Some birth plans demand more tree bark and whimsy than others.
And that is precisely how it’s going to happen. Who dares defy you and your meticulous preordination? Not me, certainly. But of course God, Nature, your own forthcoming child… I can’t speak for them.
They all have a long history of disrespecting the most carefully laid plans.
Q: Stop making fun of that stuff. A woman does have freedom—it’s her body and her birth experience. And I think replicating a cozy Victorian home birth would be wholesome and soothing. No cold, antiseptic hospital. No being pumped full of dangerous drugs. Childbirth is not an illness.
A: Yeah. You say that…
Puerperal pyrexia, placental abruption, placenta previa, general uterine hemorrhaging, eclampsia.
The black stuff… that’s your blood. It’s not in the right place and it’s not going to stop.
Q: What are those?
A: Childbirth illnesses. No… that’s the wrong word. More “agonizing complications of childbirth that end in boiled fever brain and/or blood-soaked death.” And that’s just what a Victorian version of you would risk during birth. I won’t tell you the things that could happen to your baby. Just two words. More, and worse.
Let me say this before we proceed. Have your baby at home, if you wish. Or in one of those Bed & Breakfast & Babies birthing centers. Have the child in a natural mineral warm spring at a posh ski resort! The ski resort might not like it but let’s see them try to move you once you’ve started. For pain control, use only breathing techniques, or suck on ice chips imported from an Alaskan glacier blessed by an Inuit shaman. Be attended by an unlicensed midwife, doula, or your gay best friend from high school who is sick of his dental practice and is thinking of branching out. He makes everything feel like a party!
But listen to me, please. Whatever you do, have that child within a ten-minute ambulance ride of the biggest, most frigidly modern and antiseptic hospital you can find. One filled with terrifying operating rooms, impersonal but spot-on professional medical teams, and every knock-out, hemorrhage-staunching, flesh-repairing, life-giving drug and tool of the modern age.
Because you’re right, childbirth isn’t an illness. But it can turn into an irreversible tragedy within seconds. Victorian women knew that better than anyone. Take every precaution so that you never need know the terror and grief they knew.
Q: Yeah, well… okay. I was planning that anyway. A contingency plan is just common sense. Come to think about it, women do die a lot in childbirth in Victorian stories.
A: They probably didn’t die as much as fiction would have us believe. Removing a mother from a narrative immediately frees up a romantic male lead or gives the young heroine access to freedoms and dangers she wouldn’t face under a mother’s protection. If literature retained its mothers, there would be no adventures for Tom and Huck, Catherine wouldn’t have run wild with Heathcliff on the moors, Sarah Crewe would never have been shut up in the attic by Miss Minchin, there’d be no need for a Secret Garden, and even Quasimodo would have lived his life in some faraway hut in the woods instead of consorting with gypsies and jumping lithely through the architecture of Notre-Dame. In reality, it’s hard to compile records for deaths in childbirth from the nineteenth century, but what data there is suggests there were, at any given point, between forty and seventy maternal deaths per one thousand births. Maternal deaths, not infant deaths. Those were excruciatingly higher.
The unprofessional and unpleasant midwife grumbles toward her work.
Q: I feel comfortable wanting a midwife instead of a doctor. They’re licensed today, well trained, and are more intimate with their client. I want a lady one, in fact.
A: Well, then your timing is remarkably off! Anytime before this era there would be no question that you would be attended by a well-reputed female midwife. With few exceptions, men of all cultures avoided participation in childbirth throughout history. In fact, even today obstetricians and midwives are overwhelmingly female. But in the Victorian era, men slowly took over childbirth, and owned it for the next century and a half.
Q: Oh, that is so typical. How’d the Penisocracy manage to hijack the most sacred tradition of womanhood?
A: I think you made that word up, and I like it, though it’s rather harsh. A lot of things contributed to the temporary death of the female midwife. But like so many things in the nineteenth century, it can be partly traced back to machines.
Machines were labor-saving devices, creating leisure time for those who could afford it. Leisure created curiosity, which led to study, building new machines, performing experiments, and sharing information through publications. Men looked around and found that due to the heretofore absence of the learned male mind, the study of female physiology was sorely lacking.
Male doctors began to usurp midwives by presenting themselves as more educated and sanitary than their female counterparts. Men went to college and published scholarly articles in medical journals. Midwives did not. Wealthy and important men read these journals and secured their writers to care for their wives. What wealthy folks do, middle-class folks want to do. And since doctors were popping up everywhere all of a sudden, it wasn’t hard to procure one. Midwives couldn’t compete, and doctors helped edge them out with publications decrying the filthy, ignorant state of the midwife.
In an 1890 editorial to the North American Practitioner periodical, a doctor argued the necessity of making obstetric care more available to the impoverished, in hope of doing away with midwifery:
Many of these midwives dabble in gynecology as well: they fit supporters, replace “turned wombs,” etc., and not a few do a flourishing abortion business. Physicians unanimously declare their obstetrical work as a whole to be careless, and that their mortality from septic puerperal diseases is higher than it ought to be.
In 1894, in the New York Journal of Gynecology and Obstetrics, Dr. William Pryor wrote that the proper training and registration of midwives had met with resistance in America and England because “it will be conceded that a supply of trained midwives will cut into the practice of a certain class of physicians very seriously.”
But, he says, to let midwives run free as they are is tantamount to mass murder.
That many women are ruined by sepsis and other faults of midwives, that many die, that many children are still-born owing to imperfect methods of delivery are facts well known by every physician of experience in New York.… the midwife [is an] unclean, untrained old woman who seeks this way to make a living merely because she can not gain one in any other channel. The deathrate in New York is higher than it should be because of the ministrations of these ignorant creatures.
If the mortality among women confined by midwives be too high, who may count those who have survived and remain chronic invalids as the result of infection directly due to the filthy methods of midwives!
Doctors didn’t want midwives trained and licensed because that would cut into their business. Not that it mattered much anyway; women who had to work outside the home for a living at that time were largely illiterate and would have had no time or support to receive formal education and licensing. So it was easy to paint the unlicensed midwifes as dirty, careless hags.
So, slowly, the penis-wielders won the day.
Of course, not everyone thought this was a good thing. In the earlier part of the century, before anyone, doctor or midwife, needed licensing, many people thought the entry of men into obstetrics was a travesty of indecency.
Q: Because a man couldn’t be trusted to attend a woman’s privates without being sexually stimulated? By a big mucus-plugged cervix?
A: What happened to the righteous indignation toward the Penisocracy? Now you want a male doctor?
The Man-Midwife, by Samuel Fores.
Q: I just want options. It bugs me that people made such sweeping generalizations on who was a good attendant based on gender.
A: They didn’t just base it on gender. They also considered what race you were,
where your parents came from, how nice your house was, how often you were seen at church, and how far your family pew was toward the front in that church.
What we call bigotry today was called Tuesday back then.
And, yes, it was feared that men were too lascivious to explore a pregnant woman’s body. The movement toward male midwives, or accoucheurs (French for “an aide in childbirth” with a masculine suffix), was not a popular one in its early days. In fact, many found the idea quite obscene.
There’s a certain logic to it. I mean, if nothing else, the fact that a woman is pregnant is proof that she puts out, amirite?
Q: Oooh. I am giving you such a scowl.
A: Seriously, it was a tradition started by a French whore, atleast according to people who hated male midwives. A really famous king’s whore, but still, a woman who had little regard for modesty. One Dr. Davis of London was quoted in John Stevens’s 1849 work Man-Midwifery Exposed, or The Danger and Immorality of Employing Men in Midwifery Proved; and the Remedy for the Evil Found, detailing how this strumpet laid the seeds for a wicked new trend in obstetrics.
It is pretty generally known that the Duchess of Villiers, a favourite mistress of Louis XIV, of France, was the first female who was induced to place herself under the exclusive obstetric care of a professor of surgery, independent of any anticipated necessity for a surgical operation. That event took place in December, 1665; and Julien Clement, the fortunate attendant upon the case, was soon after appointed to the most lucrative office of Midwifer to the Princess of France.
Louise de La Vallière, the rumored Mother of Man-Midwifery and also a couple of royal French bastards.
Stevens clarifies why this signifies the end of all that is good and pure in childbirth: “How very few ladies, for a moment, suspect that, when their pride admits the favourite M.D. from his carriage to their closet, they are following the blighting treason first committed against that sacred, that universal modesty God gave to all creatures, by a Court prostitute of Paris!”
Think about it: If you invite a man not your husband into your bedroom and allow him to insert parts of his body into your most private areas, well, you’re describing prostitution. Especially when you add how you’ll be all sweaty and moaning and writhing, soaking the sheets with sexy amniotic fluid and trying to not defecate. Actually Stevens, quoting a man known only as “a modern doctor,” can describe the scene better than I.
His looking sedate or even demure [cannot] alter his natural impulses.… If he be in health and vigour of constitution, can he enter a chamber, and there find a pretty young woman waiting his arrival, and proceed, in privilege of custom, with bated breath, and insinuating manner, to ask questions relating to her interesting condition; proceed next to take what freedom with her naked person he pleases to think necessary, to find out if she is six weeks or three months gone, and to know if with child or not.
Yeah. That’s hot.
Q: Oh, gag me with a speculum.
A: Gross. Doctors were of course quick to defend themselves and utilize approaches that would provide the least amount of awkwardness. Dr. Karl Schroeder, in his 1873 A Manual of Midwifery, says the best way to break the ice with a lady whose vagina you’re about to put your finger in is to just get to business.
Before examining internally no long discourse is necessary in order to prove to the woman the necessity of such an examination; let him show that it is necessary to do it by simply asking for some oil or cold cream, some water and a towel. If he examines her without many preliminaries he will not meet with any resistance or refusal on her part, since a woman who sends for the accoucheur must be prepared to be examined. He must, of course, proceed with all possible decency, but on no account whatever must he omit any method of examination if he considers it necessary.
Galabin calls this method “The Shocker”! BOOP!
Here Schroeder is setting a businesslike tone for the examination, giving the woman the benefit of the doubt that she is not a blushing child but a mother-to-be fully capable of distinguishing medical care from molestation.
Alfred Lewis Galabin, who wrote his own 1896 edition of A Manual of Midwifery, had another way of avoiding awkwardness during exams. The trick is to give the old girl a quick finger-jab right in the middle of her contraction: “It is usual and preferable to commence the examination during a pain, and hence arises the common phrase of ‘taking a pain.’ Her attention being distracted by the pain, the patient does not notice so much the inconvenience of the introduction of the examining finger.”
Boom. Womb inspected, over and done, before the lady has time to process if she just got internally goosed.
Q: Okay, I have my midwife. How would the actual at-home birth take place?
A: Preparation first.
The Air—Start a fire, as sweating helps birth. I imagine it just puts you in a frame of mind where you’re happy to excrete things out of even the tiniest of openings. If you live in a home new enough to have an attached water closet, make sure to use a towel to stop up the gap under the door. The miracle of the U-bend had perhaps not quite been perfected, and it was of utmost importance that gases seeping up from sewers and septic tanks didn’t enter the birth chamber, especially since a lot of attendants wouldn’t let you open the windows for the next two weeks.
The Bed—Lay something waterproof between your sheet and mattress. “Oil-cloth” (cloth boiled in linseed oil) was a favorite of the era, though if that could not be had, a nice thick layer of newspapers pinned to the mattress would do in a pinch, as would a rubber sheet, folded blanket, or “Turkish towels” (a large cloth made from the particularly absorbent weave of cotton or linen popular in Turkish baths, the precursor to bath towels).
The People—Kick out everyone who isn’t necessary. Your friends and your family and especially Auntie Gert, who last birthed a baby during the reign of Catherine the Great but still thinks she knows everything about the process and keeps trying to bleed off your sanguine humors with a fish-scaling knife… gone. No crowding. We’re looking at you, Irishwomen. (Per Galabin: “With the poorer classes the attendant should insist that no more persons than necessary are in the room, since, especially among the Irish, the neighbours are fond of gathering in the lying-in room.”) You can have a friend, but they must be the right sort, obnoxiously cheerful and not squeamish.
Your Personal Hygiene—It is about to be grossly neglected, so the Connecticut Training School for Nurses 1878 edition of A Hand-Book of Nursing for Family and General Use advises its students to try to tend to as much as possible before labor begins in earnest.
“Quick, lasses! Bridget is aboyt ter ’av a sprog an’ needs our ’elp!”
[The nurse] should assist her in undressing, brush her hair,—for this cannot be done again for several days,—bandage the limbs if varicose veins be troublesome, and allow her to eat and drink freely of easily-digested food and unstimulating fluids. The best food is soup and beef-tea, and farinaceous dishes; the best drink simply cold water.
Q: I’m grateful they’re willing to let me eat and drink… modern maternity nurses are real jerks about that. But why can’t I brush my hair after giving birth?
A: Phhffff. Pick a reason. Womb wobble? Milk bewitchment? Vanity-based sin scarring? Because nineteenth century, that’s why.
Continuing with your preparations. As for what you should wear, the sports bra and long socks option popular today was not available. Alfred Lewis Galabin asked women to not act as the lower classes do, wearing a full dress and corset throughout the labor, as this would “often prove inconvenient.” His suggested birth couture was as such:
It is preferable for the patient to be in her night-dress, over which she may wear a dressing-gown in the earlier stages of labour. It is a good plan for her also to wear underneath the night-dress a special petticoat, fastened loosely round the waist. The night-dress can then be tucked up and kept clean during delivery, and, when the labour is over, the soiled petticoat can be easily slipped off, and the
necessity for changing the night-dress avoided.
Other writers remind the woman to wear (thigh-high) stockings, and a few see no reason for her to remove her (open-crotched) drawers, especially if the weather is brisk. They aren’t too specific about accessorizing, but it seems only good manners to make an effort to match your hat and gloves and handbag to the curtains.
Your Mother-Bits—Even if they don’t believe in that bizarre new “germ theory” circulating through the medical community, your birth attendants are going to make an effort at cleanliness. For instance, they know you’re going to want to poop, and they are determined that you shan’t. The Connecticut Training School for Nurses is quite firm about pooping.
Above all, the midwife must remember that the patient’s desire to defecate is due to the pressure of the foetal head upon the rectum, and under no circumstance may she be allowed to sit upon the night-chair [chamber pot], since there is danger that the foetus also may be expelled, and injury to the mother and child follow.
Fountain syringe with multiple attachments for both enemas and vaginal douching.
Q: They worried… I’d… poop out the baby?
A: I know, if only it were that easy, right? But then again, some of these women were on their ninth or sixteenth delivery… for them it probably was best to pace themselves. Anyway, to prevent this, a non-negotiable part of childbirth was the enema and strenuous vaginal cleansing. The enemas usually contained fairly innocuous mixtures. Warm soapy water, emulsion of “slippery elm,” “chamomile-tea,” or “warm water with two teaspoonfuls of oil, and a teaspoonful of salt.” Repeat as necessary. Your birth canal, however—that needed to be more than clean, especially as the later part of the century brought out the OCD in the entire Western world. You needed a pelvic floor you could eat off of.
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