Pregnancy and Childbirth in the Eighteenth Century

Marriage and motherhood were viewed as a woman’s only reason for existence before the twentieth century, especially amongst the upper classes. For Women’s History Month, I’m taking a look at pregnancy and childbirth in the eighteenth century.

Let me warn you, we’re going to be covering maternal and infant death.

Before the eighteenth century, they considered pregnancy and childbirth a female-only sphere.

All pre-natal care (well, what little there was of it) and births were handled by midwives with no formal training. They earned their skills and experience on the job. Midwives were not viewed as part of the medical community.

Until the 1750s, midwifery remained steeped in a lot of superstition which had lingered from the Middle Ages. To practise, a midwife needed an Episcopal Licence from the Church of England which banned them from practising magic, coercing fees or concealing information about births. Midwives were obligated to treat the poor and perform a baptism in emergencies.

Distressing Facts about Pregnancy and Childbirth in the Eighteenth Century:

Without effective contraceptives, multiple pregnancies were normal.
50 per cent of marriages were childless—half of those because of infertility, and the other because of infant mortality.
One in five women died in childbirth and infant mortality stood at 20 per cent.
The risk of death in childbirth increased after the fifth pregnancy.
Complications often proved fatal. Obstructed deliveries, such as breech births, usually lead to the death of both the mother and child.
Infections because of poor understanding of hygiene were common. Sepsis, when the body’s reaction to infection causes injury to tissues and organs, and puerperal fever, were common. Puerperal fever, aka childbed fever, was a bacterial infection that occurred within the first three days after childbirth (usually because remnants of the placenta had remained in the womb and turned gangrenous) causing severe abdominal pain, fever and disability.

Most people were attended by female family members, while some hired a midwife to provide more skilled help and assurance. They only summoned a surgeon or doctor in dire circumstances.

Pregnancy and childbirth in the eighteenth century — Image of a birthing chair from Supplementary Appendix 123a.1 – Caroline Schelling

Pre-natal Care

It was common to prescribe purges, bleeding and starvation diets (sometimes referred to as lowering diets) to prevent the baby from growing too large and causing complications with the birth. Working-class women would be expected to continue as normal until the birth, but middle-and upper-class women had a lying-in period, where they remained in bed for weeks or even months before the birth. Exercise was not deemed healthy for an expectant mother.

The Birth

The birthing chamber was heated with a large fire, and blankets were used to cover the windows and doors. Even keyholes were blocked up to prevent a draft that may cause the mother to catch a cold. This led to a lack of fresh air and created the perfect breeding ground for bacteria.

Upper-class women would lie on a bed for the delivery, while the lower classes often used a birthing chair. C-sections had been performed for many years, but only after the mother had died and the surgeon believed they could save the infant.

Postnatal Care

If the mother and child were lucky enough to survive the birth, the first few days could still prove fatal.

The new mother’s diet was limited to tea or wine, no solid food, and they were encouraged to remain in bed for weeks, which led to intestinal issues.

The baby was forcibly fed a pap—a mixture of bread or flour soaked in milk or water—after it had been pre-chewed by the midwife.

Upper-class women did not breastfeed and used a wet nurse, usually a local woman who had a nursing infant or had recently lost a baby. Their poor understanding of hygiene also led to infant infections.

Pregnancy and Childbirth from the 1750s

With the Enlightenment, ideas regarding a rational approach to childbirth led more males to become involved. By the 1750s, male surgeons attended births and gradually childbirth became incorporated into the medical forum. Male midwives (or accoucheurs) gained acceptance in the later half of the century and by the time of the Regency, the upper classes chose an accoucheur to attend their birth.

Obstetrics moved away from superstition and traditions towards sound scientific reasoning, but the mortality rates for mothers and infants did not change, and infection inflicted women across society.

The most famous case is that of Princess Charlotte, the only legitimate child of the Prince Regent, and heir to the throne. In 1817, she died within 24 hours of delivering a stillborn son. The princess had received the best possible care (well, what they considered the best at the time) under the accoucheur, Sir Richard Croft, and Dr John Sims.

Some say her death was caused by a post-partum haemorrhage, others an infection, but either way, her passing led to an outpouring of national grief and concerns about the future of the country.

Such a high-profile death finally motivated the medical community to take obstetrics seriously to improve survival rates for mothers and infants. But it wasn’t until the 1840s, when the practice of washing hands and instruments, and providing clean linens became common, that the mortality rate lowered to six per cent.

I’ve barely touched the surface of this topic, but I hope I’ve given a small insight into what eighteenth-century women faced simply by doing what they considered their duty.