Childbirth in Early America

Digital History TOPIC ID 70

When the Mayflower left Plymouth, England, September 16, 1620, on its historic voyage to the New World, three of its 102 passengers were pregnant. Elizabeth Hopkins and Susanna White were each in their seventh month of pregnancy. Mary Norris Allerton was in her second or third month.

Their pregnancies must have been excruciatingly difficult. After a few days of clear weather, the Mayflower ran into "fierce storms" that lasted for six of the voyage's nine-and-a-half weeks. For days on end, passengers were confined to the low spaces between decks, while torrential winds blew away clothing and supplies and the ship tossed and rolled on the heavy seas.

While the ship was still at sea, Elizabeth Hopkins gave birth to a baby boy named Oceanus after his birthplace. Two weeks later, while the Mayflower was anchored off Cape Cod, Susanna White also had a baby boy. He was christened Peregrine, a name that means "pilgrim." Peregrine White would live into his eighties, but Oceanus Hopkins died during the Pilgrim's first winter in Plymouth. In the spring of 162l, Mary Norris Allerton died in childbirth; her baby was stillborn.

Childbirth in colonial America was a difficult and sometimes dangerous experience for women. During the seventeenth and eighteenth centuries, between 1 percent and 1.5 percent of all births ended in the mother's death as a result of exhaustion, dehydration, infection, hemorrhage, or convulsions. Since the typical mother gave birth to between five and eight children, her lifetime chances of dying in childbirth ran as high as 1 in 8. This meant that if a woman had eight female friends, it was likely that one might die in childbirth.

Death in childbirth was sufficiently common that many colonial women regarded pregnancy with dread. In their letters, women often referred to childbirth as "the Dreaded apperation," "the greatest of earthly miserys," or "that evel hour I loock forward to with dread." Many, like New England poet Anne Bradstreet, approached childbirth with a fear of impending death. In a poem entitled "Before the Birth of One of Her Children," Bradstreet wrote,

How soon, my Dear, death may my steps attend, How soon't may be thy lot to lose thy friend.

In addition to her anxieties about pregnancy, an expectant mother was filled with apprehensions about the death of her newborn child. The death of a child in infancy was far more common than it is today. In the healthiest seventeenth century communities, one infant in ten died before the age of five. In less healthy environments, three children in ten died before their fifth birthday. Puritan minister Cotton Mather saw eight of his fifteen children die before reaching the age of two. "We have our children taken from us," Mather cried out, "the Desire of our Eyes taken away with a stroke."

Given the high risk of birth complications and infant death, it is not surprising to learn that pregnancy was surrounded by superstitions. It was widely believed that if a mother looked upon a "horrible spectre" or was startled by a loud noise her child would be disfigured. If a hare jumped in front of her, her child was in danger of suffering a harelip. There was also fear that if the mother looked at the moon, her child might become a lunatic or sleepwalker. A mother's ungratified longings, it was thought, could cause an abortion or leave a mark imprinted on her child's body. At the same time, however, women were expected to continue to perform work until the onset of labor, since hard work supposedly made for an easier labor. Pregnant women regularly spun thread, wove clothing on looms, performed heavy lifting and carrying, milked cows, and slaughtered and salted down meat.

Today, most women give birth in hospitals under close medical supervision. If they wish, women can take anesthetics to relieve labor pangs. During the seventeen and eighteenth centuries, the process of childbirth was almost wholly different. In colonial America, the typical woman gave birth to her children at home, while female kin and neighbors clustered at her bedside to offer support and encouragement. When the daughter of Samuel Sewall, a Puritan magistrate, gave birth to her first child on the last day of January, 1701, at least eight other women were present at her bedside, including her mother, her mother-in-law, a midwife, a nurse, and at least four other neighbors.

Most women were assisted in childbirth not by an doctor but by a midwife. Most midwives were older women who relied on practical experience in delivering children. One midwife, Martha Ballard, who practiced in Augusta, Maine, delivered 996 women with only four recorded fatalities. Skilled midwives were highly valued. Communities tried to attract experienced midwives by offering a salary or a house rent-free. In addition to assisting in childbirth, midwives helped deliver the offspring of animals, attended the baptisms and burials of infants, and testified in court in cases of bastardy.

During labor, midwives administered no painkillers, except for alcohol. Pain in childbirth was considered God's punishment for Eve's sin of eating the forbidden fruit in the Garden of Eden. Women were merely advised to "arm themselves with patience" and prayer and to try, during labor, to restrain "those dreadful groans and cries which do so much discourage their friends and relations that are near them."

After delivery, new mothers were often treated to a banquet. At one such event, visitors feasted on "boil'd pork, beef, flowls, very good rost beef, turkey-pye, [and] tarts." Women from well-to-do families were then expected to spend three to four weeks in bed convalescing. Their attendants kept the fire place burning and wrapped them in a heavy blanket in order to help them sweat out "poisons." Women from poorer families were generally back at work in one or two days.

During the second half of the eighteenth century, customs of childbirth began to change. One early sign of change was the growing insistence among women from well-to-do urban families that their children be delivered by male midwives and doctors. Many upper class families assumed that in a difficult birth trained physicians would make childbirth safer and less painful. In order to justify their presence, physicians tended to take an active role in the birth process. They were much more likely than midwives to intervene in labor with forceps and drugs.

Another important change was the introduction in 1847 of two drugs - ether and chloroform - to relieve pain in childbirth. By the 1920s, the use of anesthesia in childbirth was almost universal. The practice of putting women to sleep during labor contributed to a shift from having children at home to having children in hospitals. In 1900, over 90 percent of all births occurred in the mother's home. But by 1940, over half took place in hospitals and by 1950, the figure had reached 90 percent.

The substitution of doctors for midwives and of hospital delivery for home delivery did little in themselves to reduce mortality rates for mothers. It was not until around 1935, when antibiotics and transfusions were introduced, that a sharp reduction in the maternal mortality rate occurred. In 1900, maternal mortality was about 65 times higher than it is today, and not much lower than it had been in the mid-nineteenth century. By World War II, however, death in childbirth had been cut to its present low level.

In recent years, a reaction has occurred against the sterile impersonality of modern hospital delivery. Women today are much more likely than their mothers or grandmothers to want a "natural childbirth." Beginning in the l960s, a growing number of women elected to bear their children without anesthetics, so that they could be fully conscious during childbirth. Many women also chose to have their husbands or a relative or a friend present during labor and delivery and to bear their children in special "birthing rooms" that provide a home-like environment. In these ways, many contemporary women have sought to recapture the broader support network that characterized childrearing in the colonial past, without sacrificing the tremendous advances that have been made in maternal and infant health.