On Monday, April 4, my 5th grandchild was born. I can’t help but reflect on the differences in how my grandchildren have been delivered compared to when mine were. All of my children were born in a hospital, delivered by a doctor. One was a C-section, the other two weren’t, but all involved a hospital stay. Comparatively, all of my grandchildren so far have been delivered by midwives. Only one was born in a hospital; the others were all born in deliciously comfortable birthing-centers. Two were even water-births.
As different as my experience was from that of the next generation, it’s fascinating to explore what this event was like during Austen’s life, even though she never experienced these things personally. I hope that some of the information is of interest.
Upper-Class Childbirth, Delivery and Care during the Regency Era
London vs the Country: The most common attitude was that it was safer to deliver in London than in the country. There were more doctors, and they were presumed to be of a higher caliber when compared to who passed for medical persons in rural areas. This extra level of care was considered even more important if the child being born was potentially an heir. Once an heir was securely in place, the mother had greater latitude in deciding to deliver in the country if she wished. If the mother was living in a country house during the pregnancy, the move to the city was often made at the very last minute. If the family didn’t have a city house to open for the event, even securing a house was commonly done with little time to spare. This haste wasn’t universal, however – some families went so far as to redecorate a city house in preparation for the woman’s confinement.
Medical Staff: I had always imagined births during historical periods to be always attended by a local midwife with the potential addition of a doctor if there were complications, but while this was the norm, it was not necessarily the case. Female midwives had lost some of their shine amongst the aristocracy in the 1730s when male midwives known as accoucheurs came on the scene. These men had the advantage of being able to obtain education on anatomy, and they had access to such medical instruments as forceps, which female midwives could not acquire. Some of the accoucheurs involved themselves in prenatal care, dictating diet and other lifestyle adjustments in the weeks leading up to delivery. Accoucheurs, in general, were strong advocates of letting nature take its course and considered a long, drawn-out labor to be preferable to a quick one, believing that the recovery from a lengthy delivery was better. After the delivery, a “monthly nurse” stepped in to care for the mother during the post-natal period of confinement.
Labor and Delivery: Much like today, women in the early stages of labor were encouraged to move around, and did not take to the bed until the labor had progressed enough to require it. Having watched many historical dramas where a baby was delivered in the same bed it was conceived in; I was surprised to learn that in upper class homes, a separate, portable bed was set up specifically for the birth, generally in a separate bedchamber. They took care to stay near the edge of the bed during the delivery, both for access of the midwife or accouter, and to keep the center of the bed dry for the woman to move over after the baby is born.
Sadly, the mortality rate for mothers and infants during this era was tragically high – the sources I found say it was around 20% for both the baby and the mother. Due to the danger, it was common for aristocratic women to update their wills prior to giving birth, and even to bid their husbands farewell just in case the worst happened.
Confinement or “Lying in”: The new mother was treated as nearly an invalid during the period known as “Confinement” after they gave birth. The term “lying in” was also used, but considered vulgar by the upper crust. The woman progressed during this time from staying in bed, to moving to the sofa, followed by little trips to the dressing room or other outer room. At this point, she may entertain guests. Around the third week she will be able to go downstairs to dine with the family before finally being able to leave the house. The belief at the time was that the woman must be protected from exposure to drafts, so the windows were covered with blankets and the fire was stoked. Imagine how that fire would just suck the oxygen out of a room where the ventilation was inadequate due to the windows being covered. Now factor in the reality that most women were at this stage, anemic. I can only imagine they felt weak and weary from lack of oxygen on top of all the other hazards to their health. The most dangerous threat was childbed fever, often due to bacteria introduced by the unclean hands of the midwife, accoucheur or doctor. This fever could appear after the mother had otherwise appeared to have recovered from the delivery. Other life-threatening medical issues included hemorrhage, blood clots and mastitis or milk fever.
As if this wasn’t bad enough, doctors didn’t understand anything of hormonal shifts back then, and so although they knew that some women seemed to suffer from extreme melancholy, little or nothing was done to address this, although in some cases opiates were prescribed, along with a “low diet” that was traditionally administered during confinement. The low diet consisted of gruel and tea along with a little wine. Of course, the doctors weren’t around to enforce this diet, so unless the woman’s family was insistent, many women ate as they pleased anyway.
Feeding the Baby: Baby’s first meal was not typically (as one would expect) being put to the breast. As soon as the baby was born, it was forcibly fed a substance called pap, which was bread or flour that had been soaked in either water or milk. Sometimes a little sugar was added, and sometimes the midwife pre-chewed the pap before feeding it to the baby. Soon thereafter, it would be put to the breast, either of a wet-nurse or of the mother. Wet nurses were typically of the lower classes, and there was a controversy at the time as to whether the character of the wet-nurse was transferred to the infant through the milk. The fact that the child was heavily exposed to the lower class conversation and behavior of the wet-nurse seemed to bear this theory out. For this reason, wet-nurses with a patient and loving nature were sought after. It was not uncommon for a child to live at the home of the wet nurse until it was weaned.
Baptism and Churching: The Church of England recommended that an infant be baptized on the earliest possible Sunday after it was born. When this happened, the mother, still in her confinement, was not in attendance. Families would often contrive to delay the baptism until after the mother’s confinement had ended or until the child’s chosen godparents could be in attendance. The mother could not attend until she had been churched. Typically on the fortieth day after birth. The practice of churching a mother after childbirth dates back to biblical times and involves a ritual blessing of the mother.
Christening: While the churching of the mother was fairly low key, the Christening was anything but. It was done at the house or the church, and was often the mother’s first public appearance after the birth. She would be dressed in her finest apparel, and in aristocratic families, the festivities were generally a reflection of the status the child was born to. This was an occasion where birth order and gender did not necessarily affect the size of the feast presented. A fun piece of trivia is that the custom of saving the top tier of the wedding cake for the couple’s first anniversary originated with the idea that the saved portion of the cake would be used at the christening of their first child – hoped to be within the first year.
Was there anything here you found surprising or new? How would you compare these aspects to your experiences in modern society?