A Brief History of Childbirth
By: J. Marlando
I have heard it said that if it were left to men to deliver babies there would be very few deliveries and I think we would all agree with that analysis. This is especially true in the past when the leading cause of premature deaths in healthy women was childbirth but even today with safe hospital births and quick recoveries for most women, men would still be reluctant to endure the pain and discomforts of pregnancy and birthing. And only a comparably few husbands split the duties of caring for the infant at home who needs most virtually constant attentiveness to survive in a mode of mental, emotional and physical good health. (It is agreed by many professionals that a lot of adult neurosis and behavior challenges can probably be traced back to a neglected or harsh infancy).
While we know the history of childbirth going back a few millennium it is difficult to imagine what prehistoric birth must have encountered or, for that matter, even the births delivered by the girls and women of earlier civilization some 10,000 to 15,000 years ago. This is especially true when we realize that over those earlier millenniums it was unknown how ladies became pregnant even during the agrarian (Neolithic) period when agriculture was being established and the major deity of an All Giving Mother; the life giving Goddess. It seems obvious that Goddess worship goes back at least to our Cro-Magnon ancestors and probably much further back into prehistory than this. It isn’t known exactly when it was first discovered (or realized) that it was males who impregnated ladies but that knowledge along with male brute force seems to have quickly changed the major deity from feminine to masculine. Incidentally, I believe this knowledge had to be commonly known long before the first city/states of the Sumerians because the “god” of their societies was the living king himself and thought to be connected with the invisible god of the sky. Goddess temples, however, would persist even into (and beyond) the times of Jesus and of course nature is still referred to as Mother Nature even in our own modern times.
The above is mentioned only to remind the reader that once upon a time women were exalted and even worshipped before males took over authority of church and state. With males dominating fertility, women were quickly subordinated in both private and public life. During the heyday of ancient Athens men turned to men for romance while wives were thought to be good only for delivering heirs, labor and keeping personal financial records. The idea that they were the other important half of society would only start creeping into cultures with the Roman Empire which remained chauvinistic but at least treated females with more respect and dignity than either the ancient Hebrew or Greek cultures had.
As for childbirth even into the earlier years of the 20th century superstition and folklore prevailed as nothing much beyond the obvious was understood about pregnancy or delivery. Some of the horror stories that women endured during the 15th, 16th and 17th centuries are too gruesome to retell. For only one example, the ignorant midwife of at least one poor woman yanked out her uterus in an attempt to remove the placenta with her fingernails. I will not go further into those details than this.
In any case, most women who were fortunate enough to give normal birth were sometime up the same day and back in the barnyard working on the following day. It is said that black Southern women of the 19th century would sometimes give birth and be forced to go back to work in the field on the same day.
Historically the risks of motherhood were so plentiful that women feared death more and more as their due date came closer and closer *Edward Shorter reports a “Mrs. M. gave birth on a bed of straw in a cold farmhouse near Steinau [a town in Germany] sometime in the 1860s. The midwife had manually removed the afterbirth and withdrawn her hand. The woman said to her husband, “My dearest, I think I am going to die. She’s torn everything out of my belly. And then she said, ‘my hands are dying, my feet are dying.’ Ten minutes later she died.”
By the time that 1900 rolled around women most commonly spent five hours longer in labor than women do today. It is said that she had one chance in three that she would labor for more than twenty hours and sometimes as many as forty-eight hours.
Returning to the late 1700s and early1800s midwives and helping friends did not know what to do when a pregnant lady had serious trouble and so she would simply be left to die undelivered or folklore remedies were tried. Irish people, for example, would unlock all the locks about the house, unbar the doors and windows, untie all knots and even let their cows go free. The logic was that setting all those things “free” might induce the uterus to set the baby free. Another folk remedy was for the husband to urinate in his boot with his wife drinking from it. Then there were chemicals made from local plants. If none of this work, the expectant mother was literally picked up by “two or three stout men” and shaken with “great violence” Indeed, a ploughman was mostly used for the job and often taken directly from the plough to do the deed. And as a virtual last hope the pregnant lady would be wrapped in a blanket and tossed about with hope that the violent motion “would force the child out of her body.”
So ignorance prevailed and in thinking of this we must be reminded that there was no anesthesia before the second half of the 1800s. (Indeed, ether and chloroform were first used in obstetrics in 1847. We are reminded by Shorter that an unconscious mother can no longer assist to press down to help with the birth).
With all this in mind, a decline of maternal mortality began after the 1870s thanks, primarily, to Joseph Lister who discovered antisepsis in 1867. Infection, however, remained a serious concern even into the 1930s but mainly in deliveries where instruments were used and in caesareans. Another interesting statistic is that between the 1860s and the turn of the century birth in hospitals was six times more dangerous than birth at home. Sepsis (the presence of microorganisms in the tissue or bloodstream) was the common danger which was mostly blamed on the meddlesome of midwifery. It needs to be remembered, however, that Lister did not make his vital discovery until 1867 when he first used phenol (carbolic acid) to wash the skin close to the wound. The Germans and French would be first to start using Lister’s idea to use antisepsis to kill germs before they could infect. Antisepsis was not used in the U.S. until around 1883. Since sterilizing the hands was impossible, the wearing of rubber gloves began at least in bigger hospitals and clinics in 1898. Recall to that in previous decades people knew nothing of viruses or germs and so when a woman was ready to deliver it was not unusual to call a midwife in to assist in the delivery directly from working in the field or barn. It would not even have crossed a midwife’s mind to wash her (**or his) hands before doing their internal examinations and so forth.
In the U.S. midwives were slowly being replaced by doctors in deliveries. By 1910 in America they were still delivering around half of the newborns but this was by then outside the mainstream. That is, for example, midwives still delivered 88 % of black women but only 16 % of white women. But by the First World War, there was a strong opinion still held in Wisconsin that women should be able to deliver themselves but even in places like Chicago where there was a high count of immigrants at least 50 % of births were being assisted by doctors.
As early as 1900, however, extreme concern was given to the mother’s comfort and in 1905, a German doctor, Carl Joseph Gauss created a mixture of scopolamine and morphine which would be called “twilight sleep,” a condition that did not render the delivering mother unconscious but made her oblivious to her pain. A woman by the name of ***Hanna Rion did a study of “twilight sleep” and wrote a book about her findings. Evidentially, twilight sleep failed at some clinics but only because it was mixed or administered wrong. In the end, Rion reported that twilight sleep was everything that Dr. Gauss has said it was. (By 1939narcotics such as Demerol—called Pethidine in England—was being used to block pain.
Actually by the 1920s the odds were against a mother or infant dying in childbirth. Yet there was a problem with poorly trained General Practitioners and their use of forceps. Indeed, many of those young C.P.’s had not even seen forceps used until they used them themselves. As a result newborns were born with broken limbs and prolonged heads and other maladies. (I read someplace that an early user of forceps actually pulled an infant’s head off during the birthing procedure). In the wake of it all, however, birth was becoming safer and far less painful. In the U.S., as early as 1918 doctors were beginning to resist assisting in home births which was a big change from the turn of the century when, as said earlier, only the very poor and unwed gave births in hospitals. In Germany for example no married woman gave birth in hospitals until the 1920s. By then in America midwifery was all but banished and shortly before the 1970s specialists attended over fifty percent of American births. Thankfully, today, giving birth is virtually risk free for moms and their infants in most instances and has been for over a hundred years. It remains difficult to imagine what women went through before the dawning of modernism began shedding light on pregnancy and the birthing process.
Still, it needs to be noted that even with all of modernism reducing the pain and risk of childbirth, the raising of children remains extremely challenging and often lots of hard work.
*In all my research I found no better or more thoroughly researched book that Edward Shorter’s “A History of Woman’s Bodies,” a Basic Books publication. I have leaned heavily on his material and highly recommend it for further reading.
**Infection was the most common cause of death for delivering moms even into the earlier years of the 20th century. Midwives and the pregnant ladies themselves were ignorant of the need for simply but thorough cleanliness before Lister and for a great many, for many year after Lister’s discoveries.
***Hanna Rion was a pen name for Mrs. Frank Ver Beck, wife of a well-known German artist.