childbirth in the nineteenth century

<p>Taking Caudle, (baby, midwifery), Richard Dagley caricature, 1821. Image courtesy ancestryimages.com</p>

When men and women married in 1830s Britain they generally assumed that children would follow promptly and regularly.  The prevailing sense was that children just ‘came’ and that there was little to be done about it. Women were encouraged to see motherhood as both destiny and duty, and letters and diaries from the time suggest that many tried earnestly to do so. Families were large, with an average of about six children, but averages can be misleading. Families with many more children were common. The main determinants of family size at this time were age at marriage and age at menopause. Women who married in their early to mid-twenties in other words, could expect to bear children continuously into their early to middle forties, and while the intervals between children varied between women, most could expect to have a new baby every two to three years throughout these years. The first child commonly arrived within one, or at most two years of marriage.

In the 1830s childbirth was both painful and dangerous. The only pain relief available was opium, usually sold as a sleeping draught known as laudenum, but this was almost never used.  It was widely believed that women were destined to suffer during childbirth, as the Bible had decreed. Almost all babies were born at home, usually with the assistance of family and friends. There were also women who practised as midwives, although there was no formal training, and most midwives were experienced women who had borne several children themselves. Doctors were generally only called when births were prolonged and it was feared that the mother might die, but their intervention brought grave risks.  There were instruments for use in childbirth, but no anaesthetics or understanding of antisepsis, which meant that the danger of infection from medical intervention was very high. Training in obstetrics was rudimentary at best and was not compulsory for doctors until much later. In fact doctors were often the unwitting sources of infection for women in childbed, transmitting contagion from previous patients. Hospitals were places of last resort, sought only by the very poor and the desperate. The death rates in hospitals were known to be extremely high.

The main dangers for women in childbirth were prolonged birth, excessive bleeding and infection. Prolonged births often followed when labour began with infants in the breech (feet first), or far worse, transverse (sideways) position. Desperate and agonising attempts would be made to ‘turn’ these babies, rarely successfully. In extreme cases, where it became clear after two or more days in labour that a child could not be born, a doctor might attempt to use instruments, either to pull the child free, or to crush the child and remove it. Often the baby was already dead at this stage and there was a strong chance that the mother would also die, either from shock or from infection. These were decisions made in desperate circumstances, when there was no other hope, and the success rate was low. Excessive bleeding is still a danger in childbirth, but modern obstetrics has recourse to drugs which help to control it.  In the nineteenth century there was almost nothing a midwife or doctor could do to stop a post-birth haemorrhage and many women literally bled to death.

Infection was the other great scourge of childbirth. Women are very susceptible to infection during and immediately after the process of childbirth and pueperal or childbed fever was both common and much-feared in the nineteenth century. Even an otherwise trouble-free delivery was no guarantee of a safe recovery from childbirth, but prolonged birth, or any form of surgical intervention, increased the risk significantly. Childbed fever generally set in two or three days after birth, but once established had an almost inevitable outcome. The actual cause of death was blood poisoning or septicaemia, generally between a week and ten days after delivery. Maternal mortality rates remained high in Britain (and Australia) until the twentieth century.

Women in particular, but also their men, approached each birth with foreboding. Many women routinely prepared themselves for death and the terms they used to describe their approaching ‘lying-in’ reflected this. Childbirth was often described as a woman’s ’time of trial’: Captain Morgan refers to his wife’s ‘trying hour’, and on one occasion her ‘trying hour of naturs sorrow [sic]‘. Children were often sent to stay with friends or family as the birth approached, so that they would be spared the sound of their mother crying out in pain. Sometimes they would be unaware that another baby was expected until they returned home again. The Church of England provided a special rite of thanksgiving for women who survived childbirth, rather quaintly entitled The Thanksgiving of Women after Childbirth, commonly called the Churching of Women.

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