Journal of gynecology obstetrics and human reproduction · 2026
Controversy over caesarean delivery in late 18th- and early 19th-century France: Jean-François Sacombe and the Anticaesarean School.
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de l'Aulnoit Agathe Houzé, Drouin Emmanuel
Аннотация
BACKGROUND: . In late 18th-century France, caesarean delivery on living women became the focus of an unusually sharp medical and public controversy. This article examines that debate through Jean-François Sacombe (1750-1822), founder of the Anticaesarean School, and his principal opponent, Jean-Louis Baudelocque (1745-1810).
METHODS: . We conducted a narrative historical review of primary printed sources by Sacombe and Baudelocque, contemporary institutional publications, and secondary historical literature. Sources were identified in medical-library holdings, the French National Library Gallica database, and Google Books using the keywords "anticaesarean", "caesarean delivery", "history of obstetrics", "Sacombe", and "Baudelocque".
RESULTS: . The controversy opposed two different responses to obstructed labour. Baudelocque accepted caesarean delivery when vaginal birth was judged physically impossible and supported his position with published case series; in a review of 73 operations, 31 mothers survived (42.5%). Sacombe rejected these reports as unreliable and promoted an intervention-sparing obstetrics based on the action of nature, manual examination and manoeuvres, and avoidance of forceps, destructive instruments, symphysiotomy, and caesarean section. His school was a teaching initiative rather than a durable academic institution; surviving viva announcements identify at least three pupils but do not establish a lasting organized movement.
CONCLUSION: . Sacombe's campaign illustrates a transitional period in which obstetric authority, evidence, manual skill, instrumentation, surgery, religion, and professional rivalry were simultaneously contested. His opposition was broader than anti-caesareanism alone: it was largely anti-instrumental and anti-surgical, although not opposed to manual obstetric intervention. The historical controversy should not be equated directly with current debates on caesarean rates, because the risks, indications, consent standards, and perioperative care were fundamentally different.
METHODS: . We conducted a narrative historical review of primary printed sources by Sacombe and Baudelocque, contemporary institutional publications, and secondary historical literature. Sources were identified in medical-library holdings, the French National Library Gallica database, and Google Books using the keywords "anticaesarean", "caesarean delivery", "history of obstetrics", "Sacombe", and "Baudelocque".
RESULTS: . The controversy opposed two different responses to obstructed labour. Baudelocque accepted caesarean delivery when vaginal birth was judged physically impossible and supported his position with published case series; in a review of 73 operations, 31 mothers survived (42.5%). Sacombe rejected these reports as unreliable and promoted an intervention-sparing obstetrics based on the action of nature, manual examination and manoeuvres, and avoidance of forceps, destructive instruments, symphysiotomy, and caesarean section. His school was a teaching initiative rather than a durable academic institution; surviving viva announcements identify at least three pupils but do not establish a lasting organized movement.
CONCLUSION: . Sacombe's campaign illustrates a transitional period in which obstetric authority, evidence, manual skill, instrumentation, surgery, religion, and professional rivalry were simultaneously contested. His opposition was broader than anti-caesareanism alone: it was largely anti-instrumental and anti-surgical, although not opposed to manual obstetric intervention. The historical controversy should not be equated directly with current debates on caesarean rates, because the risks, indications, consent standards, and perioperative care were fundamentally different.