[The "secret book" of Dr Friedrich Benjamin Osiander: anonymous births in the Göttingen Accouchierhaus, 1794-1819].

Abstract

The problem of anonymous or confidential deliveries, a subject of current controversy, has a long history. Some maternity hospitals offered the possibility for "clandestine" births as early as the 18th and 19th century. A recently emerged source about the maternity clinic of Göttingen University allows insight into the motives that led to keeping a birth secret and the consequences of such a clandestine birth for mother, father and child. The director of the institution, a professor of obstetrics, wrote case reports on the women, who paid a handsome sum for his help and the in-patient care they received. In return, these women could be admitted under a pseudonym, and thus falsify their child's birth certificate; moreover they were not used as teaching material for medical students and midwife apprentices, whereas "regular" patients had to give their names and, in return for being treated free of charge, be available for teaching purposes. The ten cases that have been painstakingly investigated reveal that the reasons that led the women and men to opt for an anonymous birth were manifold, that they used this offer in different ways and with different consequences. All of these pregnancies were illegitimate, of course. In one case the expectant mother was married. In several cases it would be the father who was married. Most of the women who gave birth secretly seem to have given the professor their actual details and he kept quiet about them--with the exception of one case where he revealed the contents of the case report many years later in an alimony suit. Only one of the men admitted paternity openly, but many revealed their identity implicitly by registering the pregnant woman or by accompanying her to the clinic. If the birth was to be kept secret the child needed to be handed over to foster parents. By paying a lump sum that covered the usual fourteen years of parenting, one mother was able to avoid any later contact with her son. In most cases contact seems to have been limited to the payment of this boarding money. One of the couples married later and took in the twins that had been born clandestinely out of wedlock. One mother kept close contact with her son through intermediaries. All of the women who gave birth in this clandestine fashion received practical as well as financial support, often from the child's father or from a relative. Few of them came by themselves. In those days, only women who used the maternity hospital free of charge would have been as isolated in the difficult perinatal period as are women today who choose to deliver their babies anonymously.