'What are those?" I asked, pointing to an instrument that appeared to be a fork and a spoon joined with handles. "Those are salad tongs," deadpanned Mary Hyde, my guide through the American College of Obstetricians and Gynecologists museum. I looked at her quizzically. "Just kidding," she said. "That's a lifter. For a uterus."
The lifter, also called a uterine elevating forceps, is one of a variety of instruments used when removing tissue, tumors or polyps.
Nestled in the basement of ACOG's Washington headquarters, where Hyde is senior director of the resource center, the museum opened in 2008. Its collection of about 4,500 objects takes you on a journey through the history of the medical treatment of women.
There are pills and potions, including an herbal elixir from the 1940s meant to help with "female nerves" and "the change of life." There's a 19th-century wishbone-like object that's a precursor to the modern intrauterine contraceptive device. It resembles a giant screw with two prongs on the end. While it was effective at preventing pregnancy, it was painful and caused infection. There's a modern copper one, too, that's effective for 10 years, as well as a host of other forms of birth control such as diaphragms, the Today sponge and birth control pills.
The museum is named for Ralph W. Hale, a former executive vice president of ACOG who had an interest in history and a collection of artifacts related to his profession. When I emailed him asking what he felt were among the most important innovations in the specialty over time, he pointed to something not even specific to gynecology. Antibiotics, he wrote, were instrumental in stopping sepsis, a major killer of postpartum women. Along with other medical advances, antibiotics helped decrease maternal deaths dramatically.
Now there are other changes: The majority of first-year OB/GYNs are women, according to ACOG, although those older than 55 are mostly men.
The museum's collection tells a story that's as much political as it is scientific. It's fascinating, horrifying and hopeful all at once.
Here's a look at a dozen items that have been central to the specialty:
● Forceps. Forceps were first used during difficult deliveries to save the lives of mother and child. For a few decades in the early 20th century, mothers were given a drug cocktail, including opioids, to induce "twilight sleep," and the child was frequently delivered using forceps. Forceps are rarely used today. "Fewer and fewer doctors are being instructed on the use of forceps today, so the vacuum extractor is more likely to be used in cases of obstructed labor," Hyde said in an email. But, she added, "fewer than 5 percent of deliveries in the U.S. involve forceps or vacuum extraction."
● Birth control pills. These drugs, ubiquitous today, were approved by the Food and Drug Administration in 1960. But some states prohibited their use until a U.S. Supreme Court decision in 1965 ruled that married couples could decide for themselves. A 1972 case extended that right to single people. Research on an oral contraceptive for women began in the 1950s, with initial work supported by Margaret Sanger, founder of the forerunner to Planned Parenthood. According to Hale, "It was researched, however, as a pill to increase fertility," which allowed scientists to raise money without raising eyebrows.
● Condoms. Rubber condoms were first produced in the 1850s, but evidence of condom use is documented as far back as the 16th century, and some believe condoms were used by ancient cultures including the Egyptians and Romans. For many years, due to restrictive laws on birth control, condoms were advertised and distributed only for disease prevention. Latex versions appeared in the 1920s and have been the mainstay ever since. They were given to American soldiers in World War II for disease prevention and have remained popular as a prophylactic and contraceptive.
● Vibrators. "This is the one that started our collection," Hyde says. A.C. Gilbert, who introduced the Erector set in 1913 and made the Polar Cub electric fan, also sold a Polar Cub vibrator around the same time. The first electromechanical vibrator was invented by 19th-century physician J. Mortimer Granville.
For centuries, women had been diagnosed with hysteria, a broad term encompassing numerous symptoms, including irritability and anxiety. The treatment was to bring the women to orgasm, and the vibrator meant this would not have to be done manually by doctor or midwife. Once they were commercially available, vibrators were billed vaguely as personal massagers. "They couldn't say what they were really for," Hyde laughs. "This is America, you know?" Hysteria, or "hysterical neurosis," was finally deleted from the Diagnostic and Statistical Manual of Mental Disorders in 1980.
● Specula. The speculum was invented in the mid-19th century by J. Marion Sims, a surgeon known as the father of modern gynecology. The instrument works by holding the walls of the vagina open so that the cervix is easily examined. During a routine pelvic exam, cells from the cervix are taken to test for abnormalities, and secretions are sampled to test for infections. Sims is a controversial figure. He was well known for experimenting on enslaved women without their consent and without anesthesia. The early-20th-century speculum on display at the museum contains a light whose cord could be plugged into an electric lamp.
● Tansy. Tansy is an herb that was used as an abortifacient, a substance that chemically induces an abortion. In the United States, abortifacient use was widespread — and its sale was big business — until the early 19th century. The first laws against the sale of abortifacients were not meant to prohibit their use or to restrict abortion, but rather to regulate substances that often poisoned their users.
● Practice doll. Billed as an "obstetric teaching model," the museum's doll, which is believed to date from the late 19th or early 20th century, was used to teach nursing and medical students about childbirth. Made of leather, it is probably stuffed with horse hair and features movable limbs, an umbilical cord and an attached placenta.
● Lysol douche. During the first part of the 20th century, a great many concoctions were put forth as douching agents for women. "Boric acid. That brown Lysol. Bleach, all kinds of disgusting stuff," Hyde says. "And why do you douche? Because someone said you should." Marketing materials suggest that products like Lysol were meant to get rid of "feminine odor," but Andrea Tone, writing in her book "Devices and Desires: A History of Contraceptives in America," notes that commercially produced douches were, by 1940, the most popular form of birth control for women in the United States. Using Lysol as a douche frequently caused inflammation and burns, and as contraception it was completely ineffective.
● Stilboestrol (diethylstilbestrol). This medication, known informally as DES, is synthetic estrogen that was primarily prescribed to prevent miscarriage and premature labor. But it interfered with the endocrine system, causing birth defects and other problems. The drug was prescribed from 1938 to 1971.
● Breast pump. While we generally think of breast pumps as a means for a mother to continue feeding her child breast milk while she is working or doing other activities without her baby, the original breast pumps aided mothers and babies having trouble with nursing the old-fashioned way. There have been several breast pump designs over the years, including a manual pump that resembles an old-school bicycle horn and another that required the woman to suck on a length of attached hose. The VIM Colby pump, on display at the museum, is from the 1920s.
● EPT home pregnancy test. While home pregnancy tests are taken for granted today, their availability is relatively recent. The first commercially available test, EPT (short for "early pregnancy test") arrived in the late 1970s. The tests were revolutionary: A woman could find out whether she was pregnant in the privacy of her own home and at a much earlier time than did previous tests, which had to be conducted in a lab. This allowed earlier termination of the pregnancy or prenatal care and monitoring.
● Fetoscope. "It's like a hands-free phone, but it's a hands-free stethoscope," Hyde says. The instrument is worn on the head, with the bell of the scope in front. The DeLee-Hillis obstetric stethoscope was described first in 1917 by David Hillis, and again in 1922 by Joseph DeLee, his superior. (Hillis was the first to write about the instrument, but DeLee claimed to have been talking about it for several years before that.) The instrument, which "gives easy and accurate control of heart tones," allowed physicians to monitor a baby's heart rate during labor. These days, Electronic Fetal Monitoring is commonly used.
Typical visitors to the museum are ACOG members, according to Hyde, but others are also welcome, provided they make an appointment and explain the purpose of their visit. The museum is at 409 12th St. SW in Washington. The phone number is 202-638-5577. The website is acog.org.