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The Historical Horror of Childbirth

Childbirth in much of human history has been a class act. The upper classes were encouraged to reproduce as much as possible, and a woman who was pregnant or recovering from childbirth took time to rest while servants took care of her and the child. The lower classes worked right up to and soon following birth, as they had to work to eat. The upper classes also had the latest medical knowledge at their fingertips, but this wasn't always such a good thing.

Photograph from The Victoria and Albert Museum.

Class distinctions in childbirth during the Renaissance were recorded. In 15th-century Florence, women were married as teenagers and often had five to ten children, depending on whether she survived childbirth. Childbirth was so dangerous that a woman would make out her will as soon as she found out she was pregnant. An age-old method of birth control is extended breastfeeding, which is nature's way of spacing out children. However, the custom among the upper classes was to farm out breastfeeding to wet nurses, which meant that the mother would soon be pregnant again.

It was during the Renaissance that medical doctors began to take part in childbirth, although not without a struggle. Women as whole were sheltered and their bodies hidden under plenty of clothing. It was unseemly for any man to take part in the intimate process of childbirth, and midwives did not want to give up their power or expertise in the area. Midwives had experience on their side; physicians had the authority that comes with the title. Therefore, most of the writings and advice from the period come from prominent physicians, and a lot of their advice was guesswork.  

Three women were pregnant when they boarded the Mayflower on its journey to America. One child, Oceanus Hopkins, was born during the voyage and died during the first winter in Massachusetts. Another, Peregrine White, was born shipboard off Cape Cod and lived to an old age. The third child was stillborn at Plymouth; the mother died in childbirth. Such stories were not at all shocking, as a woman's chances of dying during childbirth were between one and two percent -for each birth. If a woman gave birth to eight or ten children, her chances of eventually dying in childbirth were pretty high. The infant mortality rate was even higher. The chances of a child dying before his fifth birthday were estimated to be around 20 percent, depending on the community (accurate records are scarce). In addition to the fear of death or the fear of the child dying, there was no pain relief during labor, except for whisky in some places. In Puritan communities, pain during childbirth was God's punishment for Eve and all women who came afterward.

Motherhood in early America was even more frightening for slaves. Infant mortality among African and African-American slaves in the 18th century ranged from 28-50 percent, and mortality in children under ten was 40-50 percent, due to maternal malnutrition, overwork, disease, and lack of medical access. Slave owners blamed the mothers for infant deaths, and there is evidence that some babies were deliberately smothered to spare the child a life of slavery, but other factors contributed greatly to the infant death rate.

As Europe became more crowded in the 17th and 18th centuries, communicable diseases caused even more frequent deaths in childbirth. Puerperal fever had been around, but the rise of physician-assisted births increased its rate. It is a bacterial infection that became apparent within days of giving birth. The rise of maternity wards in hospitals meant that many women gave birth within shouting distance of each other. Doctors, in those days before germ theory, went from patient to patient, unknowingly carrying the bacteria on their instruments and their unwashed hands. In the 1790s, Alexander Gordon stressed that the disease was spread from one patient to another. He "bled" his patients at the first sign of puerperal fever, which actually helped in some cases, but no one understood why. In 1842, Thomas Watson recommended that physicians and birth attendants wash their hands and use chlorine between patients. In 1847, Ignaz Semmelweis reduced the rate of fever in his obstetric ward by ordering hand washing, but the idea was still rejected by the medical industry at large. A famous victim of puerperal fever was Mary Wollstonecraft, mother of Frankenstein author Mary Shelley. In 1797 she gave birth to her daughter Mary with the assistance of a midwife. But then a doctor was called to help remove the placenta and he came quickly, with unwashed hands. Wollstonecraft died a painful but typical death over the next week.

Photograph by Billy Hathorn.

Pioneers who settled the American West didn't have it much better than their eastern or European counterparts. Both doctors and midwives were scarce, and the midwives who were able to help in childbirth rarely had more knowledge than the experience of giving birth themselves. Infant mortality remained high, but the isolation of living on wilderness farmland many miles away from settled towns had one advantage: the spread of disease was lessened somewhat.

Childbirth changed dramatically in the 19th century with the introduction of anesthetics. Dentist William Morton developed the use of ether for surgery in 1846. Obstetrician Sir James Young Simpson introduced chloroform as an anesthetic in 1847. Queen Victoria used chloroform during her eighth delivery in 1853. The practice of childbirth anesthesia spread quickly afterward, despite protests from the clergy, who claimed that labor pains are God's will.

In 1914, a method called Twilight Sleep was developed, which involved morphine and scopolamine. The mother slept through delivery, but the drugs also affected the baby, and sometimes the child didn't breathe at all. The morphine also caused some mothers to die in childbirth. 

Comic by Kate Beaton.

In the 20th century, advances in medicine and germ theory raced ahead of public health and the access of the lower classes to medical care. When Dr. Josephine Baker was appointed as city health inspector for the Hell's Kitchen area in 1901, she found that 1,500 newborn babies died in the district every week. Her crusade to improve prenatal care and child health practices involved inventing formula, opening clinics, launching a school lunch program, training babysitters, and opening milk stations in the city, and it resulted in a huge decrease in infant and child deaths.

Childbirth, though still an ordeal, is much safer today for mothers. Children are much more likely to survive to adulthood. And widely available birth control gives people the option of deciding when and how many children to have. But the hard part comes after childbirth -raising a family, which is more complicated every day. And that's why you should honor your mother this Mother's Day.

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Aidan Monaghan/AMC
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History
What AMC's The Terror Got Right (And Wrong) About the Franklin Expedition
Aidan Monaghan/AMC
Aidan Monaghan/AMC

WARNING: This post contains spoilers for The Terror. If you haven't finished the show, don't read further!

We know the outcome of Captain Crozier's battle with Tuunbaq in the AMC series The Terror, and that he chose (as some rumors have suggested) to live with the Inuit rather than return to London when he has the chance. Now, it's time for a post-mortem (sorry) of the show's historical highlights. While Dan Simmons, author of the book on which the show is based, created Lady Silence and her supernatural evil spirit—Tuunbaq definitely wasn't stalking the men of the Erebus and Terror back in 1847—much of the show is faithful to the actual events of the Franklin expedition, one of the most enduring mysteries in polar exploration. Here's a rundown of what The Terror got right, and where the show slipped up.

RIGHT: THE TERROR’S ARCTIC ATMOSPHERE

A scene from AMC's The Terror with Sir John Franklin and James Fitzjames
Capt. James Fitzjames (Tobias Menzies), left, and Sir John Franklin (Ciaran Hinds) survey the ice.
Aidan Monaghan/AMC

Right off the bat, The Terror envelops viewers in an icy world that increasingly mirrors the crews’ isolation and desperation. In the first tragic scene, a sailor falls overboard into a sea of accurately rendered pancake ice. In another scene, Captain Francis Crozier sees a sun dog—a solar phenomenon caused by sunlight refracting through clouds of ice crystals, often witnessed by polar explorers. The officers' uniforms and caps are also recreated with authentic details. As the hopelessness of their predicament dawns on the officers and men, summer’s 24-hour daylight vanishes, replaced by the 24-hour darkness of winter. The imprisoned ships tilt with the pressure of the pack ice.

There were a few hiccups noticed by sharp-eyed viewers in the Remembering the Franklin Expedition Facebook group, however. Caulker's mate Cornelius Hickey has a fondness for cigarettes, but most sailors probably smoked pipes at the time, and definitely not inside the ship. (Good thing they had that fire hole bored into the ice!) And assistant surgeon Harry Goodsir’s technique with the Daguerrotype camera in the blind would have produced a terrible photo. His 20th-century stopwatch wouldn’t have helped.

WRONG: FRANKLIN’S BACK-UP PLAN

A scene from AMC's The Terror with Sir John Franklin and Capt. Francis Crozier
Captain Francis Crozier (Jared Harris), right, tries to convince Sir John that they're going to need rescuing pretty soon.
Aidan Monaghan/AMC

In a flashback in Episode 3, Sir John Franklin’s good friend Sir John Ross asks the soon-to-depart commander if the Admiralty had any plans for his rescue. When Franklin says one won’t be needed—since the HMS Erebus and HMS Terror are the best-provisioned ships ever sent to the Arctic—Ross warns him that he’s being naïve. In real life, this conversation was much different, and it didn’t take place at the Admiralty.

Franklin and Ross knew firsthand how a well-provisioned expedition can become a fight for survival. (In Episode 6, Captain James Fitzjames hears the story of Ross’s disastrous Victory expedition from the Erebus's ice master Thomas Blanky, who was really there in 1829-1833.) Ross instead offered to rescue Franklin himself, and captained (at age 72!) a privately funded schooner in search of his lost friend in 1850. And because Ross and the Admiralty had had a major falling out decades before, Ross wouldn’t have been chatting with Franklin at the Admiralty's HQ in Episode 3, and he definitely wouldn’t have been there to hear Lady Jane Franklin’s plea for a search party in Episode 4.

Sir John Ross was the uncle of Sir James Clark Ross, whom we see in the first scene of Episode 1 and its replay, from a different point of view, at the end of Episode 10. In real life, Sir James was one of Crozier's closest friends.

WRONG (MAYBE): KILLER CANS

In a foreboding sign of things to come, Franklin removes a tiny blob of lead from his mouth while eating dinner with Fitzjames in the first episode. By Episode 4, the ships’ cooks are complaining that much of the canned meat is spoiled, and able seaman John Morfin shows up in Goodsir’s infirmary with a blackish line along his gums, an ominous sign of lead poisoning. To test that hypothesis, Goodsir feeds the monkey Jacko some of the canned meat, and then reveals his theory to the surgeon Stephen Stanley: The meat is contaminated with lead and the men have been eating it for more than two years.

The storyline is built upon a famous theory that is now in doubt. In the mid-1980s, forensic anthropologists found high levels of lead in Franklin crewmembers' remains. They suggested the source was poorly sealed food cans, and that lead poisoning led to the men’s deaths. But recent research has pointed to the Erebus’s and Terror’s unique water systems [PDF], which used lead pipes, as the primary source of contamination. And, a 2015 study compared lead content among seven crewmembers’ remains and found wide variation, suggesting some men may not have been debilitated.

RIGHT: SERIOUS SCURVY

A scene from AMC's The Terror with Goodsir and Young
Dr. Goodsir (Paul Ready) tries to save David Young (Alfie Kingsnorth).
Aidan Monaghan/AMC

David Young, the first fatality of The Terror, doesn’t show any signs of scurvy in Goodsir’s autopsy. But by the summer of 1848, the remaining crew camped on King William Island hasn’t eaten fresh meat in three years, and the Navy-issued lemon juice rations have either run out or lost potency. Signs of severe Vitamin C deficiency appear: Fitzjames’s old bullet wounds, which he boasted about at the officers' table in the first episode, begin to open up, and a rough-looking Lieutenant George Henry Hodgson loses a tooth as he chews the leather from his boot (a nod to Franklin’s awful 1819-1822 Arctic expedition) in Episode 9. The scenes match what most, though not all, historians and researchers now believe: that a grim combination of scurvy, starvation, exposure, and underlying illnesses spelled the end for Franklin’s men.

(VERY LIKELY) WRONG: FRANKLIN’S CAUSE OF DEATH

A scene from AMC's The Terror with Sir John Franklin and Tunnbaq
Tuunbaq takes a deadly swipe at Sir John.
Aidan Monaghan/AMC

The terrifying scene in Episode 3 in which Tuunbaq mauls Franklin to death and shoves him down the fire hole is most likely not the way it actually happened. Historically speaking, just after the men abandon ship in April 1848, Crozier and Fitzjames updated the note left in the cairn the previous spring. They reported that “Sir John Franklin died on 11th June 1847”—just 19 days after Lieutenant Graham Gore and mate Charles Des Voeux had left the same paper behind on May 24, 1847 and reported the crews “all well.” Unfortunately, it’s the only record ever found about the expedition’s progress, and no one knows for sure how Franklin died or what happened to his body. Inuit oral histories collected by Franklin scholar Louie Kamookak suggest Franklin was buried under a flat stone somewhere on King William Island, but to date, no trace has been found.

RIGHT: THAT CRAZY CARNIVAL

The wild masquerade party in the middle of the bleak and frozen Arctic, which Fitzjames orders as a morale-booster for the men in Episode 6, may seem like a total anachronism. In real life, it was a time-honored tradition. (We don't know for sure if the Erebus and Terror had a carnival because no logbooks from the expedition have been found, but it's likely that they did.) In 1819-1820, Sir Edward Parry led the first polar expedition to purposefully overwinter in the Arctic. He worried about how the men would fare psychologically during the months of darkness and teeth-cracking cold, so he brought along trunks of theatrical costumes and launched the Royal Arctic Theatre, a fortnightly diversion for the officers and men to perform silly plays and musicals. It kept the men busy writing shows, practicing their parts, and building sets, which Parry thought was the key to staying sane. The scheme was such a success that subsequent expeditions kept the tradition going. But unlike in The Terror, the frivolities didn’t end in fiery conflagrations and mass casualties. 

(POSSIBLY) WRONG: HICKEY’S MURDEROUS MUTINY

A scene from AMC's The Terror with Cornelius Hickey
Mr. Hickey (Adam Nagaitis) cooks up a mutiny.
Aidan Monaghan/AMC

In Episode 7, Hickey plans a mutiny and convinces enough of the desperate men to follow him, splitting the remaining officers and men into two groups and, in Episode 9, taking Crozier captive. Hickey also kidnaps Goodsir because, as the expedition’s sole remaining surgeon, he is the only one who knows how to wield a bone saw. We don’t know, though, if there was an actual mutiny among the Franklin survivors. The remains of some of Franklin's men were found in different locations, but that doesn’t necessarily indicate a breakdown of order. Smaller groups may have split off from the main group because they simply couldn’t march any farther or had decided to return to the ships. Despite the harsh conditions of service in the Royal Navy, mutinies were quite rare.

RIGHT: CANNIBALISM

Hickey’s followers, starving and desperate, dine on morsels of steward William Gibson in one of Episode 9’s most wrenching scenes with historical precedent. Hudson’s Bay Company trader John Rae discovered the truth about the Franklin expedition from interviews with Inuit in 1854, including testimony that the men resorted to cannibalism to survive. In his infamous letter to the Admiralty, he wrote, “from the mutilated state of many of the bodies, and the contents of the kettles, it is evident that our wretched countrymen had been driven to the last dread alternative as a means of sustaining life.” Victorian England refused to believe it—but Inuit testimony and forensic research [PDF] supported Rae’s account, finally revealing the expedition’s fate.

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(c) Field Museum, CSZ5974c, photographer Carl Akeley, used with permission.
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Animals
The Time Carl Akeley Killed a Leopard With His Bare Hands
(c) Field Museum, CSZ5974c, photographer Carl Akeley, used with permission.
(c) Field Museum, CSZ5974c, photographer Carl Akeley, used with permission.

Carl Akeley had plenty of close encounters with animals in his long career as a naturalist and taxidermist. There was the time a bull elephant had charged him on Mount Kenya, nearly crushing him; the time he was unarmed and charged by three rhinos who missed him, he said later, only because the animals had such poor vision; and the time the tumbling body of a silverback gorilla he'd just shot almost knocked him off a cliff. This dangerous tradition began on his very first trip to Africa, where, on an otherwise routine hunting trip, the naturalist became the prey.

It was 1896. Following stints at Ward’s Natural Science Establishment and the Milwaukee Public Museum, Akeley, 32, had just been appointed chief taxidermist for Chicago’s Field Museum of Natural History, and he was tasked with gathering new specimens to bolster the 3-year-old museum's fledgling collections. After more than four months of travel and numerous delays, the expedition had reached the plains of Ogaden, a region of Ethiopia, where Akeley hunted for specimens for days without success.

Then, one morning, Akeley managed to shoot a hyena shortly after he left camp. Unfortunately, “one look at his dead carcass was enough to satisfy me that he was not as desirable as I had thought, for his skin was badly diseased,” he later wrote in his autobiography, In Brightest Africa. He shot a warthog, a fine specimen, but what he really wanted was an ostrich—so he left the carcass behind, climbed a termite hill to look for the birds, then took off after a pair he saw in the tall grass.

But the ostriches eluded him at every turn, so he returned to camp and grabbed the necessary tools to cut off the head of his warthog. However, when he and a “pony boy” got to the spot where he’d left the carcass, all that remained was a bloodstain. “A crash in the bushes at one side led me in a hurry in that direction and a little later I saw my pig's head in the mouth of a hyena travelling up the slope of a ridge out of range,” Akeley wrote. “That meant that my warthog specimen was lost, and, having got no ostriches, I felt it was a pretty poor day.”

As the sun began to set, Akeley and the boy turned back to camp. “As we came near to the place where I had shot the diseased hyena in the morning, it occurred to me that perhaps there might be another hyena about the carcass, and feeling a bit ‘sore’ at the tribe for stealing my warthog, I thought I might pay off the score by getting a good specimen of a hyena for the collections,” he wrote. But that carcass was gone, too, with a drag trail in the sand leading into the bush.

Akeley heard a sound, and, irritated, “did a very foolish thing,” firing into the bush without seeing what he was shooting at. He knew, almost immediately, that he'd made a mistake: The answering snarl told him that what he’d fired at was not a hyena at all, but a leopard.

The taxidermist began thinking of all the things he knew about the big cats. A leopard, he wrote,

“... has all the qualities that gave rise to the ‘nine lives’ legend: To kill him you have got to kill him clear to the tip of his tail. Added to that, a leopard, unlike a lion, is vindictive. A wounded leopard will fight to a finish practically every time, no matter how many chances it has to escape. Once aroused, its determination is fixed on fight, and if a leopard ever gets hold, it claws and bites until its victim is in shreds. All this was in my mind, and I began looking about for the best way out of it, for I had no desire to try conclusions with a possibly wounded leopard when it was so late in the day that I could not see the sights of my rifle.”

Akeley beat a hasty retreat. He’d return the next morning, he figured, when he could see better; if he’d wounded the leopard, he could find it again then. But the leopard had other ideas. It pursued him, and Akeley fired again, even though he couldn’t see enough to aim. “I could see where the bullets struck as the sand spurted up beyond the leopard. The first two shots went above her, but the third scored. The leopard stopped and I thought she was killed.”

The leopard had not been killed. Instead, she charged—and Akeley’s magazine was empty. He reloaded the rifle, but as he spun to face the leopard, she leapt on him, knocking it out of his hands. The 80-pound cat landed on him. “Her intention was to sink her teeth into my throat and with this grip and her forepaws hang to me while with her hind claws she dug out my stomach, for this pleasant practice is the way of leopards,” Akeley wrote. “However, happily for me, she missed her aim.” The wounded cat had landed to one side; instead of Akeley’s throat in her mouth, she had his upper right arm, which had the fortuitous effect of keeping her hind legs off his stomach.

It was good luck, but the fight of Akeley’s life had just begun.

Using his left hand, he attempted to loosen the leopard’s hold. “I couldn't do it except little by little,” he wrote. “When I got grip enough on her throat to loosen her hold just a little she would catch my arm again an inch or two lower down. In this way I drew the full length of the arm through her mouth inch by inch.”

He felt no pain, he wrote, “only of the sound of the crushing of tense muscles and the choking, snarling grunts of the beast.” When his arm was nearly free, Akeley fell on the leopard. His right hand was still in her mouth, but his left hand was still on her throat. His knees were on her chest and his elbows in her armpits, “spreading her front legs apart so that the frantic clawing did nothing more than tear my shirt.”

It was a scramble. The leopard tried to twist around and gain the advantage, but couldn’t get purchase on the sand. “For the first time,” Akeley wrote, “I began to think and hope I had a chance to win this curious fight.”

He called for the boy, hoping he’d bring a knife, but received no response. So he held on to the animal and “continued to shove the hand down her throat so hard she could not close her mouth and with the other I gripped her throat in a stranglehold.” He bore down with his full weight on her chest, and felt a rib crack. He did it again—another crack. “I felt her relax, a sort of letting go, although she was still struggling. At the same time I felt myself weakening similarly, and then it became a question as to which would give up first.”

Slowly, her struggle ceased. Akeley had won. He lay there for a long time, keeping the leopard in his death grip. “After what seemed an interminable passage of time I let go and tried to stand, calling to the pony boy that it was finished.” The leopard, he later told Popular Science Monthly, had then shown signs of life; Akeley used the boy’s knife to make sure it was really, truly dead.

Akeley’s arm was shredded, and he was weak—so weak that he couldn’t carry the leopard back to camp. “And then a thought struck me that made me waste no time,” he told Popular Science. “That leopard has been eating the horrible diseased hyena I had killed. Any leopard bite is liable to give one blood poison, but this particular leopard’s mouth must have been exceptionally foul.”

He and the boy must have been quite the sight when they finally made it back to camp. His companions had heard the shots, and figured Akeley had either faced off with a lion or the natives; whatever the scenario, they figured Akeley would prevail or be defeated before they could get to him, so they kept on eating dinner. But when Akeley appeared, with “my clothes ... all ripped, my arm ... chewed into an unpleasant sight, [with] blood and dirt all over me,” he wrote in In Brightest Africa, “my appearance was quite sufficient to arrest attention.”

He demanded all the antiseptics the camp had to offer. After he'd been washed with cold water, “the antiseptic was pumped into every one of the innumerable tooth wounds until my arm was so full of the liquid that an injection in one drove it out of another,” he wrote. “During the process I nearly regretted that the leopard had not won.”

When that was done, Akeley was taken to his tent, and the dead leopard was brought in and laid out next to his cot. Her right hind leg was wounded—which, he surmised, had come from his first shot into the brush, and was what had thrown off her pounce—and she had a flesh wound in the back of her neck where his last shot had hit her, “from the shock of which she had instantly recovered.”

Not long after his close encounter with the leopard, the African expedition was cut short when its leader contracted malaria, and Akeley returned to Chicago. The whole experience, he wrote to a friend later, transported him back to a particular moment at the 1893 World’s Columbian Exposition, which he’d visited after creating taxidermy mounts for the event. “As I struggled to wrest my arm from the mouth of the leopard I recalled vividly a bronze at the World’s Columbian Exposition in Chicago, depicting the struggle between a man and bear, the man’s arm in the mouth of the bear,” he wrote. “I had stood in front of this bronze one afternoon with a doctor friend and we discussed the probable sensations of a man in this predicament, wondering whether or not the man would be sensible to the pain of the chewing and the rending of his flesh by the bear. I was thinking as the leopard tore at me that now I knew exactly what the sensations were, but that unfortunately I would not live to tell my doctor friend.”

In the moment, though, there had been no pain, “just the joy of a good fight,” Akeley wrote, “and I did live to tell my [doctor] friend all about it.”

Additional source: Kingdom Under Glass: A Tale of Obsession, Adventure, and One Man's Quest to Preserve the World's Great Animals

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