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[Learning at the bedside of pregnant patients. On the typology of the birthing center in Germany (1728-1840)].

The process of institutionalization of obstetrics in the German universities is investigated on the basis of contemporary accounts and archival documents. The inauguration of the "school for midwives" by Johann Jakob Fried at Strasbourg (1728) was followed after 1750 by the foundation of numerous other obstetric departments and lying-in hospitals, in which midwives and medical students could attend a regular and systematic bedside-teaching for the first time. As to the architectural types, four basic structures have to be distinguished: Whereas in big cities the teaching centres were integrated in pre-existing hospitals (type A), the setting up of lying-in hospitals in regional universities took place in decaying old buildings (type B). The organizing of an obstetric ward in the former "clinicum" together with the medical and surgical department (type C) was rather seldom. Before 1850 the construction of expensive new buildings for lying-in hospitals (type D) was only realized at few places. In conclusion the emphasis is put on the political intentions and tendencies of the enlightenment philosophy which influenced considerably the creation and the development of the first teaching centres for obstetrics.