Giving birth in the early 1900s was no joke. Maternal and infant mortality was astoundingly high, with 9 out of 1000 women dying during birth and as many as 100 per 1000 infants dying before their first birthday. These gruesome statistics stayed the same even as mortality rates for other sectors of the population improved, meaning while everyone else was getting healthier, childbirth stayed as dangerous as ever.
The risk of a mother dying in childbirth was as high in the 1930s as it had been in the 1860s. But apparently modern medicine had been advancing at an unprecedented rate. Doctors were replacing midwives as the most used type of birth attendant, all kinds of new medical technologies and procedures were being introduced and women had more birth resources at their disposal than at any other time in history. So why were so many of them still dying? Why, in some areas of the United States, did as many as ⅓ of new babies die before their first birthday? The answer is that while birth practices were definitely changing and becoming more medicalized, those changes weren’t always for the better.
The medical procedures doctors used often didn’t make women any safer. In fact, they were often responsible for mutilating them, maiming their babies and causing easily preventable deaths. Doctors didn’t have even a basic understanding of germs and bacteria, nor did they appreciate the dangers of sedation. Archaic social pressures, rural isolation and a ton of other factors unique to the early 1900s added to the dangers of childbirth.
Even though it may have seemed to those living at the time that they were in the middle of a medical revolution, the reality was that the birthing practices being used were extremely dangerous. Here are some of the worst ones that would leave modern 21st century women running for the hills if they were still in practice today. 13
1.Don’t Call The Midwife
For most of the 19th century, most women gave birth at home with the help of trained midwives. This changed in 1902 when public health initiatives put heavy restrictions on who qualified as a midwife. Those without the right credentials were fined and sometimes even jailed. On the surface, the government tried to get rid of midwives to channel all prenatal care into newly created obstetric clinics that used more advanced techniques and had a more modern and in-depth knowledge of obstetrics.
The trouble was that the doctors trying to grapple for control of birth were more poorly trained than the midwives they were trying to replace. They also didn’t care so much about making childbirth safer but about garnering more profit. Obstetrics was becoming more lucrative than ever before but since midwives charged less for their services, doctors had a hard time competing with them directly. In order to attract clients, they made a huge effort to make midwives seem like a barbaric relic of days passed. Midwives stopped being available and women often had no choice but to give birth in hospital, where infection, unnecessary interventions and bizarre practices ran rampant.
2.Rural Women Gave Birth Alone
North America was very sparsely populated in the 1900s. Those who lived in the countryside were often days or weeks away from larger cities and organized medical care. Country doctors and midwives did exist but they were few and far between so a lot of rural women had to rely on untrained family members to coach them through birth.
Even then, it was possible for a homesteading woman to be left completely alone to give birth. If her husband went out to look for a doctor and was delayed by weather, a labouring woman not only had to deliver her baby alone but had to clean herself up afterward, cook her own food and take care of the house on her own until her husbands returned. Rural isolation was a big reason maternal mortality stayed as high as it did for so long. It wasn’t until urbanization and the advent of motorized transportation took off, bringing women closer to cities and the doctors who lived there, that rural women began to have safer, healthier births.
Doctors Had Little Medical Training
Doctors worked hard in the early years of the 20th century to attract women to hospitals so they could attend to multiple births in one day and therefore increase their profits. One of the new and exciting things they advertised were “highly advanced” specialized techniques and tools, such as forceps and episiotomies. Unfortunately, the doctors using and performing these things were barely practiced with them which could lead to horrific birth injuries to babies and debilitating and often fatal injuries to birthing women.
These injuries routinely left them disabled or at least at much higher risk for complications in subsequent pregnancies. Doctors felt they had to use these tools and techniques to prove their worth over more cheaply priced but probably better trained midwives. This over-medicalization of birth in the early 1900s by doctors with inadequate obstetric training is a reason infant and maternal mortality stayed as high as it did for so long.
Enemas For Everyone
Aside from the over use of forceps and other invasive techniques, a handful of less dangerous but still unpleasant (and completely useless) practices were routinely performed on labouring women. One of the most bizarre ones was the enema, which was immediately given to every woman the minute she entered the hospital to give birth. Enemas were thought to prevent infection and disease and, even more absurdly, give the baby more room to maneuver in the birth canal. Even though a ton of scientific research proves the only thing they’re good for is causing more pain to a labouring woman, enemas are sometimes still performed today, and are even routine procedure in some areas of the world. It seems like they are one of the last ways doctors can mess around with a woman’s body just for the sake of it.
They Put WHAT Down There?
While doctors in the 1900s didn’t have anything close to a comprehensive understanding of how germs and contamination worked, they did figure that a woman’s private parts should be as sterilized as possible when giving birth. We know now that with proper basic hygiene, there’s nothing going on down there that could possibly be a risk to either mom or baby, but back in the day the medical community went to town on women’s nether regions.
Not only was her pubic hair usually completely removed as soon as she was admitted into the hospital (this practice also made stitching for routine episiotomies easier) she was given a douche made from bichloride of mercury, a caustic and poisonous chemical. Then, to really finish things up, she was sprayed down with 1% lysol disinfectant. Sound like fun? It wasn’t. And even worse, it did absolutely nothing to prevent the rampant deadly infections that did plague women in birthing hospitals.
Doctors Didn’t Wash Their Hands
One of the leading causes of maternal and infant death was a deadly infection called Puerperal Sepsis, or childbed fever. For a long time doctors were absolutely baffled as to why so many otherwise healthy women developed a horrifying general infection immediately after giving birth. The infection was nearly impossible to treat: almost everyone who got it died from it. At first doctors thought the fever had to do with mysterious vapours in the air. It took them a long time to accept that they themselves were the cause of the infections.
They would go from birthing bed to birthing bed, delivering babies via forceps, manually removing pieces of placenta from a woman’s uterus and sometimes even going straight from dissecting corpses to treating living patients without ever stopping to wash their hands. Even when they began to understand their role in transmitting infection, doctors were very reluctant to change their habits. They took the suggestion that they needed to wash their hands very personally. “Doctors are gentleman,” insisted one Philadelphia based doctor. “And gentleman’s hands are clean.” Once science began to overrule the male ego and doctors began to regularly wash their hands, cases of Puerperal Sepsis dropped dramatically and the maternal death rates plummeted.
Fungus Was Used To Induce Labour
The history of childbirth is replete with the use of different herbs and foods. As civilization developed, many of these natural remedies fell to the wayside as more scientifically proven methods took their place. One of the last traditional treatments to stick around as part of routine medical practice was the use of a fungus called Ergot to induce labour. Found on grains of rye, Ergot was discovered to cause uterine contractions after people accidentally ingested it when it was baked into bread. It’s medical use was quickly developed, but it wasn’t a perfect science.
Getting the dose just right was difficult and too much could cause a number of serious complications. The contractions it brought on were so strong that if a woman’s cervix wasn’t fully dilated she could suffer debilitating tears or even a uterine rupture. The baby was also at risk of suffocation if her cervix closed on its head or on the umbilical cord during a contraction.
Staying Absolutely Still
o many birthing practices from a hundred years ago assumed that women were deeply fragile. That’s why forceps, manual placenta removal and cesarean sections were so often employed. Women’s bodies were thought to be so delicate they couldn’t bear the strain of labour without significant (male) help. This mentality persisted even after the baby was born. Women were instructed to hardly move at all for weeks at a time after giving birth because it was thought their uterus and other organs were at risk of literally falling out of their bodies. Visitors were restricted for days at a time to prevent women from being overly stimulated or to hear anything that might distress them. They were required to lie in bed on their backs and were only allowed to begin rolling over onto their sides after a week. Most women were told that they needed to stay in bed for over a month after giving birth.
While women were more likely to give birth in a hospital than ever before in history, up to 50% of them still preferred to stay at home. This changed completely with the advent of Twilight Sleep, which was introduced to North America in 1914. A combination of morphine and scopolomine was adminstered to labouring women which left them completely unconcious for the entire duration of their labour. Sound ideal? It was actually a horror show. Women tended to react badly to the medication which led them to thrashing around and screaming even while unconcious.
They would subsequently be tied to their beds to prevent them from injuring themselves. Babies would be born in a severely drugged state and suffering from respiratory distress. The common birthing practice of smacking a newborn baby on the bum came from this time; it was the doctors’ way of trying to revive an unconcious “Twilight Sleep” baby. However, the promise of pain free childbirth was immensely attractive and women continued to demand the treatment in droves. This filled up hospitals, which was the only place Twilight Sleep was available, to such an extent that by the 1930s almost 100% of women in North American gave birth there.