A17th century mother of nine, Yorkshire gentlewoman Alice Thornton remembered the pain of labour as resembling being on the rack, the medieval instrument of torture which stretched one limb from limb. Thornton was reminiscing about giving birth to her fifth child in the mid-17th century, but the metaphor was a regular one, appearing for example in the midwife Jane Sharp’s 1671 midwifery guidebook. This article explores the ways in which women prepared for and experienced labour and birth in the early modern era. Sharp’s book provides a useful focus for this because its whole point was to teach trainee midwives and in doing so to save women from mistaken beliefs or ill-informed midwifery care.

The resulting book, The Whole Art of Midwifry Discovered, drew extensively on the works of medical writers and doctors such as Daniel Sennert and Nicholas Culpeper, but her borrowings are not taken wholesale. Often Sharp would amend the doctors’ words to match more closely to what she had found in her 30 years of practice. It was the first female authored book on the topic to be written in English, and so most unusually it gives a female voice to the subject which women inevitably knew most about.

The onset of labour
When a woman felt her ‘throes’ or labour pains start, the advice seems very modern. Sharp advises women in ‘travel/travail’ to try and keep as active as possible. She should also keep herself warm. All early modern women gave birth at home, as there was no concept of a hospital as we know it. She wouldn’t be alone though as births were a female social event, and a woman would have a party made up of her ‘gossips’: her friends, neighbours, and family, supporting her in labour. The name gossips derived from the phrase ‘god’s helpers’, and men were mostly excluded from the process.

The midwife would arrive carrying her bag containing oils, medicines, some tools, but also various cloths for different tasks. In The Ten Pleasures of Marriage (1682), the author joked that a midwife might offer warmed beds and other Clouts, the number and names whereof are without end. She might also carry a birthing stool (a stool with a section cut out for the delivery), although these were more common in Europe than England.

When the midwife arrived, the first thing she would do was to pray for the safe delivery of the woman and child. The threat of death was never far from the early-modern birthing chamber, despite the fact that the vast majority of births were problem free. After getting married in her mid-twenties, the average woman could expect to give birth around five times, and the maternal mortality rate was around 1% per pregnancy. The main difference between then and now is that that if something went wrong during the course of the labour, the chances of a woman and her child surviving were very much lower than they are nowadays. This means that most women would have known or at least heard of someone who had died during their delivery.

Care in established labour
The name midwife comes from the German phase ‘with woman’ and the midwife would stay with a labouring woman throughout her labour and delivery. Jane Sharp advises midwives to keep the labouring woman’s spirits up with comforting words, also one of the jobs of the ‘gossips’. Some pain was expected in labour and broadly accepted as being God’s will, a consequence of Eve’s transgression in the Garden of Eden. John Marten explained in 1711 if the first Woman Eve, had not sinned, she had never been exposed to the Pangs of Child-birth .

However, most medical guides offered suggestions for pain relief for women who were suffering extremely hard labours. Certain types of women were thought more likely to have an uncomfortable labour, including very young women, women who were gross and fat or conversely those who were spare and lean. The Birth of Mankind (1545) offered advice for easing labour pains, mainly concerned with trying to speed up the delivery, and recommends various things from oiling the woman’s private parts, to ‘suffumigations’ which were medicines heated on hot coals to produce a specifically smelling smoke or ‘fume’ to open up her body. A pessary dipped in the herb rue might also speed up the labour.

To help a labour along midwives sometimes applied an ‘eagle stone’ (a type of geode) to the woman’s private parts. But, as Sharp warns, this was thought to be so powerful that it should be removed as soon as the afterbirth had been delivered or it would cause the woman harm. Other things to help labour along included herbal drinks made up of betony, sage or other suitable herbs. To help the birth or to help bring down the after birth the midwife might administer pepper to cause a sneezing fit. If the woman had been in labour a long time and needed sustenance then it would be in order to give her chicken broth, or a poached egg, with a little wine or other strong water. Later in a labour the gossips often helped to hold the woman up as she was about to deliver; they might also be encouraged to stroke the pregnant woman’s belly in a downward motion to encourage the baby to move into the birth canal.

The delivery
There was no one preferred position for women to give birth in, but Sharp advises that very fat women should be encouraged to kneel face down to give birth. Some women lay on the bed, propped up by her gossips, others used a birthing stool or sat on the side of her bed. In the final stages of labour women were also encouraged to hold their breath to encourage the baby to come out in search of air. The midwife would cover her hand with oil of lilies or almonds, or a little grease such as butter, and perform internal examinations to ascertain the position of the child in the womb. She might keep her hand inside the woman from then on to be in a position to help when the baby started to come. The waters surrounding the baby were thought to make delivery easier if they broke on the point of delivery, since they made the birth canal more slippery, so they were never deliberately broken in advance. If this had already happened then it was suggested that the woman’s vagina was smeared with egg, or more oil of lilies to help the birth. Sharp warns her sister midwives not to force the baby out for fear of harming the mother or child, and of causing the woman terrible pain.

After the child’s delivery, and especially in cases where the woman still seemed to be in some discomfort, the midwife would check the abdomen to check that no further babies were in the womb.

After the birth
After the baby was born and the afterbirth, or womb-cake as it was often called, was delivered, the midwife had several further tasks to perform. If the labour was particularly hard then wrapping the woman’s back in a newly flayed sheep skin, presumably to keep her warm and comfortable, was thought to be a good idea. It was also considered good practice after all deliveries to lay a hare skin, covered in its own blood, on a woman’s abdomen for two hours in winter and an hour in summer. This was thought to close up the womb. After this the stomach was wiped with the oil of St John’s wort. Some midwives still advocated binding the woman’s abdomen to help it return to its usual size but this wasn’t advocated by doctors who warned that it should not be thought of for at least 15 days. A linen pad was sometimes used internally too to raise up the womb and encourage it to return to its normal situation. The woman was then covered in cloths and encouraged to lie still for ten to twelve hours to let her blood settle. However, she was not allowed to go to sleep for the first four hours, but given a little broth and a little wine.

Care for the newborn
After delivering the baby and settling the woman, a midwife still had a number of jobs to do. The umbilical cord (or navel string) should be cut at four fingers’ distance from the body. An old wives’ tale stated that the longer the cord of a boy was left the longer his manhood would be in later life! The child’s navel was anointed with ash and covered in lint to help it to dry and to keep the cold out. The child was then washed over with a warmed cloth dipped in diluted wine, to clear off all the matter from the birth. Sometimes too they were given a sip of wine as a purge to stimulate their bowels to excrete the meconium.

Newborn babies were next swaddled, or bound from head to toe in rags, which needed changing regularly to keep the baby warm and dry. The swaddling bands were used to encourage the child’s limbs to grow strong and straight. The baby was swaddled for around four months. This practice had been used from antiquity until the later 18th century when it went out of fashion.

The general advice was to change swaddling bands frequently so that babies didn’t get what we would think of as nappy rash or as it was then known, ‘galling of children’. John Pechey’s childhood diseases book (1697), explains that galling is uncommon in children who are frequently changed, but in babies who aren’t, the skin of the hips and genitals could be ‘fretted off’ due to the acrimony of the urine. Pechey gave a recipe for a soothing bath made from bran and marsh mallows, followed by a powder made from rose and frankincense to cure this if it happened.