Joys and sorrows

Joys and sorrows

Childbirth and childhood were hazardous for our ancestors, and both social and medical practice were caught between science and religion. Luke Mouland investigates

Luke Mouland, Genealogist, historian and writer

Luke Mouland

Genealogist, historian and writer

While family history is often a patchwork of fascinating stories, ranging from tales of wealth and grandeur to those of destitution and misery, each of our ancestors’ lives was essentially framed by two events – birth and death. Here, we take a look at the social history surrounding the former and attempt to investigate the significance and role of childbirth in the lives of our forebears.


From the medieval period to the end of the 17th century, labour and childbirth were surrounded by ancient ritual and superstition, while the practices and knowledge of midwifery were shrouded in a veil of secrecy. It was a primitive time, where the skill of a midwife or surgeon could rarely save mother and child in the event of a serious complication and the reliance upon religion, herbs and amulets reigned supreme. Towards the end of that period, in London and the larger towns, approximately one woman died for every 40 births. To some extent, death during childbirth was considered an ‘inevitable’ tragedy and women were encouraged to prepare themselves for such an event before going into labour. The acceptance of pain and danger was perceived as a test of faith, in which women obeyed God’s first commandment, be fruitful and multiply, while suffering for the sins of Eve. The biblical phrase, in sorrow thou shalt bring forth children, was heavily invoked.

Nursemaids were the norm among the wealthy classes
Nursemaids were the norm among the wealthy classes

Meanwhile, religion also played an important role in the practice of midwifery, as midwives were required to obtain a licence from the bishopric in order to pursue their career; this continued well into the Georgian period. The licence often carried the names of those who could testify to the competence and good and honest life of the midwife and stated that they either belonged or conformed to the doctrines of the Church of England. In part, this was due to the fear of witchcraft, which was still prevalent in the 17th century. As midwives possessed a fair knowledge of herbal remedies and potions, occasionally this led to accusations of harnessing magic or demonic powers to assist with childbirth. The phrase, the better the witch; the better the midwife, was popular.

woman giving birth on a birthing stool
Illustration from early midwifery of woman giving birth on a birthing stool

As a new century dawned, changes within the profession saw the reputation of the midwife decline further still. With the 18th century came advancements in surgical equipment, including the development of obstetrical forceps, which had been a closely guarded secret and rarely used for almost a century. Now, physicians argued that midwifery required nothing short of surgical skill and, as society prohibited women from pursuing a medical education, ‘man-midwives’ began to take control of the field. As a result, female midwives came to be viewed as incompetent and inexperienced by the medical establishment, though many continued to assist poorer families who could not afford the services of a trained physician.

Meanwhile, the customs surrounding childbirth itself also continued to develop. Instead of the warm, darkened lying-in chambers used during previous centuries, a bright, airy environment during the ‘confinement’ period was advocated by male physicians. Women were now advised to breastfeed their own children rather than employ a wet nurse, as had been the norm among the upper classes, while the practice of hiring a ‘monthly’ nurse to care for mother and child during the recovery period became more common. On the other hand, many poor and rural families continued to use the more traditional practices as before.

A lady’s ‘confinement’ in the late 18th century
A lady’s ‘confinement’ in the late 18th century

During the 19th century, childbirth became an event which regularly punctuated the rhythm of family life and the Victorian ideal of the dutiful wife and mother, surrounded by a large brood, began to take hold. The royal household was soon depicted as the ‘model family’ and Queen Victoria herself became an influential figure in the progress of childbirth and obstetrical procedures. Illegitimacy was only spoken of in hushed tones as it shattered the ideals of the ‘perfect household’ and single mothers often found themselves giving birth alone in the dreaded workhouse, away from the prying eyes of society.

Queen Victoria
Queen Victoria’s choice to use chloroform during childbirth was influential

Those who conformed to society’s expectations were often surrounded by female friends and relatives during labour, to the extent that childbirth was frequently considered a communal event. For many young women, assisting family members was undoubtedly how they learned about the process of labour and delivery, as well as the conduct expected of a woman being observed in labour. Behaviour during childbirth itself was sometimes as equally important as how a woman prepared for the event.

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In 1847, the Scottish physician Dr James Young Simpson first used chloroform as a general anaesthesia during childbirth. This soon raised questions among the clergy, who were concerned about its effects. Highlighting that the pains of childbirth were derived from the curse of Eve, it was argued by some that such drugs were the decoy of Satan and that they robbed God of the deep, earnest cries which arise in time of trouble for help. However, despite this opposition, Queen Victoria chose to receive chloroform during the birth of Prince Leopold on 7 April 1853; she later extolled the virtues of the drug by stating that the effect was soothing, quieting, and delightful beyond measure and, as Head of the Church, she essentially legitimised its use in society.

Yet physicians remained wary of using anaesthesia and questions soon arose over the drug being administered by midwives in particular. In 1870, according to a report by the Obstetrical Society of London, 50-90% of babies born to the poor were attended by midwives with little or no training, which only fuelled arguments regarding the incompetence of those who practised.

Nurse and Baby

Ironically, since male physicians had begun to take a more prominent role in the profession during the 18th century, the number of deaths resulting from puerperal (childbed) fever had risen significantly. While midwives often remained with an expectant mother for the labour and delivery, physicians had adopted the habit of attending multiple patients in a day, without sterilising their hands or clothing as they went. The death toll peaked towards the end of the 19th century, with 2.6 per thousand newborns having died from infection between 1885 and 1896. This was despite Joseph Lister’s calls to embrace higher standards of hygiene since discovering the connection between bacteria and infection in the 1860s.

Towards the turn of the century and into the Edwardian period, efforts were made to improve matters, beginning with The Midwives Registration Act of 1902. This was the first government attempt to regulate the profession, therefore marking a new era in the history of midwifery and childbirth.

The Foundling Hospital

Thomas Coram, a shipbuilder and merchant, had made his fortune in the colonies, from which he returned in the late 1730s. On arriving in London, he was appalled at the number of babies abandoned on the streets of the city and obtained a Royal Charter for the establishment of a hospital for the maintenance and education of exposed and deserted young children. This he eventually founded in 1741, with the first stone being laid the following year on the outskirts of the city, in Bloomsbury. It was the first institution of its kind in Britain.

The Foundling Hospital

Timeline: Birth

Obstetrical forceps first invented by Dr Peter Chamberlen, though these were rarely used at the time
First obstetrics ward in Britain opened at the St. James’ Parochial Infirmary, Westminster
Dr William Smellie began to give obstetrical lectures to midwives and medical students
The Stamp Act introduced a tax of 3d on all entries in baptism registers
The word obstetrician formed from the Latin, meaning ‘to stand before’
The Births & Deaths Registration Act introduced civil registration of all births in England & Wales
Dr James Young Simpson first used chloroform for general anaesthesia during childbirth
Civil registration of all births introduced in Scotland
Louis Pasteur discovers the connection between poor hygiene and puerperal (childbed) fever
The Midwives Registration Act introduced state regulation of midwives

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