Jean Louis Baudelocque

Jean Louis Baudelocque was one of the most influential obstetricians of the eighteenth century. He refined and popularized many of the theories and practices of William Smellie (1697-1763) and André Levret (1703-1780), and made a number of original contributions to the field. His fame rests primarily on the development of a technique for measuring the pelvis before delivery and the invention of a pelvimeter for this purpose, and his efforts in improving the education of midwives. His classic treatise on midwifery went through a number of editions and was widely translated.

Baudelocque came from a family of physicians and was guided towards medicine at an early age by his father, a médecin-chirurgien. He was the third of six children born to Jean Baptiste Baudelocque and Anne Marguerite Lavasseur in Heilly in Picardie in the Département de la Somme.

After receiving his first medical education from his father, he went to Paris to study at the Charité hospital, where he was trained in surgery and obstetrics by the distinguished obstetrician Giuseppe Solayrés de Renhac (1737-1772). When on one occasion the latter was sick, Baudelocque, while still a student, took over his lectures. Executing this duty in a most satisfactory way, Baudelocque continued the courses on his own after the death of Solayré.

In 1776 he was accepted to the Collège de Chirurgie with a thesis arguing against the practice of symphysiotomy in the management of pelvic contraction, entitled "An in partu propter angustiam pelvis impossibilis, symphysis ossium secanda". Shortly after this he joined the staff, and his reputation rose rapidly both as an academic and as a private practitioner.

On April 6, 1777, he married André de Voulier ou de Rullie. She died in January 1787 and on September 14, 1788 he married Marie Catherine Rose Laurent. They got five children.

At this time Rickets was commonplace and as a result dystocia due to pelvic deformity had become a major problem of childbirth. Baudelocque showed how external measurements using a pelvimeter might reveal contractions of the bony pelvis that were not otherwise obvious. His measurement, the external conjugate, became known as Baudelocque’s diameter and, although inferior to Smellie’s internal conjugate, was widely used for more than half a century.

In the management of dystocia, he opposed the use of the premature induction of labour introduced by Macaulay (probably George Macaulay, dead 1776) in 1756, and also the operation of symphysiotomy, first undertaken by Jean René Sigault and his assistant Alphonse Louis Vincent Leroy (1742-1816) in 1777. Instead he advocated the use of forceps, or alternatively of internal version and breech extraction, and in very severe cases of the use of caesarean section, an operation he described in great detail and undertook on occasion himself.

In 1798, after the French Revolution, the École de santé was built on the ruins of the Faculté de médecine and the Collège de chirurgie. Baudelocque was appointed to the chair of midwifery, and at the same time became physician in chief of the newly established Maternité clinic. Here he supervised the training of midwives as the 1700–2000 deliveries each year. This hospital with its excellent clinical and teaching facilities was unique in Europe at that time and was the main French centre for the training of accoucheurs and midwives. Among the obstetric techniques taught there were internal version followed by breech extraction and the use of his forceps, designed by Baudelocque on the basis of an earlier model by Levret. Baudelocque’s practice thrived, and he became the acknowledged master accoucheur in France, being referred to as le grand Baudelocque.

A bitter part of his career was the accusations raised against him by Jean François Sacombe (1750-1822) that he had caused the death of an expectant mother and her child. This maligning, however, was taken to court; Baudelocque was acquitted of malpractice, and his adversary was sentenced to pay 3000 francs to the Maternité and the poor, but this episode remained a stain to his career.

In 1806 emperor Napoleon appointed him to the first chair of obstetrics in France, and at the same time he became physician-in-chief to the newly established Maternité, where he educated midwives. This institution was later renamed the Maternité Baudelocque.

Napoleon also appointed him accoucheur to Empress Marie-Louise, but he died before she gave birth to their only child, Napoléon François Joseph Charles Bonaparte, named King of Rome.

He was also accoucheur to the Queen of Holland and Napoleon's younger sister, Maria Annunziata Carolina Bonaparte, Grand Duchess of Berg and Cleves, better known as Caroline Bonaparte.

In his comprehensive work Baudelocque corrected many of the errors and misunderstandings of his time, besides leaving behind a textbook of midwifery long in use. He was undisputedly the foremost teacher of obstetrics in his time, and his teaching of natural delivery is almost unsurpassed.

Baudelocque was buried in the cemetery Ouest de Vaugirard. In 1937 his body was exhumed because of the construction of the Pasteur boulevard. On August 17, 1939 he was reburied in the Père Lachaise cemetery in Paris.

• An in partu propter augustiam pelvis impossibilis, symphysis ossium secanda. Thesis for the Collège de chirurgie. 1776.
• L'art des accouchemens. 2 volumes; Paris: Méquignon, 1781.
  2nd edition:
  
• L'art des accouchemens. Nouvelle edition, revue, corrigée et augmentée.
  2 volumes. LVIII, 581 and VIII, 698 pages. Paris, Méquignon l'aîné, 1789.
  4th edition:
  
• Principes sur l'art des accouchemens, par demandes et réponses, en faveur des éleves sages-femmes.
  Quatrième édition ... précédée de l'éloge de l'auteur, par M. Leroux, ... et d'une notice sur sa vie et ses ouvrages, par M. Chaussier.
  Paris, Méquignon, 1812. 532 pages.
  Referring to Laurent Charles Pierre Leoux (1730-1792) and François Chaussier (1746-1828).
  English edition:
  
• A system of midwifery. Translated from French by John Heath. London, 1790.
  German edition:
  
• Anleitung zur Entbindungskunst. Zwote Ausgabe, nach der sehr vermehrten französischen zwoten Ausgabe des Verfassers übersetzt, mit Anmerkungen versehen, und durch einen neu ausgearbeiteten Anhang, auch mit mehreren neuen Kupfern vermehrt von Philipp Friedrich Meckel.
  2 volumes, 756 + 556 pages. Leipzig, Weygand, 1791-1794.
  Translated from the second edition.
  Philipp Friedrich Theodor Meckel ( 1756-1803) was the son of Johann Friedrich Meckel, the Elder (1724-1774).
• Anfangsgründe der Geburtshülfe, in Fragen und Antworten; zum Unterrichte der Hebammen. Aus dem Französ. von L. G. Morel.
  Colmar, Decker und Sohn, 1807. XVIII + 460 pages.
  
  
• John Hull, publisher:
  A translation from the French of two memoirs on the caesarean operation by J.L. Baudelocque. London, 1801.
  In this text, Baudelocque had reported 31 successful cases of section collected from many sources since 1750. He described the technique in detail that he used in his own cases, emphasising the importance of emptying the bladder with a catheter first and of persuading the woman to suckle her child afterwards in order to "more speedily dry up the discharges which are made through the wound ..."
• An abridgement of Mr. Heath's translation of Baudelocque's Midwifery.
  With notes by William P. Dewees. Philadelphia: Printed by Bartram and Reynolds, for William Dobson, 1807. XIV + 658 pages.
• P. M. Dunn:
  Jean-Louis Baudelocque (1746–1810) of Paris and L’art des accouchemens.
  Archives of Disease in Childhood Fetal and Neonatal Edition, July 2004, 89 (4): F370-372.
• H. L. Houtzaeger:
  Jean Louis Baudelocque. European Journal of Obstetrics & Gynecology and Reproductive Biology, August 1982, 13 (5): 323-324.