A history of childbirth
We’re constantly deluged with stories about overstretched maternity services, but the reality is that childbirth is safer than ever before.
Long gone are the days when women were whipped to induce labour and a swig of sow's dung mixed with water was about the most you could hope for when it came to pain relief.
We take a look at giving birth in days of yore; read on, and you might just see your local maternity ward in a far more positive light.
Ancient times
In most ancient societies a handful of older women in each village would help deliver babies. Egyptians commonly gave birth squatting or kneeling over two birthing bricks or on a brick birthing stool, a forerunner to the birthing stools still popular today. Birthing bricks and stools were decorated with hieroglyphic inscriptions of the owner and painted scenes of the mother, baby, and goddesses.
Greek and Roman women also used birthing stools. In many other cultures of the time, women gave birth in an upright position, using a tree, a pole or another person for support.
In ancient Rome there is evidence that women were given a drink made from powdered sow's dung to relieve pain. It was also thought that fumigating the room with the fat from hyena loins would help a problematic labour, as would placing the right foot of a hyena (presumably not still attached to the living animal!) on the woman.
Other beliefs included drinking goose semen mixed with water or tying the sloughed off skin of a snake to the woman's thigh to aid the birthing process.
Medieval to Seventeenth Century
Childbirth was surrounded by superstitions and folklore, and practices and knowledge were not shared between midwives. In fact, from the 14th to the 17th century many midwives were accused of being witches and were hunted and executed.
During this period it wasn’t unheard of for women to be whipped to induce labour or, in more affluent families, for servants to be whipped to help their mistress go into labour. There is a story of a Medieval German empress in whose labour room 20 men were whipped, two to death.
Births were generally managed by midwives and all but the poorest women would give birth in a specially prepared room with the windows closed, curtains drawn and fires lit. Female relatives and friends would attend the birth to lend their support, but the woman’s husband would be kept well away, unless there was an emergency and his physical strength was required.
There is some evidence that women gave birth in a sitting or squatting position. Once the woman started pushing, it was expected that the baby would arrive within 20 contractions. If this didn’t seem likely to happen, everyone in the household might try to help things along by opening cupboards and drawers and untying knots; acts symbolic of the opening of the womb.
When the baby had been born, the midwife would bathe it in warm water or, in more affluent homes, in milk or wine. The infant would be swaddled in linen strips in order to help its limbs grow straight and strong and then laid in a crib in a dark corner, as it was thought that bright light could damage a baby's eyes.
While the mortality rate for mother and child is probably not as high as we are traditionally led to believe, there was little midwives could do when there were serious complications. Obstructed labour was perhaps the number one cause of death for women giving birth up to the 1600s. Even when the birth went smoothly, there was no effective anaesthetic to relieve pain.
Victorian times
Victorian principles of purity and modesty ruled supreme, with doctors encouraged to work by touch alone. Women most commonly gave birth in the Sims position: lying on the left side of the body with knees bent up. This position prevented the doctor and patient from seeing each other, so helping to preserve the mother’s dignity.
The use of chloroform and forceps in birth became more common, especially for women of upper classes. Birth was still mostly at home, and chloroform might be administered by woman’s relatives, friends, servants or even the woman herself.
The invention of forceps
With the invention of forceps came a huge increase in the survival rate of mothers and babies. Before they became widely available, death during childbirth was an “expected tragedy”.
Forceps are commonly thought to have been invented by Peter Chamberlen, a French-born surgeon who moved to London and became obstetrician to Queen Anne, wife of James I.
Peter and his younger brother, who was also a surgeon, went to great lengths to keep the invention to themselves. They carried the forceps into houses in a huge, ornate box to add to their mystery. The labouring woman would be blindfolded to prevent her from seeing what was happening, and everyone else would be instructed to leave the room. The family kept their invention a secret for another three generations, much to the annoyance of their fellow physicians, one of whom wrote: “He who keeps so secret so beneficial an instrument as the harmless obstetrical forceps deserves to have a worm gnaw his vitals for all eternity.”
Caesarean sections
The oldest reference to a caesarean section, performed on woman who had died in labour, dates back to Roman times. Although there may well have been caesarean sections performed over the following centuries where mother, baby or both survived, there is little documentation to verify this. For a long time caesareans were used as a last resort, and the operation was not intended to save the mother’s life.
In 1500 there is a documented case of a successful caesarean. Jacob Nufer, a Swiss pig gelder, called in all thirteen of the local midwives as well as two lithotomists (people who could perform surgery to remove kidney and bladder stones) unsuccessfully after his wife had been in labour for several days. Eventually he gained permission from the local authorities to attempt a caesarean himself. Not only did his wife and her baby survive, she went on to give birth normally to five children, including twins.
One of the best recorded accounts of an early caesarean is by Italian surgeon Scipione Mercurio (1540- 1615). He gives a detailed and illustrated description of how to make the incision, using four strong assistants to hold the patient down. Afterwards he applied a concoction containing, among other things, artemisia, agrimony, betony, mallow and flowers of pomegranate in sour black wine to the wound. Whether or not the woman survived is not made clear.
In 1849 a Dr Radford of Manchester reported that he had lost three mothers and babies out of five caesareans he had performed. However, by 1900 Dr Sinclair at the same centre reported a success rate of ten out of ten operations.
Anaesthesia
Up until around 150 years ago, the only pain relief available to women came in the form of herbs and flowers such as poppy mandragora and henbane. In the 1800s, Scottish physician and Queen Victoria’s doctor James Simpson introduced ether anaesthesia, followed by chloroform, to help alleviate the pain of giving birth.
Simpson recorded the first midwifery case in which he used chloroform as follows: “I placed her under the influence of chloroform, by moistening, with half a tea spoonful of the liquid, a pocket handkerchief, rolled up into a funnel shape, and with the broad or open end of the funnel placed over her mouth and nostrils... after the delivery she observed that she had enjoyed a very comfortable sleep... but would now be more ready for the work before her... it was a matter of no small difficulty to convince the astonished mother that the labour was over and that the child presented to her was really her ‘own living baby’.”
In 1853 he gave Queen Victoria chloroform to help her through the birth of her seventh child. The Queen was so delighted she later made Simpson a baron.
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Last Modified: 28/07/2008