by Donna Hatch
In Regency England, childbirth was one of the most dangerous threats to a woman’s health and life. Most sources I read claimed that up to 20% of all women died either in childbirth, or immediately following birth, most often due to infection. Many accounts place the infant mortality rate at about the same level. That’s a sobering reality.
After giving birth six times to six healthy babies, I have a deep appreciation for the medical practices of modern-day America. There were complications during two of my deliveries which might have threatened the life of my child and myself but for the intervention of knowledgeable doctors and nurses, as well as technology to provide early warning signs of problems. Unfortunately, our historical counterparts were not so lucky. In fact, in many of the cases I read, including the tragic and fatal “lying in” of Princess Charlotte, the lucky ones were those who gave birth without the interference of doctors, midwives, and accoucheurs.
Based on today’s standards, medical treatment was barbaric, and obstetrics was no exception. Common prenatal care included purges, bleedings, starvation diets, and induced vomiting in misguided attempt to keep the baby from getting too large for the mother to deliver. Such practices were surely factors in the death of Princess Charlotte hours after she delivered a stillborn son in 1817. Charlotte was the only legitimate child of Prince George “Prinny” who later became King George IV. Princess Charlotte’s death and her stillborn child rocked the country and caused such public outrage that the medical community took a good hard look at common practices and make some key changes. But it took time to create any real improvements.
One such common practice for prenatal care that eventually changed included “lying-in” where the expectant mother remained in bed for a period of time ranging from a few weeks to a few months before giving birth, even if the birth seemed normal with no early labor signs. Though Princess Charlotte was told to get some exercise by walking, this did not appear to be the normal practice.
Once the mother was in labor, the birthing or lying-in rooms were heated and completely shut up to prevent the flow of air. Fear of drafts causing the mother to catch cold created the practice of building up the fire, putting blankets over all the windows and doors, and covering every crevice. Not only would have that been uncomfortable and not allowed for adequate oxygen but it would have been a breeding ground for bacteria so it likely caused the very problem they were trying to prevent.
Many accounts report the mother lying in bed directly on her back, while only a few cite having the mother lie on her side. Apparently, the upper classes were more likely to lie in beds more than the poor who are generally depicted sitting in birthing chairs. This may have been due to the desire to keep the lady more modestly covered but certainly would have made it difficult to push effectively.
If the mother seemed to be having trouble pushing out a baby, some doctors and midwives during the Regency used forceps. However, forceps were a new invention and few doctors in England accepted their use. Some believe that if forceps had been used for Princess Charlotte, as was originally determined but never carried out, her baby might have lived.
Cesarean sections had been in practice for many years, but generally only if the mother had died and the doctor believed the baby could be saved. This may have been partially due to the fact that people claimed that were was no anesthesia available. However, laudanum and opium were in use many years before for chronic pain and the surgery so I don’t know why it couldn't have been used during a Cesarean for a live mother. Maybe it didn’t matter, because the mother would likely develop infection and die. It makes me wonder how any one survived surgery of any kind considering their lack of knowledge about cleanliness. I have not discovered how successful a C-section was in those days to the baby but I suppose with nothing to lose once the mother died, the doctors were willing to try to save the infant.
If a woman were lucky enough to have survived birth, the next few weeks could still prove fatal. A new mother’s diet for was often limited to warm tea and/or wine for the first several days. A lack of solid food could cause a dysfunctional intestinal system, a condition aggravated by the mother remaining lying in bed for days and sometimes weeks.
Infection was one of the most common reasons for a woman dying after childbirth. Medical personnel seemed tragically unaware of the need for washing their hands and instruments. The practice of washing hands and instruments, and providing clean linens did not become common until about the 1840’s which lowered the mortality rate from 20% to about 6%.
Childbirth in Regency England was risky enough that two out of ten women and babies failed to survive it, which means most women would have known someone who died during or immediately following birth. Some have speculated one of the reasons Jane Austen never married was due to the potential disaster for mother and child. Three of Jane’s sisters-in-law died in childbirth, according to JOAN AUSTEN-LEIGH in her article My Aunt, Jane Austen. With such a grim family statistic, I might have thought twice about marrying and having children, too.
Once again, researching Regency England serves the dual purpose of providing the information I need for a book I’m writing, as well as making me really, really glad I live in a western nation in today’s world. But I still wish I could visit Regency England :-)
Fascinating post! I've been doing some reading for a story too. The first known Caesarean in which both mother and child survived was performed in the 1820s, I think, in South Africa, by Dr James Barry, a woman disguised as a man. Interesting, isn't it, that it was a woman who first did this operation right. She was known for keeping things clean in her hospitals and had some advanced ideas.
Dr. James Barry performed the first successful Caesarean - in Africa. Other successful Caesarean surgeries had been performed throughout Europe, the UK and the US.
I believe that the most important part wasn't about anesthesia but about sewing the mother up – there were some issues with sewing two layers. And germs – it drastically decreased the chance to get back to health after surgery – any surgery but especially such a serious one.
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