gms | German Medical Science

Background: Until the 1970s, young pregnant women were examined at university women’s hospitals in Germany in exchange for housing and supplies for teaching purposes. This paper presents for the first time results from interviews with medical staff and former “in-house pregnants” who witnessed these so-called “in-house pregnant women” during their training period. This practice was characterized by the simultaneity of seclusion and arbitrary invasions of women’s privacy. The staff assumed an involuntary role of simultaneous gratitude and solidarity as well as profiting for the training.

Aim/research question: This study aims to gain initial insights into the experiences and viewpoints of co-medical staff in obstetrics and affected “in-house pregnants” from the 1960s and 1970s. It investigates how both co-medical staff and the “in-house pregnants” themselves dealt with the challenges of implicit coercion, unwanted pregnancy, and the duality of social exclusion and a context shaped by in-clinic hierarchy that allowed for the use of violence. In addition, the study explores the dynamics of gratitude and solidarity toward the “in-house pregnants” and the first forms of committed resistance to the established practice of non-consensual examinations.

Methods: Oral History Interviews with medical personnel and former “in-house pregnant women” involved in obstetric care who worked in the 1960s and 1970s. Interviews were tape-recorded and transcribed. Purposively selected interview passages were analyzed using content analysis to identify and interpret the range of perspectives and experiences as well as overarching patterns and themes from interviewees’ statements.

Results: Based on the research questions, our results include the working situation of the pregnant women in everyday hospital life, as well as their experience of the physical examinations. Additionally, a central finding consists of the experience of everyday contact with clinical staff as exclusionary and hierarchical. Further, we found the pregnant women are coming from structurally similar contexts to the clinic.

Relevancy: This study helps to broaden the historical perspective on the educational practices of medical and gynecological students, midwives, and nurses in gynecology and obstetrics, and to better understand the complex hierarchical situations that medical personnel faced. This is particularly relevant in the context of the current issue of violence in childbirth, as many of the issues and ethical dilemmas are still present in obstetrics today, and we examine for the first time the historical antecedents in the teaching context.

Recommendations/conclusion: The study shows that the “in-house pregnants” were abused for teaching purposes in an examination and living situation in the university women’s hospitals that can be described as violent. Information about the familial-social situation of coercion, the simultaneity of exposure and compartmentalization, and the frequent lack of consent to examinations can be derived from the history of interactions between “in-house pregnants” and learners in obstetrics. Further research on this is needed.

Ethics and conflicts of interest: The project has received a positive ethics vote from the Charité Ethics Committee. So far, this project has not received any third-party funding. The project is currently funded by the Institute of Midwifery Sciences and the Institute for History of Medicine and Ethics in Medicine at the Charité. There are no conflicts of interest.