One area of the 18th century I knew reasonably well before I began detailed work on A Gentleman’s Folly was medicine. I still had to do some additional research and especially that involving pregnancy and childbirth.
Sadly, statistics from the era prove that the greatest cause of death among women of child bearing age in the 18th century was child bearing. One in five women could expect to die either in pregnancy, during the birth process or in the days following the birth of their child. With no effective methods of contraception, yes, sheaths were available but they were only used by men visiting prostitutes to prevent the pox, women who married suffered repeated pregnancies. Each birth after six becomes progressively more dangerous. Spare a thought for poor Mrs. Hodgson of York who died aged thirty eight in her twenty fourth labour. Even the wealthiest women weren’t exempted. The Duchess of Chandos though marrying as late as the age of thirty had nine children in fourteen years and four miscarriages.
Women in this era didn’t find joy and happiness in their pregnancies. They met each with a sense of fear as can be seen in their letters to loved ones or diary entries. Many wrote their wills.
A comment from the diary of Elizabeth Drinker, who had reached a certain age, “I have often thought that women who live to get over the child bearing years, if other things are favourable to them, experience more pleasure and comfort than at any other period of their lives.
The Diary of Elizabeth Drinker: The Life Cycle of an Eighteenth-Century Woman.
Changes occurred in the 18th century to the centuries old tradition of the midwife helping a mother through the pregnancy and birth. Male doctors got involved in the birthing process. Doctors were still all male in this era as women in England and much of Europe were not allowed to go to university to study. The notion of the male midwife was born, no pun intended. The idea behind it seems to have been that doctors had a far better understanding of anatomy in this era and would be better able to help the mother. I do have to say the cynic in me says they were also able to see the possibilities of handsome profits. The doctor would be paid a worthy sum on attendance ranging up to five guineas. He would be paid the same whether the baby lived or died, and of course, if the mother sickened after the birth he’d attend again.
I don’t think doctors did anything to deliberately harm patients, after all they had sworn the Hippocratic Oath, but the common treatment of bleeding often didn’t do much good. They still worked using treatments to balance the four humours and used ingredients like arsenic and mercury.
One change which offered help in difficult births was the use of forceps. This invention is accredited to a member of the Chamberlen family of surgeons. For one hundred and fifty years they kept the secret of the instrument able to release a live child in difficult cases. All three generations acted as obstetricians, some attended the royal families of Europe.
The final release of the needed information and design of forceps meant that they were introduced into England in 1735 and made a difference to some difficult births.
Wealthy women in the 18th century would chose to return to a large town such as London or Bath for the birth of their child, as there they could guarantee a male doctor or male midwife. Women with less money still used a female midwife and only in the most difficult cases might a doctor be called. In many cases if this happened the doctor was often called too late.
Astonishingly there are many, many cases that appear in the records at the Old Bailey of servant girls from as young as their mid teens delivering themselves of their infants and disposing of the child. Tragic. Sentence for the crime of infantacide was death.
There was no help for unwed mothers and servants were usually turned onto the street if they became pregnant. Infants abandoned at the church door, the home of a wealthy man, in the street were not uncommon in London in the mid 18th century. It was this that led the philanthropic Captain Corum to establish his foundling hospital in 1739.