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.

Marshall McLuhan, the Man Who Predicted the Internet in 1962

Futurists of the 20th century were prone to some highly optimistic predictions. Theorists thought we might be extending our life spans to 150, working fewer hours, and operating private aircrafts from our homes. No one seemed to imagine we’d be communicating with smiley faces and poop emojis in place of words.

Marshall McLuhan didn’t call that either, but he did come closer than most to imagining our current technology-led environment. In 1962, the author and media theorist, predicted we’d have an internet.

That was the year McLuhan, a professor of English born in Edmonton, Canada on this day in 1911, wrote a book called The Gutenberg Galaxy. In it, he observed that human history could be partitioned into four distinct chapters: The acoustic age, the literary age, the print age, and the then-emerging electronic age. McLuhan believed this new frontier would be home to what he dubbed a “global village”—a space where technology spread information to anyone and everyone.

Computers, McLuhan said, “could enhance retrieval, obsolesce mass library organization,” and offer “speedily tailored data.”

McLuhan elaborated on the idea in his 1962 book, Understanding Media, writing:

"Since the inception of the telegraph and radio, the globe has contracted, spatially, into a single large village. Tribalism is our only resource since the electro-magnetic discovery. Moving from print to electronic media we have given up an eye for an ear."

But McLuhan didn’t concern himself solely with the advantages of a network. He cautioned that a surrender to “private manipulation” would limit the scope of our information based on what advertisers and others choose for users to see.

Marshall McLuhan died on December 31, 1980, several years before he was able to witness first-hand how his predictions were coming to fruition.

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Harris and Ewing, Library of Congress
14 Facts About Margaret Sanger
Harris and Ewing, Library of Congress
Harris and Ewing, Library of Congress

Born in 1879, activist Margaret Sanger sparked both revolution and controversy when she began pushing for legalized access to birth control and founded the Planned Parenthood Federation of America. Sanger remains a controversial figure even today, more than 50 years after her death.

1. SHE BLAMED HER FATHER FOR HER MOTHER'S DEATH.

Sanger was born Margaret Louise Higgins, the sixth of 11 children. Her mother, Anne Purcell Higgins, also had seven miscarriages, for a grand total of 18 pregnancies within 22 years. She suffered from poor health for much of that time, and when Anne died of tuberculosis at age 50, Margaret was just 19 years old. According to TIME Magazine, Margaret confronted her father at her mother's coffin and said, "You caused this. Mother is dead from having too many children."

2. SHE WANTED TO BE A DOCTOR.

Margaret Sanger sitting at a table.
Harris and Ewing, Library of Congress

Sadly, medical school was too expensive, so instead she entered a probationary nursing program in 1900. In early 1902, she met architect William Sanger. The two got married later that year and moved to Hastings-on-Hudson, New York, a suburb about 20 miles away from New York City. They had three children.

3. HER HOUSE CAUGHT FIRE, LEADING HER TO MOVE TO THE CITY.

After the Sangers' house in Hastings-on-Hudson caught fire, Sanger stopped enjoying life in the suburbs. By 1911 the couple had decided to start a new life in Greenwich Village, where Sanger joined the Women's Committee of the New York Socialist Party. There, she met fellow radicals and reformers—like novelist Upton Sinclair, anarchist Emma Goldman, art patron Mabel Dodge Luhan, and intellectual Max Eastman—who supported her ambitions to help working women.

In New York City, Sanger decided to jump back into her career by working as a visiting nurse in the Lower East Side tenements. She often treated women who attempted to give themselves abortions because they didn't have the money to care for another child. Dismayed by the poor health and poverty she saw among immigrants there, she developed opinions that would later lead to her advocacy for birth control.

4. SHE BELIEVED BIRTH CONTROL WAS A FREE SPEECH ISSUE.

Soon after arriving in Greenwich Village, Sanger began writing sex education columns for the New York Call, a socialist newspaper. Her frank discussion of women's sexuality and reproduction offended some readers. In 1913, politician and post office official Anthony Comstock censored her column because he considered her usage of words like syphilis and gonorrhea too vulgar.

A year after her column in the New York Call was banned, Sanger launched The Woman Rebel, an eight-page monthly newsletter advocating contraceptive use. Operating under the slogan "No gods, no masters," Sanger used the newsletter to openly defy Comstock's eponymous 1873 laws. (The Comstock laws made it illegal to use the United States Postal Service to send anything containing information about contraceptives or anything else deemed obscene.) She was indicted in August 1914, but she fled to Europe to avoid arrest. She would eventually return to the United States to face trial, but in February 1916 the prosecution dropped the charges.

5. SHE WAS AGAINST ABORTION.

Despite her advocacy for family limitation, Sanger disliked the idea of abortion. She believed proper education and legalized contraceptives would reduce the need for the procedure. In her 1938 autobiography, Sanger described her experience treating Sadie Sachs, one of the women in the East Side tenements. In 1912, Sachs's husband called for Sanger's help after he found Sachs unconscious from a self-induced abortion. After three weeks of treatment from both Sanger and a local doctor, the only advice the doctor could offer Sachs was to avoid "any more such capers" and have her husband sleep on the roof.

Three months later, Sachs became comatose from another self-induced abortion, and Sachs's husband again reached out to Sanger for help. The woman died within 10 minutes of Sanger's arrival. Frustrated by the lack of resources and information available to lower-class women, Sanger resolved to make changes. From that time forward, she wrote, she wanted to "do something to change the destiny of mothers whose miseries were as vast as the skies."

6. SHE POPULARIZED THE TERM BIRTH CONTROL.

Sanger is often credited for coining the term, but that honor actually goes to Robert Parker, a friend of hers who helped create The Woman Rebel. In her 1979 biography on Sanger, author Madeline Gray described Parker as a polio victim who studied yoga with the hopes of gaining more control over his partly paralyzed hand. Gray wrote:

"It occurred to him that control might apply to birth as well. 'Birth control,' he mused. 'Birth control … I think I like it.' They all liked it. As they put on their hats and left, they agreed that birth control was the best name for the movement."

Otto Bobsien, another of Sanger's colleagues, was the first to use the term to proclaim the start of the Birth Control League of America, a new organization he later said "never had more than a nominal existence." In 1915, when Sanger was away in Europe, Bobsien joined the National Birth Control League and offered the fledgling organization use of the movement's new name. When Sanger returned from Europe later that year, she helped popularize the term, considering it more straightforward than phrases like "family limitation."

7. SHE OPENED THE FIRST BIRTH CONTROL CLINIC IN THE U.S.

Historical image of Margaret Sanger standing on a street in New York City
Sanger outside of her trial on January 30, 1917.
Bain News Service, Library of Congress

In October 1916, Margaret Sanger opened a birth control clinic in Brooklyn with the help of her sister, Ethel Byrne, and interpreter Fania Mindell. It was the first of its kind in the U.S., and she modeled it after a Dutch clinic she had visited while evading American police. In the Netherlands, Sanger had learned about pessaries and diaphragms and became convinced they were more effective than the suppositories and douches she promoted in the United States. Sanger brought that new knowledge to her Brooklyn clinic, which served more than 100 women on its first day. For a cover charge of 10 cents, Sanger gave every woman a pamphlet of her New York Call column on "What Every Girl Should Know," a lecture on the female reproductive system, and instructions on several types of contraceptive use. The clinic closed just nine days later when Sanger was once again arrested for violating the Comstock laws. Sanger immediately attempted to reopen the clinic after being released on bail, but, as she wrote, she was promptly re-arrested and charged as a public nuisance.

8. SHE ONCE TOLD A JUDGE SHE COULDN'T RESPECT EXISTING LAWS.

Sanger and Byrne's court trials began in January 1917. Sanger's sister was tried first and sentenced to 30 days in a workhouse, but she immediately went on a hunger strike; Byrne fasted for a week before being force-fed by prison staff. When Sanger went to trial on January 29, she was supported in court by several Greenwich Village socialites and about 50 of the women she'd treated in the Brooklyn clinic. Presiding Justice John J. Freschi offered her a lenient sentence if she promised to obey the law, but Sanger responded by saying, "I cannot respect the law as it exists today." Sanger was found guilty and Freschi also sentenced her to 30 days in a prison workhouse.

In 1918, Sanger appealed the court decision and won a victory for the birth control movement. Although the court upheld Sanger's conviction and she still had to serve her 30 day sentence, Judge Frederick E. Crane of the New York Court of Appeals also ruled that doctors could prescribe contraceptives and disseminate information about birth control under certain conditions. Sanger ran with the new loophole in 1923, when she established a new clinic staffed largely by female doctors. The new clinic operated alongside the American Birth Control League. Almost two decades later, in 1939, the league and the clinic merged, forming the Birth Control Federation of America, and in 1942 this new organization officially became known as the Planned Parenthood Federation of America.

9. THE ROCKEFELLERS ANONYMOUSLY SUPPORTED HER CAUSE.

In the mid-1920s, John D. Rockefeller Jr. anonymously donated $10,000 to the American Birth Control League to fund research into contraceptives. Rockefeller's son, John D. Rockefeller III, continued his father's early support of Sanger's work, albeit more publicly. The Rockefeller Brothers Fund donated money to Planned Parenthood until 1981, when it decided to start funding agricultural research—which was decidedly less controversial—instead.

10. LIKE MANY WELL-KNOWN INTELLECTUALS OF HER DAY, SANGER SUPPORTED EUGENICS.

Many historians believe Sanger's support of eugenics was part strategic and part ideological. Sir Francis Galton, a cousin of Charles Darwin's, initiated the Western eugenics movement by suggesting that traits like "talent and character" could be passed down to children through intentional breeding. Several British and American academics latched onto the idea, including figures like Theodore Roosevelt, John D. Rockefeller Jr., and Alexander Graham Bell. Sanger's support for sterilizing the diseased and "feebleminded" legitimized the birth control movement by aligning her ideas with those of contemporary intellectuals.

Sanger's belief in eugenics was a little different from other intellectuals', though. Eugenicists, she said, believed a woman's first duty should be to the state, and that all "fit" women should bear children. Sanger, on the other hand, thought a woman's first duty should be to herself. She contended the primary reason for birth control was to prevent pregnancies among women who couldn't support a child financially. Sanger believed her ideal of economic eugenics was morally superior to the views posed by traditional eugenicists.

The modern-day Planned Parenthood doesn’t hide Sanger's controversial support of the eugenics movement, but it doesn't endorse it, either. In a document published in 2016 [PDF], the organization said, "We believe that [those ideas] are wrong. Furthermore, we hope that this acknowledgement fosters an open conversation on racism and ableism—both inside and out of our organization."

11. HER BOOKS WERE AMONG THE FIRST BURNED BY NAZIS.

In May 1933, Nazis sanctioned the burning of more than 25,000 books deemed "un-German." Sanger had published at least nine books by that point, and they were all among that number, as were titles by Jack London, Ernest Hemingway, Sigmund Freud, Albert Einstein, and dozens of others. Sanger's books, which advocated for women's choice in everything from childbirth to politics, directly contradicted everything the Third Reich believed. Adolf Hitler supported traditional gender roles and wanted to maintain high birth rates, ideas Sanger decried in her books.

12. HER NIECE WAS PART OF THE INSPIRATION FOR WONDER WOMAN.

A panel of a Wonder Woman comic from 1978.
Tom Simpson, Flickr // CC BY-NC-ND 2.0

Olive Byrne, Sanger's niece, was involved in a polyamorous relationship with Wonder Woman creator William Moulton Marston and his wife, Elizabeth Holloway Marston. Marston credited both Olive and Elizabeth as his muses, according to historian Jill Lepore. In her 2014 book The Secret History of Wonder Woman, Lepore wrote that Marston based part of Wonder Woman's costume on the silver bracelets Olive often wore. Lepore also suggested Sanger herself may have been an influence on the popular comic book character. Feminist movements in the early 1900s often symbolized female oppression with chains, and Sanger was quick to adopt such symbolism with books like Motherhood in Bondage. Wonder Woman's use of chains and ropes as weapons echoed Sanger's vision for female liberation.

13. SHE WAS NOMINATED FOR THE NOBEL PEACE PRIZE 31 TIMES.

Margaret Sanger received 31 nominations for the Nobel Peace Prize between 1953 and 1963. In 1960 alone, she received 20 nominations from 16 university professors and four members of India's parliament (Sanger took several trips to India, where she worked with people like Gandhi to discuss birth control).

14. SHE LIVED JUST LONG ENOUGH TO SEE HER LIFE'S WORK COME TO FRUITION.

Planned Parenthood's publicity director looks over a poster in 1967.
H. William Tetlow, Fox Photos/Getty Images

Two important legal milestones happened after Sanger founded the American Birth Control League in 1921. In December 1936, the 2nd U.S. Circuit Court of Appeals effectively overturned all federal restrictions on birth control, making it legal for doctors throughout the United States to provide access to contraception. On the state level, contraception was legal in some form or another everywhere except Connecticut, Mississippi, and Massachusetts. In 1965, Griswold v. Connecticut overturned the state laws preventing married women from accessing birth control. Griswold v. Connecticut later served as precedent for cases like Eisenstadt v. Baird (1972), which gave unmarried couples unrestricted access to contraception; Roe v. Wade (1973), which legalized abortion; and Carey v. Population Services International (1977), which made it legal for doctors and pharmacists to distribute contraceptives to minors.

Sanger died on September 6, 1966, about a year after the Supreme Court decided on Griswold v. Connecticut. The next day, Alaska Senator Ernest Gruening spoke about Sanger in Congress. In an address to the president, Gruening said Sanger was "a great woman, a courageous and indomitable person who lived to see one of the most remarkable revolutions of modern times—a revolution which her torch kindled."

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