At the 1939-1940 World’s Fair in New York City, among the spectacles was a wildly popular exhibition: a set of two dozen sculptures grouped under the title “The First Year of Life,” the brainchild of Brooklyn obstetrician-gynecologist, artist and marriage counselor Robert Latou Dickinson. When visitors approached the display, according to historian Rose Holz of the University of Nebraska-Lincoln, they encountered a neatly progressing narrative of pregnancy, ordered from conception through birth. As they passed by each sculpture, an attendant offered pamphlets describing each stage of development. Nearby, a rotating display showed a model of the famed Dionne quintuplets, born in 1934 in Canada, and stretching overhead was a sculptural tree bearing babies instead of fruit.
It was the first time, outside the realm of medical education or a sideshow cabinet of curiosities, that crowds of people had had a way to envision together what a human fetus might actually look like—and it was a sensation. Holz notes in an academic article that “the installation attracted long lines every day from ten in the morning to ten at night. Neither rain nor shine stopped the crowds from coming; nor did the occasional stampede. … By one account 700,000 people had viewed it in 1939 alone.” The goal of “The First Year of Life” was to frame maternity “as a family affair and not simply something mothers alone ought to be concerned with,” Holz writes. Mothers of large families devoured it with their eyes, eager to discover what exactly had happened to them. High-school couples also wandered through, and parents brought their children—at least those parents who found the exhibition appropriate for young eyes.
In designing the Birth Series, as the sculptures were collectively known, “Dickinson was riffing off 18th-century sculptures, 19th-century flap anatomies and more,” Holz says in an interview. The artist was inspired by birth models that had been used at the School of Obstetrics in Bologna, Italy, for the past two centuries; drawings by famed Scottish midwife William Smellie; and extensive Mason-jar collections of miscarried or stillborn specimens kept in American museums and laboratories. He also had a newer technology at his disposal: X-rays. Their risks to pregnancy were not yet known, but Dickinson consulted images taken by his colleagues as well as others taken of laboring women that he commissioned specially for the Birth Series. Drawing from these sources, the resulting models were detailed, rendered lovingly, with the growth of the fetus and birth progressing as a serene, beatific event. The woman’s body acted as a frame; her own movements and expressions remained a mystery.
Dickinson’s fascination with looking inside of bodies started early. Aged 10, he suffered a canoeing accident that slashed open his abdomen; “I got an eight-inch tear and held my bowels in and swam ashore,” he recalled in notes found in a folder titled “Incidents in a Happy Life,” collected for a never-written memoir. Though the nearest doctor was too arthritic to stitch the wound—he left the job to a carpenter—Dickinson was enthralled by the man’s confidence. “That man I adored so, that doctor,” he wrote. “Strong—that’s what I wanted to be.”
After medical school, he started his career seeing patients in his home on Clinton Street in Brooklyn, then moved into scientific research; he founded the Committee on Maternal Health, served as president of the American Gynecological Society and was a senior vice president at Planned Parenthood. Where gynecology had once been deemed a branch of surgery, concerned with correcting aberrations, under Dickinson’s leadership it became a field of preventative care, sex education, fertility aid and couples counseling.
“He saw himself as a crusader,” says Wendy Kline, a historian of medicine at Purdue University. “Other doctors were buying into [his] notion that gynecologists needed to play a role in marital counseling. They were starting to believe that so many of the issues around painful sex, frigidity, divorce and so on had their root in female gynecology. He was at the forefront of that.”
Dickinson was passionate about legitimizing the study of sex and reproduction at a time when many thought comprehensive knowledge about anatomy and physiology would be a corrupting influence on young people. Occasionally he ran up against censorship from the Comstock Act, which made it illegal to mail out materials that could be deemed “obscene,” though as a physician he was largely shielded from prosecution.
It likely helped that he was a family man with deep-set, twinkling eyes; a churchgoing Episcopalian, puckish and unrelentingly energetic. A contemporary observer marveled at how “Dickinson often carried his sculptures out to Flushing Meadows on the BMT subway. He would sit in the corner of the subway car and then with a pixie-like gleam in his eyes, slowly unwrap the birth model. Soon his blasé neighbors in the car would take notice. Some would begin to ask questions. Then a crowd would collect and he would begin a public lecture on human reproduction.”
For his longtime patients, Dickinson was a rare expert who took their pain and pleasure seriously, who stopped to pay attention to them. At the time, this quality of attention must have been rare enough in a physician that the women were willing to accept his obsessive, even exploitative curiosity about their bodies. During his years in private practice, Dickinson made detailed drawings of his patients’ anatomies, measuring them with a ruler.
Kline says, “He did it in such a way that they saw him as a liberator, not as perverse. Or if [the latter], it’s been lost. … So many of his patients he saw for up to 30 years. They developed this trust, ironically.” Unbeknownst to his patients, Dickinson even devised a system where he would furtively snap photographs of them via a pedal-operated camera hidden in a decorative column at one end of the examining table.
His fascination with the female anatomy almost alienated his Birth Series collaborator, the young sculptor Abram Belskie, who had emigrated from Glasgow. “When I looked beyond the door,” Belskie recalled when interviewed for an oral history, looking back on his first visit to Dickinson’s studio at the New York Academy of Medicine, “my first impulse was to get the heck out of there. This was something that I never saw before. They [Dickinson and assistants] were painting something to do with genitalia.” The 32-year-old Belskie and 78-year-old Dickinson grew close, however; Belskie later reported he had to “hustle to keep up with the doctor.” Dickinson made sketches for each sculpture, measured down to the millimeter, then supervised his colleague’s craftsmanship. Together, with funding and studio space provided by the New York Academy of Medicine and Committee on Maternal Health, they finished all 24 sculptures in a few months.
Dickinson had to surmount several hurdles to realize his vision for the series and display it at the World’s Fair. As Holz describes in her article, their “The First Year of Life” exhibition was developed under the auspices of the New York-based Maternity Center Association (MCA), a group of obstetricians, nurses and reformers. Dickinson was one of a dozen physicians on the planning committee, charged with creating a display that would effectively convey a message about the importance of proper medical care during pregnancy and birth. When a proposal to feature midwives was raised, Dickinson didn’t object when the majority shot it down.
However, when another doctor suggested too much “anatomy and embryology” would overcomplicate the exhibition and be inappropriate for family viewing, Dickinson managed to persuade the committee that his Birth Series would achieve the MCA’s aims.
“Some expressed disapproval, but for the most part people seemed to be okay with it, much to the relief of the MCA,” says Holz. “To present pregnancy and childbirth in a way that was respectable was key for Dickinson. He didn’t like what he saw as garish sexual representations of the body—be it in art or in medical illustration.”
The Birth Series had a tremendous impact in its time. Schools and museums soon commissioned replicas of the series; the sculptures were photographed and turned into a large-format book, The Birth Atlas, which became a fixture of universities, libraries and classrooms through the 1980s.
By then, other, more sophisticated images of the human fetus were readily available. In April 1965, the fastest-ever selling issue of Life magazine featured an 18-week-old fetus on the cover, shot by Lennart Nilsson. “The embryos shown on the following pages had been surgically removed for a variety of medical reasons,” wrote the Life editors; the majority of Nilsson’s work was done with miscarried and aborted fetuses suspended in a tank of water at the hospital. Nilsson’s images were widely reprinted on anti-abortion posters until the photographer himself, aghast at the politicization of his work, took action. From the 1980s through 2017, when he created a definitive, black-and-white version of the series for public exhibition, he refused to allow them to be reproduced in the general media.
As abortion was legalized in more states, fetal imagery became associated with efforts to turn public opinion against abortion, although 79 percent of terminations occur before an embryo becomes a fetus. A 1972 anti-abortion pamphlet titled Life or Death featured images of a fetus along with suggestive language. (At eight weeks, the pamphlet imaginatively proclaimed, a fetus “swims freely in the amniotic fluid with a natural swimmer’s stroke.”) After the U.S. Supreme Court’s 1973 Roe v. Wade ruling, which protected the right to abortion, the imagery intensified even further. The film The Silent Scream, released in 1984, used cinematography to give the misleading impression that a fetus, viewed via ultrasound, was writhing in pain during an abortion. As Nancy Gibbs wrote in a 2006 Time reappraisal, the film aimed to “shift the public focus from the horror stories of women who had suffered back-alley abortions to the horror movie of a fetus undergoing one.” Widely discredited by the medical community, the film is a quintessential example of fetal imagery used as political propaganda.
The title of the 1939 World’s Fair display would seem to place Dickinson and Belskie’s sculptures in this tradition of sanctifying the earliest stages of pregnancy. It was, after all, called “The First Year of Life,” and one of the pamphlets proclaimed, “A baby’s life begins not when he puts in his squalling appearance but at the moment the sperm (from the father) meets the egg (from the mother) in the Fallopian tube.”
Dickinson, however, was a champion of birth control and abortion, a renegade voice for both within the medical establishment. He supported contraception and abortion for both medical and religious reasons. In an unpublished piece titled “Blessed Be Abortion,” he argued, “Abortion is a blessing whenever relief from intolerable burden of added maternal care, or freedom from lifelong shame, or stigma of bastardy, is the stake.” His papers at Harvard University’s Countway Library of Medicine include a scrapbook he kept of clippings from medical literature about therapeutic abortion.
Yet it would also be wrong to see his views as wholly aligned with today’s abortion rights advocates. “Part of the problem is the oversimplification of the ‘pro-choice’ movement as largely secular,” Holz explains, noting this topic could be a dissertation in itself. “‘Pro-choice’ as a feminist slogan was born in the 1970s, and activists in the 1960s (for example, [an underground group called] the Jane Collective) wanted to move away from doctor-centered authority over women's bodies, as Leslie Reagan wrote in When Abortion Was a Crime. I can’t imagine Dickinson would be on board with that. He believed that doctors knew best.”
Then there is the matter of the more recent shift away from “choice” to “reproductive justice,” which places abortion in a larger campaign for bodily autonomy. “Dickinson was a product of another era,” Holz says, “and had such ideas been proposed in his generation—who knows, maybe versions of this were!—I’m not inclined to think he would have embraced the authority of women of color.”
In her book Building a Better Race, Kline notes that while Dickinson “firmly believed that reproduction needed to be regulated by doctors,” he also “actively supported eugenic sterilization,” which disproportionately targeted racial minorities. The fetus in the series had classically European features, and the terra-cotta sculptures were coated in gleaming white. As Kline writes, “Eugenicists expressed enthusiasm over the [American Medical Association’s] acceptance of Dickinson’s models as appropriate for an exhibit.” They were the miniature forebears of two later sculptures Dickinson and Belskie created for the American Museum of Natural History—an adult woman called “Norma,” whose measurements reflected the average sizing of 15,000 white Americans, and an adult male called “Normman,” whose features were calculated from the measurements of World War I soldiers compiled by a team that included prominent eugenicist Charles Davenport.
In 1942 and 1949, Dickinson brought yet another set of models to the American Medical Association’s general meeting—this time, demonstrating techniques for sterilizing the “unfit.” Dickinson finessed his cautery-based sterilization technique on inmates of a state institution in California: people whose fertility was then legally controlled by the state, regardless of their consent. He died in 1950.
One part of Dickinson’s legacy, Holz says, has been to contradict the notion that images of fetuses “inherently conjure up a pro-life (or anti-abortion) image.” These sculptures represented a breakthrough in terms of knowing what a fetus looked like, and that’s why they were included in teaching materials for years to come. It’s difficult to find any inherent moral symbolism in them. Instead, like Nilsson’s photographs, the Birth Series serves today as a kind of Rorschach test, capable of conveying any number of meanings. As Holz says, “These sculptures challenge you not to assume you know the hidden message, or the right message, about what representations of pregnancy mean.”