Pregnancy today comes with ultrasounds, prenatal vitamins, epidurals, and a medical team whose entire job is to make sure both mother and child survive the experience. Pregnancy in the Victorian era came with a doctor who had probably never formally studied obstetrics, a bedroom full of people offering contradictory advice, and a genuinely meaningful chance that neither of you would make it through.
Today we’re going to take a look at what giving birth was actually like in the Victorian era. But before we get started, be sure to subscribe to Victorian Medicine and let us know in the comments below what other medical horror stories from history you’d like to hear about. Okay. Take a deep breath.
You are going to need it. The first thing to understand about Victorian childbirth is that it killed people in enormous numbers. Maternal mortality rates varied significantly by class and location, but even for relatively affluent women with access to trained attendants, giving birth carried risks that modern medicine has largely eliminated.
The primary killer was not the birth itself, but what came after. Puerperal fever, also known as childbed fever, a bacterial infection that could take hold within days of delivery and kill a healthy woman within a week. In the lying-in hospitals that served poorer urban women, puerperal fever moved through wards with the efficiency of something that had found its ideal environment, which it had, because the ideal environment for the spread of bacterial infection turns out to be a room full of doctors moving directly from performing autopsies to delivering babies without washing their hands in between. This was not a secret, exactly. The connection between dirty hands and dead mothers had been observed and documented. A Hungarian physician named Ignaz Semmelweis had demonstrated in the 1840s that maternal mortality dropped dramatically when doctors washed their hands with chlorinated lime solution before delivering babies. The medical establishment’s response to this finding was to largely reject it, question
Semmelweis’s methodology, and continued not washing their hands. Semmelweis, driven to a breakdown by the refusal of his colleagues to act on evidence that was costing women their lives, died in an asylum in 1865, ironically of the same kind of infection he had spent his career trying to prevent.
It was not until Joseph Lister’s work on antiseptic technique in the late 1860s that hand hygiene began to be taken seriously. And even then, adoption was slow, uneven, and resisted by physicians who found the implication that they were killing their patients professionally objectionable. For most of the Victorian era, childbirth took place at home.
The lying-in hospitals that existed in major cities served primarily the poor, and middle and upper-class women regarded them, not entirely without reason, as places you went to die. Homebirth was attended by a midwife, a doctor, or some combination of the two, depending on what the family could afford and what was available.
The relationship between doctors and midwives in the Victorian era was one of sustained professional hostility, with the medical establishment increasingly pushing to marginalize midwives in favor of trained physicians, while simultaneously producing evidence that trained physicians, with their unwashed hands and their enthusiasm for interventions, were in many cases achieving worse outcomes than experienced midwives who had been attending births for decades.
The interventions available to a Victorian doctor facing a complicated labor were limited and frequently dangerous. Forceps, which had been in use since the 17th century, could be used to assist delivery when the baby was positioned awkwardly or labor had stalled, but their use required skill that not every practitioner possessed and could cause serious injury to both mother and child when applied incorrectly.
Turning a badly positioned baby manually, a procedure called version, was agonizing for the mother and required the doctor to work largely by feel in conditions that were neither clean nor well-lit. In cases where delivery was impossible and a choice had to be made between the mother’s life and the child’s, Victorian medicine had procedures for that, too, and they were exactly as grim as you are imagining.
Pain relief during labor was minimal for most of the era. The dominant view in both medical and religious circles held that pain in labor was natural, necessary, and in some quarters theologically mandated, a position that conveniently required no expensive medication and could be dressed up as principle.
This began to change in 1853 when Queen Victoria accepted chloroform during the birth of her eighth child, Prince Leopold. The Queen’s endorsement of anesthesia during labor was one of the more consequential acts of her reign, at least from a medical history perspective, because it made pain relief during labor socially acceptable for women who had previously been told that wanting it was somehow improper.
If the Queen herself had taken chloroform and survived the experience with her dignity intact, the argument that pain relief in childbirth was morally dubious became considerably harder to sustain. Chloroform was not without its own risks. Administered incorrectly or in too large a dose, it could stop the heart, and the line between a dose that relieved pain and a dose that caused serious harm was not always easy to judge in a home bedroom with inconsistent lighting and no monitoring equipment. But for women who had previously faced labor with nothing more than a suggestion that they might like to hold on to something, the risks of chloroform were an entirely acceptable trade. The postpartum period carried its own hazards beyond infection. Victorian medical advice for women after childbirth emphasized rest to a degree that today looks less like recuperation and more like confinement. Women were advised to remain in bed for extended
periods, avoid exertion, avoid cold air, avoid visitors beyond the immediate household, and submit to a dietary regime designed for someone whose digestive system was considered to be in a state of profound fragility. The practical consequence of this advice for working-class women who could not afford weeks of bed rest any more than they could afford a physician, is that it was largely ignored.
They got up, they went back to work, they managed, and the medical establishment recorded their failure to follow instructions with a disapproval it was in no position to back up with evidence that the instructions were helping. What childbirth in the Victorian era reveals, more nakedly than almost any other aspect of the period’s medical history, is the gap between what the era believed about women’s bodies and what it was willing to do about that belief.
Women were considered delicate, fragile, and in constant need of medical supervision, but the medical supervision on offer was frequently inadequate, sometimes actively harmful, and almost always designed around the convenience and professional status of the men providing it, rather than the survival of the women receiving it.
The mortality rates that resulted were not invisible. They were documented, discussed, and mourned. They were also, for most of the Victorian era, accepted as the cost of a biological process that medicine had not taken seriously enough to properly study. It got better, slowly, unevenly, too late for too many women, but it got better, which is in Victorian medical history about as optimistic as the endings get.
So, what do you think? Which part of this surprised you the most? Let us know in the comments below, and while you’re at it, check out some of these other videos from Victorian Medicine.
