CHILDBIRTH IN THE 19TH CENTURY

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Over the course of the 19th century, the average American woman gave birth to six children, not including children lost to miscarriages and stillbirths. There was no modern medical care so the women had frequent complications such as lacerations and permanent damage to their bodies. This made subsequent birth even more painful. In addition, most working-class women did not have the opportunity to rest and recover for very long after giving birth. They were expected to resume domestic chores and work, along with mothering the newborn infant.

A midwife usually assisted in births. The midwife could sometimes stay with the family for a few days following the birth. If the option of a midwife was unattainable financially, the pregnant woman would have to rely on relatives and neighbors to aid in the birth. They were likely to call in a physician only if a crisis arose during the birth. Midwives had a clear and important role in the 19th century. Laurel Thatcher Ulrich explored this in her Pulitzer Prize winning book: A Midwife's Tale: The Life of Martha Ballard, based on Ballard's diary that was written from 1785 through 1812. For 27 years, Ballard chronicled her daily tasks and her midwifery duties (she delivered close to one thousand babies) and countless incidents throughout her career. Although Ballard's career ended in the early 19th century, the practice of midwifery was largely unchanged until the late 19th century when people, especially the medical society, began to question the safety of the practice.

In 1847, the pain-relieving and anesthetic properties of ether and chloroform were discovered and used in America for childbirth for the first time. This began a new era in childbirth methods. Mothers could be relieved of pain in childbirth. This discovery led to increasing medical dominance in obstetrics, which had been almost exclusively in the hands midwives. It also led to medical and moral controversy that lasted for several decades. On one hand, women were destined to suffer due to the "curse of Eve" and were expected to experience pain during childbirth. On the other hand, humanitarians and the medical society believed that there were very good moral and technological reasons for controlling or eliminating pain in childbirth. Researchers have noted that upper-class mothers, with their education and liberal outlook, had a certain ambivalence towards motherhood. This influenced their attitudes toward the use of chloroform and the process of childbirth.

Caption: Woman receiving a gynecological examination

BIRTH CONTROL IN THE 19TH CENTURY

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Prior to any developed methods of birth control, women had to rely on male withdrawal, and on crude infanticide and abortion for backup. Mechanical means were the most common birth control methods in the 19th century. These included: withdrawal by the male; melting suppositories designed to form an impenetrable coating over the cervix; diaphragms, caps, or other devices that were inserted into the vagina over the cervix and withdrawn after intercourse; douching after intercourse designed to kill or drive out the sperm; condoms, and a variety of rhythm methods. There were also potions and pills that were extremely dangerous for the mother as well as the fetus.

The rhythm methods used in the 19th century (calculating the woman's fertile period and abstaining during that period) were largely ineffective because the calculations were based on observations of animals, and the recommendation was that women abstain during their menstruation period or just before it. Modern science has proved that, unlike animals, women are least fertile during their menstruation, and most fertile in the days in the middle of the menstruation cycle. Women in the 19th century who relied on the rhythm method were actually abstaining from sexual activity when they were least fertile and having sex when they were most likely to conceive.

Abortion, while controversial and considered largely immoral, was relatively common. It is estimated that in the 1840's, one in every thirty pregnancies was terminated by abortion. Methods ranged from surgery, poisons, home remedies from plants and herbs, and mechanical means such as striking the woman's abdomen repeatedly. Abortion was considered illegal in the United States by 1880 in most cases, with the exception being those considered "necessary to save the life of the woman". Caucasian urban women from affluent society had greater access to abortion by a physician. Rural and non-white women were much more likely to depend on herbal or mechanical means.

Caption: Figure 1, a sponge; Figure 2, a syringe (used after intercourse to wash semen out of the vagina); Figure 3, a cap

None of the birth control methods of the 19th century (aside from infanticide and abortion) were particularly effective and none of them were new. Women would sometimes nurse their children for up to two years, which would prolong their infertile period. Withdrawal by the male, douching and vaginal suppositories were around in ancient times and common in the 19th century. In 1838 condoms and diaphragms were produced with vulcanized rubber. It was second in popularity to withdrawal, but was not really advocated as birth control. Rather, it was to be used to prevent venereal disease. The most effective form of birth control was abstaining from sexual intercourse, but this was not acceptable to most spouses.

Attitudes about birth control were changing readily by the mid 19th century. Early suffragists campaigned for voluntary motherhood during the 1870's, but they advocated celibacy and abstinence for birth control rather than mechanical means or abortion. Many states had made abortion a crime at any stage of fetal development by the mid 19th century and the Comstock Law of 1873 made abortion and birth control illegal in the United States. Also, by this time the medical care of women was passing from midwives to male doctors, most of whom did not respect a woman's right to terminate or prevent pregnancy. It was not until the mid 20th century that the advent of the birth control pill successfully controlled pregnancy and birth.