Although pregnancy is the same biological process now as it was in the 19th century, attitudes toward and management of pregnancy have changed considerably over the past hundred years. For women living in the United States in the 1800s, pregnancy was an expected and often repeated life event, but it could also be very dangerous for both mother and baby.
A Woman's Place
In 19th-century America, women were expected to be wives and mothers. They were defined and judged by how well they carried out this role, and not doing so could cause major social difficulties. In 1800, women gave birth an average of seven times during their lives, and a survey of births in Illinois in the 1820s shows that 30 percent of women gave birth to 10 or more children. Bearing this many children in a time of questionable nutrition and medical care took its toll on the health of both women and babies. Life expectancy for women was below that of men, and the 1850 U.S. census shows the infant mortality rate at 28 percent.
Artificial methods of birth control were largely absent from 19th-century American society. There is little historical record of popular birth control use during this time due to the taboo nature of the subject, but the widespread practice of extended breastfeeding helped with child spacing, and coitus interruptus, or withdrawal, was a traditional and often-used birth control method.
Abortion was common in the 19th century, and it was widely considered morally acceptable if it was done before the "quickening," the point at which a woman could feel the baby move. In the early 1800s, abortion was mostly used to avoid the scandal of pregnancy out of wedlock, but by the middle of the century, more married women were seeking abortion to limit the size of their family.
The Pregnant Pioneer
Because 19th-century women gave birth so many times during their lives, they had no choice but to continue their everyday work throughout their pregnancies. It was common for women to engage in strenuous physical tasks and heavy lifting while pregnant, and this was thought to help women prepare for labor. The high rates of infant and maternal mortality created a culture of fear and superstition surrounding pregnancy and childbirth. Many people believed that a mother's state of mind or random occurrences during pregnancy would negatively impact the baby, making it disfigured or mentally ill.
The vast majority of births in the 19th century happened at home and were attended by traditional midwives who obtained their training through practical experience. Even in 1900, more than 90 percent of births still occurred at home. In the late 19th century, however, a movement started that shifted maternity care from midwives to doctors and started to define birth as a medical event. Doctors, motivated in part by the income potential of attending births, began offering the hospital as a cleaner, newer, more "scientific" place for wealthy, urban mothers to have their babies. Doctors also offered drugs for pain relief, and by the early 20th century, it was standard practice to give laboring mothers a combination of morphine and scopolamine. These drugs relieved pain and erased the memory of the birth, but they also caused complications in childbirth for mother and baby, and they did not improve maternal or infant mortality rates.
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