The increasing professionalization of medicine meant that experienced midwives were being squeezed out of middle-class childbirth. Doctors liked attending childbirths – they saw it as a good way for a young practitioner to forge a bond with a newly set up family which, with luck, would continue for the rest of the family’s lifespan. For this reason they fought the possibility of midwives being formally qualified.*50 Even if half to three-quarters of all births were still attended by midwives, that would mean that by the end of the century as many as three-quarters of a million women a year were being attended by a doctor – possibly the bulk of the middle classes.
Another reason to have a doctor was the increasing use of chloroform. It had been administered safely as early as 1847; in 1857 it gained wide recognition when Queen Victoria was given it during childbirth. Yet the drug still had to be defended repeatedly: it was not generally accepted until the late 1870s – the delay being caused not by women, who were clamouring for it, but by doctors, who were deeply resistant.51 It was not so much the danger – medicine had not reached a stage where practitioners expected to save every patient – as the immorality of the drug: did not Genesis 3:16 remind women everywhere that, for Eve’s sin, ‘in sorrow thou shalt bring forth children’? Dr Charles Meigs, two years after chloroform was first administered successfully, spoke for many in his profession: ‘To be insensible from whisky, gin, and brandy, and wine, and beer, and ether and chloroform, is to be what in the world is called Dead-drunk. No reasoning – no argumentation is strong enough to point out the 9th part of a hair’s discrimination between them.’52 Not all felt this way. Both Charles Darwin and his friend, the botanist Joseph Hooker were, in the old-fashioned manner, present when their wives gave birth but – new style – they administered the chloroform themselves.
Despite this divergence on medical treatment, both women and doctors agreed in regarding childbirth as an illness. Mrs Panton called it a ‘plight’, and warned that ‘Naturally these times are looked forward to with dread by all young wives.’53 The lower middle classes, and a substantial swath of the more prosperous, did not have the servants to permit them to lie in bed for weeks (or even days). And it was they – overburdened with heavy housework which they performed themselves, and with the care, feeding, clothing and education of children – who would probably have benefited from time in bed. Some were forced to remain in bed, whether or not they had servants: Emily Gosse was unable to leave her room for six weeks.54
Prosperous middle-class women, on the other hand, were expected to stay in bed after the birth for at least nine days; those who got up earlier did so, it was supposed, not because they felt well enough, but out of ‘bravado’, and they were considered to be acting foolishly, because ‘the strength and health of the mother’s whole life depend upon judicious treatment at such a critical time’.55 Louise Creighton, an upper-middle-class woman married to an Oxford fellow,* accepted this fully. She gave birth to her second child in 1874, and a month later a close friend who had also just had a child came to visit. ‘We spent the afternoon happily together wondering which was the most fit to get up & ring the bell when we needed anything.’56 Ursula Bloom noted that, in her upper-middle-class family, after giving birth the women were kept flat on their backs and fed with a feeding cup, a china cup with a partial covering and a spout, through which the recumbent patient could drink. The windows remained closed, and small sandbags were laid along the edges of the frames to keep out any draughts. A lamp was left burning all night, and the monthly nurse slept on a sofa in the room. This lying-in lasted a month, and was then followed by churching, which no men attended (and seems to have been relatively uncommon – Bloom came from a clergy family).57 The woman was usually faint and weak at the end of the month: without any fresh air or exercise, and with only an invalid diet, all the while breastfeeding, it was to be expected.
Serious illness always lurked. Although women had a slightly longer life expectancy than men throughout the period, all joined in regarding them as the frailer vessel. The most dangerous time was childbirth: childbed fever (or puerperal fever, now simply septicaemia) was the most common cause of death in childbirth. From 1847 to 1876, 5 women per 1000 live births died, with puerperal fever causing between a third and a half of these deaths. There was no cure available: doctors merely prescribed opium, champagne, and brandy-and-soda, trying to ease the passing, rather than making a vain attempt to cure a mortal illness.58
In Vienna in 1795 Ignaz Semmelweis had radically cut the number of deaths from septic poisoning among his patients by insisting that anyone who entered his wards first scrubbed with chloride of lime. A paper on the subject, noting his results, was read before the Royal Medical and Chirurgical Society in 1848,59 but general acceptance was extremely slow: after the Female Medical Society in 1865 warned doctors against coming from dissecting rooms straight to childbed. The Lancet dismissed their suggestion as ‘all erroneous’.60 Instead, doctors insisted that ‘mental emotion’ and overexcitement were what caused death – women suffered in childbirth because they led ‘unnatural lives’, and therefore they were entirely responsible for their failure to thrive.61 Many women colluded with this attitude: Mrs Warren’s imaginary narrator was ill after the birth of her child because, according to her monthly nurse, she ‘shouldn’t have eaten all sorts of fanciful trash, but kept yourself to pure wholesome food, for a depraved appetite soon comes’.62 The ideas behind this comment were sound enough, but the ‘depravity’ of the mother’s thoughtlessness added the requisite moral as well as a physical dimension to women’s illness.
With childbirth being regularly repeated, one can see the women’s insistence on their weakness as making a certain amount of sense, even if it was not always phrased in ways that today we feel an immediate bond with. Mrs Panton was vehement that the mother ‘should be the first object of every one’s care until she has been for at least a fortnight over her trouble, and I trace a good deal of my own nervous irritability and ill-health to the fact that after my last baby arrived I had an enormous quantity of small worries that the presence in the house of a careful guard would have obviated’. The monthly nurse, she went on, should be ‘a dragon of watchfulness’ who keeps ‘away all those small bothers which men can never refrain from bringing to their wives, regardless that at such times the smallest worry becomes gigantic’. It was essential that, ‘if at no other time can we obtain consideration and thought, it is imperative that for at least three weeks after the arrival of a baby the wife should have mental as well as bodily rest, and that she should be absolutely shielded from all domestic cares and worries’. The querulous tone was unattractive, but when she pointed out that, by the time a woman had had her fifth or sixth child, her husband might have become so used to the event that he would ‘so depress and harass his wife by his depression that she may slip out of his fingers altogether’, one does feel for the overburdened woman.63
There was not much escape, either. Mrs Beeton was firm that babies should not sleep with either their nurse or their mother: ‘The amount of oxygen required by an