The next day Woodforde baptised the baby at Weston House: ‘I walked up to Mr Custance’s this morning soon after, named the little girl by name Frances Ann[e], and a very pretty infant she is.’18 Since the baby had arrived earlier than anticipated, this was a precautionary measure in case she did not survive to be christened in church, though Frances actually lived to beyond her ninetieth birthday.
Two years later, in July 1785, Woodforde recorded another premature birth: ‘I was sent for to go to Weston House to name a child of Mrs. Custance’s who was brought to bed this afternoon about 2 o’clock. I therefore walked up directly to Weston House and named the child by name Mary Anne, the smallest infant I think I ever had in my arms. The child came 10 weeks before its time, therefore afraid that it would not live.’19 Mary Anne survived just seventeen weeks.
Childbirth traditionally involved only female friends and family to assist in the birth and possibly a paid midwife – someone possessing experience, though no formal qualifications. When educated surgeons became involved in obstetrics, as ‘man-midwives’ or ‘accoucheurs’, they replaced some of the female midwives. In London the radical Francis Place, by trade a breeches maker, related: ‘After the birth of our first child [in 1792]…we employed a medical man in good practice, he had two guineas for his first attendance and a guinea for each of the succeeding two. The guinea was always carefully saved and immediately paid.’20
Man-midwives transformed childbirth, making use of the recently invented forceps and scientifically researching, debating and publishing on aspects of pregnancy. The most famous man-midwife was the Scottish anatomist William Hunter, at whose anatomy school in London deceased women in various stages of pregnancy were dissected. After years of work, he published The Anatomy of the Human Gravid Uterus Exhibited in Figures in 1774, containing for the first time life-sized images of the developing foetus.
In this era before anaesthetics, antibiotics or any understanding of infection, giving birth was hazardous and painful. Most mothers suffered at least one miscarriage or stillbirth, and many died of complications during labour or afterwards from sepsis (usually called ‘puerperal fever’).21 Those in the lying-in hospitals were at particular risk of bacterial infection, which could spread rapidly. Jane Austen in Northanger Abbey made Catherine Morland’s mother more robust: ‘She had three sons before Catherine was born; and instead of dying in bringing the latter into the world, as anybody might expect, she still lived on – lived to have six children more – to see them growing up around her, and to enjoy excellent health herself.’
For women who experienced complications in childbirth, the only option was a caesarean section, but surgeons were reluctant to attempt this procedure. The first operation in which the baby survived, though not the mother, was performed in London in 1774 on Elizabeth Foster. When twenty-four-year-old Elizabeth Sedgley had married Joseph Foster at St Andrew’s church, Holborn, in April 1759, she was ‘perfectly strait, very thin, and measured five feet four inches’.22 A succession of children and deteriorating health followed. ‘When in labour of her eighth child,’ the physician William Cooper related, ‘she was a patient of the lying-in charity, for delivering poor married women at their own habitations, to which I am one of the physicians. The attending midwife, therefore, after waiting a proper time, sent for me on December 18, 1770.’23 Elizabeth was in such a bad state that Cooper removed the foetus by an embryotomy.
For the next two and a half years she was helpless, with severe curvature of the spine, ‘scarce ever able, without assistance, even to turn herself in bed’.24 Yet in this state her husband impregnated her twice more, the first time leading to a miscarriage. By the next pregnancy, ‘she measured only four feet four inches; and she generally stooped so very much, especially lately, as to appear to be little more than three feet high’.25 In mid-August 1774 Elizabeth was ready to give birth and in such severe pain that Cooper persuaded John Hunter (brother of William Hunter) to come to her home in Robinhood Court, close to St Andrew’s church, and perform a caesarean. ‘During the whole of the operation,’ Cooper recorded, ‘the poor woman behaved with remarkable patience and fortitude.’26 Without anaesthetics she was, of course, fully conscious. The next day she died and two days later was buried in St Andrew’s churchyard.27 Incredibly, the baby girl, Sarah, survived and was baptised at the same church in July the following year.
It was the surgeon James Barlow from Blackburn in Lancashire who performed the first caesarean in England where the mother survived. She was forty-year-old Mrs Jane Foster, a mother of several children from the village of Blackrod near Wigan. Some months earlier, she had been attended by Charles White of Manchester and Mr Hawarden from Wigan after falling beneath a cart and fracturing her pelvis.28 Not long afterwards, she became pregnant again, and when she went into labour in late November 1793, it was realised that the pelvic injury made giving birth impossible. Barlow was consulted, and he recommended a caesarean, even though ‘of the nine or ten instances then on record, in which that operation had been performed in this country, not one had furnished a voucher for its success’.29 Mrs Foster refused to give consent, but relented on the fifth day of labour. The baby was pulled out dead, but the woman survived and lived another three decades.30
Barlow later discussed the case with Charles White, the celebrated man-midwife and former pupil of William Hunter in London. In 1773 White had advanced the understanding of caesareans and other aspects of childbirth when he published A Treatise on the Management of Pregnant and Lying-In Women. With old traditions difficult to eradicate, he warned: ‘The nurses in London are a numerous and powerful body, and an attempt to reform their ancient customs might be looked upon as an open attack upon them, and an actual declaration of war.’31
Meanwhile, their practices were killing women, and he advocated that mothers-to-be should give birth naturally, with minimal interference from midwives or instruments, and that they should be clean and not remain stationary in bed. In his opinion, ‘The thick fustian waistcoats and petticoats usually worn during the lying-in, are much too warm.’32 He disagreed with the old customs that were intended to prevent women from catching cold:
As soon as she is delivered, if she is a person in affluent circumstances, she is covered up close in bed with additional cloaths, the curtains are drawn round the bed, and pinned together, every crevice in the windows and door is stopped close, not excepting even the key hole, the windows are guarded not only with shutters and curtains, but even with blankets, the more effectually to exclude the fresh air, and the good woman is not suffered to put her arm, or even her nose out of bed, for fear of catching cold.33
One of White’s recommendations was for increased ventilation, so that the ‘lying-in chamber should in every respect be as sweet, as clean, and as free from any disagreeable smell, as any other part of the house’.34 In most cases the bedroom where the birth occurred was anything but sweet and clean. Women traditionally recovered in overheated, airless rooms, which was no doubt true for Mrs Austen when her daughter Jane was born on 16 December 1775, at the start of a severe winter.
Before 1800 around 1.5 per cent of mothers died in childbirth, but where White worked, in Manchester, the situation was much improved, with a mortality rate of less than 1 per cent. The details he gave of one woman who became ill after giving birth must have been typical of paupers across the country:
MARY LORD of Manchester, a poor woman aged 31, was delivered on the 25th of May 1772, in the morning, by a midwife in the neighbourhood. She had an easy labor…her third lying-in…[but] she gradually grew worse till I first saw her, which was on the fourth day in the evening…The whole family lived in the same room in which she lay, being the only one they had; it was very warm, having a large fire in it, and smelt very disagreeably. I desired the fire might be lessened, and more air let into the room, accordingly the window was set open and remained open all night. She had scarcely sitten up in bed since her delivery, but had lain in a horizontal position all the time.
I advised her to sit up frequently in bed, and to get out of it once every day, to put on clean linen…On the fifth day the room was much cooler, and did not smell so disagreeably…On the sixth day all her complaints were vanished.35
The wealthy were not immune from death in childbirth. Despite the lavish arrangements for the birth of the first child of Mr and Mrs Bankes at Winstanley Hall, both mother and baby died, even though the renowned Charles White attended. Nelly Weeton described what happened: ‘Dr. White from Manchester resided in the house upwards of three weeks before Mrs. B’s confinement…After suffering a most severely painful time, a son was born, but heir only to the grave, for it was dead. The mother survived little more than a week – and died too; few more beloved or more lamented, she was so kind to her servants, so charitable to the poor.’36
Another eminent man-midwife was Edward Rigby of Norwich, and he and his wife Anne had twelve children. Two were twins, a girl and a boy born on 1 August 1804, and four were quadruplets, three boys and a girl, born on 15 August 1817. This remarkable event was reported in the newspapers: ‘BIRTHS EXTRAORDINARY – The Lady of Edward Rigby, Esq. M.D. of Norwich, was safely delivered of three sons and a daughter. Mrs. R. is as well as usual so soon after childbirth; and the children are all alive and hearty. Before the birth of these little ones Dr. R. was the father, by his present wife, of eight most lovely and healthy children, the two eldest of whom are twins.’37 Tragically, all the quadruplets died, the girl surviving the longest, for almost three months.38
Multiple births were rare, and such babies stood little chance of surviving. For the village of Selborne in Hampshire, close to the Austens, the curate Gilbert White compiled a statistical analysis of its population. The period 1720 to 1780, he said, saw just under a thousand baptisms, including ‘Twins thirteen times, many…dying young’.39 Any exceptional birth was worthy of comment, as in January 1789 when the New Exeter Journal mentioned the arrival of triplets: ‘Tuesday the 6th instant the wife of Richard Hannaford, of South-Brent, in the county of Devon, was delivered of three fine girls, all of whom are likely to do well.’40 The more mundane births of prominent citizens were also announced in the local newspapers. As with all such news, the name of the mother was traditionally ignored, as in the Hull Packet in October 1801, which reported: ‘BIRTH. Lately, at Everingham, near Pocklington, the lady of M. Constable, Esq. was safely delivered of a daughter.’41
It was not unusual for fathers to be absent from home when their children were born, and it took some time for the news to reach William Wilkinson, at sea in the navy, that he was a father. Finally he held the letter that his sister-in-law Fanny Platt had excitedly written from their lodgings at Kensington in London, a few hours after his daughter’s birth. ‘Heartily do I wish you were now here,’ she said, ‘that we might congratulate with each other on the happy arrival of your little daughter. It was born at 17 minutes past 9 o’clock this 9th day of Novbr [1807].’42 Fanny next gave William an affectionate description: ‘the precious Babe, it is, I think, the loveliest little creature I ever saw. Its eyes are dark and beautifully bright, its nose and chin we all agree in our opinion as to their being exactly like your own. It has a pretty little head with a good bit of hair, which is very dark. It is in good health and so plump you cannot think.’43 Fanny’s use of ‘it’, not ‘she’, was commonplace when speaking of infants and would not have appeared uncaring. William was extremely happy, and early the next year he wrote to his wife: ‘in my Prayer Book (which I keep in my desk) I have your hair, Baby’s and a piece of my own. I cut mine off the other day to see the contrast. They are all in a small piece of fine India paper…and they do look very pretty, yours light, mine dark, and Baby’s between both.’44
For those who could afford it, a wet-nurse might be hired, a centuries-old tradition but an alien concept today and one that could be detrimental, even fatal, to the health of the newborn infant. Wet-nurses were usually married working-class women, capable of producing milk, perhaps having just lost a baby or recently weaned their own child. Some worked continuously for years. They took over the care and feeding of newborn babies, primarily from middle- and upper-class families. All too often, babies did not stay with their mothers, but were transferred to the homes of wet-nurses, especially if those women lived in the countryside rather than the less healthy town.45 There is no conclusive evidence about Sarah Wilkinson’s newborn daughter, but Fanny told William that ‘We have a nurse who thoroughly understands her business’,46 implying that a wet-nurse was employed.
Various taboos deterred mothers from breastfeeding, such as the belief that they should be churched first as they were unclean from having given birth; that their first milk, the colostrum, was harmful; or that babies should be purged for a few days after birth with liquids such as wine, sugared water, or butter and honey. However, physicians and midwives were gradually realising the benefits of breastfeeding right from birth. In the late eighteenth century the employment of wet-nurses began to decline, and the increase in breastfeeding led to a drop in the mortality rate of newborn infants. Georgiana, Duchess of Devonshire, decided to breastfeed her daughter ‘Little G’ because the wet-nurse was a drunk, but she was criticised by the family as they believed it would prevent another pregnancy, and Georgiana’s duty was to produce a male heir.47
Some women did not breastfeed for other reasons, such as husbands forbidding the practice, or because of physical problems and illness. The Exeter physician Hugh Downman was a pioneer in understanding how infants should be nursed, unfortunately setting down his recommendations in a lengthy, albeit well-received, piece of blank verse, Infancy, published in six books from 1774. For mothers unable to breastfeed, he advised choosing a wet-nurse in the countryside:
Far from the bounds
Of the rank city, let some trusty mind
Explore the straw-rooft cott; there, firm of nerve
Her blood from every grosser particle,
By hardy labour, and abstemious fare,
Sublimed; the honest peasant’s mate shall ope
Her hospitable arms, receive with joy
The infant stranger, and profusely yield
Her pure balsamic nurture to his lip.48
Tight clothing, especially stays, hindered breastfeeding, according to Charles White: ‘This dress by constantly pressing upon the breast and nipple reduces it to a flat form…and the nipple is buried in the breast. By being constantly kept in this position, it contracts adhesions; it is prevented from coming out…The tightness of the stays is alone sufficient to do much harm, but they are also, often made hard and unpliable by packthread and whalebone, which must greatly increase the mischief.’49 Working-class women, he observed, were better at breastfeeding, because many did not wear stays: ‘Hence it will appear evident why women of rank, and those in the middle stations of life meet with difficulty in giving suck to children…why hard working, labouring women, who are obliged to go very loose about their breasts generally make good nurses, and that too with very little trouble.’50
Distress in weaning, it was recommended, could be lessened by administering laudanum or alcohol. Once babies were weaned, they were fed with a semi-liquid pap, which, as the man-midwife and surgeon William Moss explained, ‘is composed of bread and water boiled and sweetened with brown sugar; to which is, sometimes, added a small quantity of milk: or; oatmeal and water, in the form of thin water gruel, with the same additions’.51 From the late eighteenth century various types of feeding vessels were used, including animal horns, spoons, boat-shaped sucking bottles and upright pots with spouts, but sterilisation was unheard-of.
Some children were breastfed by their mothers and then handed to foster-parents after weaning. This is how Jane Austen and her siblings were brought up, fostered for several months (possibly by a woman called Bessy Littleworth) until deemed old enough to return home. In November 1772 Mrs Austen told her sister-in-law Mrs Walter: ‘My little boy [Henry, born in June 1771] is come home from nurse, and a fine stout little f
ellow he is, and can run anywhere, so now I have all four at home, and some time in January I expect a fifth.’52 This fifth one would be Cassandra.
In June 1773 Mrs Austen wrote: ‘I suckled my little girl thro’ the first quarter; she has been weaned and settled at a good woman’s at Deane just eight weeks; she is very healthy and lively.’53 Deane village was 2 miles from their parsonage at Steventon, and years later James Austen-Leigh, the nephew of Jane and Cassandra, mentioned this peculiar start to their lives:
Her [Jane’s] mother followed a custom, not unusual in those days, though it seems strange to us, of putting out her babies to be nursed in a cottage in the village. The infant was daily visited by one or both of its parents, and frequently brought to them at the parsonage, but the cottage was its home, and must have remained so till it was old enough to run about and talk…It may be that the contrast between the parsonage house and the best class of cottage was not quite so extreme then as it would be now, that the one was somewhat less luxurious, and the other less squalid.54
Writing in the Victorian era, he was perplexed by the concept of babies from the middle class or above being raised by their social inferiors.
Another custom that now seems strange or superstitious was that of ‘churching’. A woman who gave birth was considered by many to be spiritually unclean and was supposed to be confined until her churching ceremony a few weeks later, when she left home for the first time to go straight to church and be ritually cleansed. Although sanctioned by a passage in the Old Testament,55 this was a contentious issue within the Church, variously condemned as a relic of the Jewish religion or as a Catholic rite. It remained a widespread practice, probably bolstered by superstitions about women being dangerous and bringers of bad luck after childbirth until such ritual cleansing had taken place. The Church explained the ceremony as one of purification or of thanksgiving for the birth.
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