perinatal health and history
Because of the curtailment of breastfeeding and the loss of its contraceptive effects, in both the aristocracy and amongst the poor, the gap between pregnancies dwindled and the number of pregnancies increased.
When the industrial revolution took hold from the mid-1700s, rural livelihoods were ruined by the mass-production of machines and factories. Poverty drove peasant families into the towns and cities, where the male doctors and barber-surgeons began to remove the care of what they felt to be the unpredictable, leaky, dangerous, even catastrophic maternal body out of the hands of traditional, mostly untrained, female guardians. Respectable midwives, some with certificates from training programs in Europe, protested that the new metal forceps used by barber-surgeons did unnecessary damage. But the doctors offered new technologies just as local and collective female authority was fragmenting.
In 1746, in that filthy, overcrowded metropolis of London, where half of all children died before 5 years of age, Dr William Cadogan (in the image below) wrote about the causes of infantile colic and infant death.
He observed that the breastfed children of peasants in rural areas enjoyed better health than the upper classes, and he bravely aimed to make breastfeeding attractive to the upper class woman, despite the constraints of her delicate breeding and the complications of corsetry:
"It need be no Confinement to her, or Abridgment of her Time: Four times in four and twenty hours will be often enough to give it Suck… It may be fed and dress’d by some handy, reasonable Servant … whom likewise it may sleep with."
Unfortunately, Dr Cadogan had not sat with peasant families long enough to know the patterns of successful breastfeeding. From this time until today, well-intentioned experts advocate breastfeeding, but may accidentally set it up to fail.
Soon, in the heaving new urban centres, most mothers had no choice anyway but to leave their babies in the care of older children or neighbours as they went to work on the factory floor, feeding them paps or gruels or, if they could afford it, cow’s milk. Because of the curtailment of breastfeeding and the loss of its contraceptive effects, in both the aristocracy and amongst the poor, the gap between pregnancies dwindled and the number of pregnancies increased.
The doctors treated pregnancy as a medical condition, inspired by the modern French idea of body as machine, offering ether during birth with the backup of the forceps (as well as leeches and blood-letting). Seeing a doctor conferred status on the woman who saw him, and their services were highly sought after in the cities. I think it’s fair to say that contemporary midwives still carry the grief for us, a grief passed down through two centuries for the losses to women inherent in this great and inevitable social shift, which has eventually saved countless lives, but which also has had such profound effects on the social behaviours surrounding mothers and babies.
7 October 2015. Adapted from Douglas, Pamela, 'Appendix 1: An Intimate History of Mother-Baby Care in the English-speaking World,' The Discontented Little Baby Book, UQP: 2014;pp. 208-221.
References
- Carroll L, Alice’s Adventures in Wonderland, first published Macmillan and Co., London 1866; Books of Wonder, William Morrow & Co., Inc. New York 1992.
- Cadogan W, An essay upon nursing, and the management of children, from their birth to three years of age. By a Physician, 2nd ed, J Roberts, London, 1748, p.25.
Image credit
Dr William Cadogan: Wellcome Library, London.
