike.

The illustrations in Obstetric Tables are hand-coloured lithographs which would have required a lot of care and attention to produce. It is possible that Spratt’s daughter and son helped with this.

Designing a facsimile

While the fantastic work of the Imaging Team enabled remote audiences to get a real impression of the book’s mobile illustrations, Rebecca hoped she could find a way to recreate the immersive experience connected to Spratt’s use of materials in his book, particularly those imitating human body tissue.   What responses could this evoke today?

Rebecca writes:

I reached out to designers at Hartland Design to see whether they could produce modern copies – or facsimiles – of some of the flap constructions.  When I tried to make a reconstruction, I struggled to understand how the flaps had been layered and secured, but Paul’s reproductions were extremely accurate. facsimiles have allowed me to bring the physical experience of looking at Spratt’s illustrations to wider audiences, including the public at Library Collections Encounters, and audiences at talks and conferences

Paul and Sarah Hartland, Hartland Design write:

We were impressed with the intricacy and detail of the paper-based Obstetric diagrams – the publication is extremely effective and immersive. We were very keen that our reproduction should capture not just the aesthetics and feel of the original but that it should function well and help recreate the experience of looking at the original. Being able to look at the original was extremely important and helpful in terms of not only seeing the content but being able to observe paper weights and types for example. For the actual project development we worked with high-quality digitised images of the publication from the library We post-produced the supplied images; mainly tweaking them for size, alignment and colour matching and used these worked images as the basis for the reproduction artwork

Research engagement

Equipped with both digital and material versions of Spratt’s work, Rebecca could share her research with different audiences.

Rebecca writes:

Some of the most rewarding discussions I have had about the Spratt illustrations have been with professional midwives and teachers, who can bring totally different perspectives and knowledges to these historic images. medical professionals have brought insight not only into how medical knowledge, but also medical culture has changed, and into how the teaching materials of the early nineteenth century compare to those of today.

We reached out to Dr Janette Allotey,  retired Lecturer in Midwifery at the University of Manchester and Chair of De Partu, History of Childbirth Research Group, to hear her thoughts about the visual culture of midwifery, Spratt’s Obstetric Tables and modern midwifery teaching aids. She offered some fascinating stories.    

Dr Janette Allotey writes:

Spratt’s tables would probably not have been seen by many traditional female midwives, with limited access to such texts. The original target readership was ostensibly male medical subscriber.

In her article, Rebecca has been able to explore how the interactive illustrations in Obstetric Tables , alongside Georgian popular ephemera, engage with Georgian apprehensions regarding the presentation of the nude female body in private and public spheres.

Dr Janette Allotey continues:

Strangely, the book was published at a time when female modesty was becoming a religious and cultural issue.  By adding a mother’s face and scant clothing to the image, the image is transformed into a picture of a person, This image is of a woman revealing her body to the observer.  What kind of a woman is depicted? Do we know if the image is based upon an actual person? Possibly a working class person or a servant…if it was based upon a real person, was she aware of this use of her portrait? 

During the late twentieth century an advert was produced to advertise a  ‘Beneton’ product which contained an image of a naked pregnant abdomen. It created a furore, but in a relatively short space of time, public censorship of sex and nudity was relaxed. Today, Nude scenes in general and childbirth scenes are a frequent occurrence on television, films like One born every minute’ have served to ‘lift the lid’ on the mystique of childbirth. 

There is a value to showing midwifery students examples of traditional texts. It allows them to consider their professional heritage and encourages their skills of reflection and interpretation. In my experience of organising a number of ‘close-up’ experiences for students with midwifery texts at JRL in the past, they are usually fascinated when they see some of them; and sometimes appalled or amused!  

Concluding our tour of Rebecca’s research, you can delve into the world of nineteenth-century obstetrics and view a fully digitised copy of Spratt’s Obstetric Tables .

Rebecca has also worked with the University’s Museum of Medicine and Health and you can read her blog about the intricacies of modelling forceps and fetal heads.

We have shared this research journey on International Women’s Day to celebrate Rebecca’s collaborative and inclusive approach to sharing her discoveries.  

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