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Maternal Mortality and “The Mother’s Legacy to Her Unborn Child”

Content Warning: Childbirth pain and death

Giving birth in early modern Europe was a dangerous rite of passage, one which most women would go through, and some would not survive. Women were largely defined by their domestic roles as wives and mothers: going through childbirth often changed a woman’s social status, as matrons were usually more respected, in no doubt thanks to their lived experiences giving birth and caring for their families. Yet many women feared childbirth. Besides the promise of pain, the possibility of either or both mother and baby not surviving could be daunting, which made some expectant mothers write to their unborn children, in case they were never able to meet them.

The Social and Spiritual Complexities of Childbirth in Early Modern Europe

Those about to give birth would pray to be able to endure the suffering of childbirth and its unavoidable pain. According to the Bible, as daughters of Eve, all women were cursed with pain, to atone for the original sin:

‘I will greatly multiply your pain in childbirth; In pain, you will bring forth children’.
Genesis 3:16
Adam and Eve, by Lucas Cranach the Elder (1526). (Wikimedia Commons)
Adam and Eve, by Lucas Cranach the Elder (1526). (Wikimedia Commons)

So, childbirth pain was more than natural and physiological: it was God-given. And, although midwives knew many ways of speeding the delivery and alleviating pain, many women would pray to be able to endure it and survive the birth. Elizabeth, Countess of Bridgewater (d. 1666), wrote down the prayer she would utter as her time approached:

‘Lord Jesus since thou art pleased my time is come, to bring forth this my babe, thou hast made in me, give me a heart full of all truth and obedience to thee and that I make take this height of pain patiently, without grudging at thy holy will and pleasure […] O Lord hear, O Lord forgive, and suffer me not to accompany my sins in the deep, but part us, and make me become a new creature, and if it be by thy will, O God, that I should be no more in this world, Christ raise me to life everlasting in the true belief of thee, who art my only saviour: Amen.’
The Nativity of the Virgin, by the Circle of Lucas Cranach the Elder (Kronach 1472 - Weimar 1553). (Wikimedia Commons)
The Nativity of the Virgin, by the Circle of Lucas Cranach the Elder (Kronach 1472 – Weimar 1553). (Wikimedia Commons)

Elizabeth asked for the strength to face the expected pain, but, knowing how perilous the journey was, she also asked to survive. For those interested in history, it is easy to find many examples of women dying in childbirth. Just think of Henry VIII’s wives: two of the six died following difficult deliveries, Jane Seymour and Catherine Parr, who by then was married to Thomas Seymour. Yet these famous cases might give us an inaccurate picture of early modern childbed deaths. Most women survived childbirth with few complications and recovered well.

Famously, in the 1612 Child-Birth, or The Happy Deliverie of Women, Jacques Guillemeau wrote how of a thousand births, ‘there is scarce one found that is amiss’. That number was probably closer to 1% in Elizabethan and Jacobean England, but still, dying in childbirth was not as common as we tend to believe. (You can also watch a video in which I talk about statistics here.) However, that did not mean that women did not fear the perils of childbirth.

Jacques Guillemeau's midwifery manual (1635). (Google Books)
Jacques Guillemeau’s midwifery manual (1635). (Google Books)

Maternal Letters and Prayers: A Legacy for the Unborn Child

It was not uncommon for expectant mothers to write wills as their time approached, as well as letters to their unborn children, in case they survived, and the mothers did not. That is exactly what happened to another Elizabeth, a Jacobean gentlewoman called Elizabeth Joceline (1595–1622), who died at 26 years old, nine days after giving birth to a daughter. The text she wrote before the delivery was published posthumously and called The Mothers Legacie to her Unborn Child. And it’s just heartbreaking.

Elizabeth wrote of her happiness at being pregnant; the book is joyful and full of advice for her unborn child. Elizabeth was clearly determined to be the best mother she could be. So, she advised the child to pray often, respect sacred days, be charitable, and avoid temptation. She was very much a woman of her time, and so, she also issued specific advice depending on gender: girls should be raised to be obedient and, eventually, good mothers – presumably, just like she had been. It was not necessary for them to learn much else, although that could be valuable – if they were virtuous:

‘I desire her bringing up may bee learning the Bible, as my sisters doe, good housewifery, writing, and good works: other learning a woman needs not; though I admire it in those whom God hath blest with descretion, yet I desired not much in my owne, having seene that sometimes women have greater portions of learning than wisdom […] But where learning and wisdom meet in a vertuous disposed woman she is the fittest closet for all goodnesse. She is like a well-balanced ship that may beare all her saile. […] I pray God give her a wise and religious heart, that she may use it to his glory, thy comfort, and her own salvation.”
An 18th-century reprint of The Mother's Legacy. (Public Domain)
An 18th-century reprint of The Mother’s Legacy. (Public Domain)

Elizabeth goes on to say that, if the baby is a girl, her daughter might think that Elizabeth had died in vain delivering her, highlighting the usual preference in families for sons. Yet that was not the case:

‘…thou shalt see my love and care of thee [a girl] and thy salvation is as great, as if thou wert a sonne, and my feare greater”.

As a woman, Elizabeth understood what awaited her unborn daughter; she was full of empathy for her future daughter. The Mother’s Legacy allows us a glimpse into the intimate life and thoughts of an early modern mother-to-be. It is perhaps the best example of how conscious early modern women were of the perils of childbirth and how, despite that, many of them were able to feel joyful and hopeful.

Self-Portrait with Her Daughter Julie (1789), by Elisabeth Louise Vigée Le Brun. (Wikimedia Commons)
Self-Portrait with Her Daughter Julie (1789), by Elisabeth Louise Vigée Le Brun. (Wikimedia Commons)

This book was reprinted multiple times, well into the 19th century, and read by countless women. Once more, just like the Countess of Bridgewater’s private prayer, this text delineated a model of fortitude based on faith for all expectant mothers. Fulfilling the role expected of her by a patriarchal and Christian society, even after death, Elizabeth was an ideal early modern mother: she thought of her child and family above all else. It is particularly hard not to feel emotional when reading her advice to her husband about how to select a nurse to breastfeed their child in case Elizabeth died, especially because we know he needed to do so, just over a week after the birth.

References:

Jacques Guillemeau, Child-Birth, or The Happy Deliverie of Women (London, 1612).

Elizabeth Joceline, Mothers Legacie, to her Unborne Childe (London, 1624).

Further Reading:

David Cressy, Birth, Marriage & Death: Ritual, Religion, and the Life-Cycle in Tudor and Stuart England (Oxford, 1999).

Roger Schofield, ‘Did the Mothers Really Die? Three Centuries of Maternal Mortality in ”The World We Have Lost”’, in The World We Have Gained: Histories of Population and Social Structure, edited by L. Bonfield, R. Smith, and K. Wrightson (Oxford, 1986), pp. 231-60.

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Motherhood and Wet Nurses: Breastfeeding in Early Modern Times

Louis XIV and his wet nurse by Charles Beaubrun, Palace of Versailles (late 17th century). (Public Domain)
Louis XIV and his wet nurse by Charles Beaubrun, Palace of Versailles (late 17th century). (Public Domain)

If you were living in early modern England (say in the 17th century), there were so many things to consider after you had a baby. But one of the main decisions had to do with breastfeeding: should the mother feed the child herself, or should a wet nurse be hired? (A wet nurse was someone whose job was to care for and breastfeed the baby.) If you chose the latter, how would you choose a wet nurse? Luckily, there was no lack of advice available. Midwifery manuals, recipe books, and domestic guides offered plenty of information, as did sermons at church and conversations with friends and family.

One of the main issues discussed had to do with the controversy over wet nurses. What defined a ‘good’ mother? What role should women have in society? Wet nurses exemplified a commodification of the reproductive body and were viewed with suspicion – yet wet nursing was arguably one of the most common occupations for women at the time.

Detail of a 17th-century painting by Lucas Cranach in Larvik Church, Norway. (Wikimedia Commons)
Detail of a 17th-century painting by Lucas Cranach in Larvik Church, Norway. (Wikimedia Commons)

So, how was breastfeeding understood from a medical point of view? And I don’t mean the use of breast milk as a remedy, which you can read about here. (I also wrote on this subject as a guest blogger on the Recipes Project – you can read the post here.) Well, according to the humoral theory, women stopped menstruating when they got pregnant because the blood was used to nourish the foetus. After birth, it travelled upwards in the body and, through heat, was transformed into milk, to continue its role of feeding the baby. That was why nursing women did not menstruate. Additionally, breastfeeding was usually considered incompatible with sexual activity, as sex might stimulate menstruation and, therefore, dry the milk. The same was true for aphrodisiacs such as celery. Since ancient times, nursing had been used as a contraceptive – and we know today that exclusive breastfeeding can delay the return of fertility, although it varies from one person to another.

That posed the first problem for someone who just had a child in early modern England. If you breastfed the baby, that would probably mean you wouldn’t get pregnant straight away. If you were someone who didn’t want to, such as a peasant wife with plenty of children already, great. But what if you were a queen, and your main job was to produce heirs? For instance, Anne Boleyn is said to have wanted to breastfeed her daughter Elizabeth herself, but because of the pressure to have a son, was not allowed to. Wet nurses were just a fact of life, a fixture of wealthy households and an integral part of society. Royal wet nurses were well paid and enjoyed a comfortable life as well as the prestige of nourishing and caring for royal children.

Louis XIV and his wet nurse by Charles Beaubrun, Palace of Versailles (late 17th century). (Public Domain)
Louis XIV and his wet nurse by Charles Beaubrun, Palace of Versailles (late 17th century). (Public Domain)

So, for those who couldn’t or didn’t wish to breastfeed, wet nurses were the best option. (Both animal milk and pap, a mixture using bread, were a less-than-ideal alternative, unsuitable to very young babies.) Wet nursing was one of the most significant female occupations in this period, and one of the most common ways for women to earn money. Many of them would be employed privately by families, but some worked for hospitals (such as the London Foundling Hospital) or were employed by parishes to take care of abandoned children. For families with means, the choice of a wet nurse was a very important matter.

But why was that? As Thomas Raynalde wrote, the ‘affections and qualities [of the wet nurse] passeth forth through the milke into the child, making the child of like condition and manners’. Breast milk had the potential to shape babies, to make them more similar (and emotionally attached to nurses) than to their biological families. In Shakespeare’s The Winter’s Tale, Leontes is glad his wife Hermione (whom he believes to be wicked and adulterous) did not nurse their son, thereby contaminating him. (You can read more about it here.) Breast milk was often used in Elizabethan plays as a metaphor for purity/contamination, but also for influence and transformation, such as in Lady Macbeth’s invocation for her milk to be exchanged for gall.

Suckling Mother and Maid by Pieter de Hooch, c.1670. (Wikimedia Commons)
Suckling Mother and Maid by Pieter de Hooch, c.1670. (Wikimedia Commons)

The 16th and 17th centuries were a paradoxical time in England: medical and moral discourse grew increasingly anti-wet nurses, urging women to breastfeed their own children. Yet the number of wet nurses hired by aristocratic families grew. For centuries, wet nurses had been eyed with suspicion, but it was the Reformation that inspired a surge of Protestant writings condemning them and advocating for mothers to nurse their babies. There were two main arguments against wet nurses. The first was medical: milk was the primary agent of heredity, it was what shaped children into the adults they would become, from their health to temperament and physical form. The mother’s body became ‘porous’ through breastfeeding, with the sharing of fluids between mother and infant helping to attain humoral balance and, therefore, health. Medical writers also highlighted the importance of breastfeeding for the mother-child bond, and as the basis for maternal and filial love.

The second argument against wet nurses was less medical and more moral. The nurse’s character was intimately connected to the quality of her milk. The ‘wrong’ nurse could do more damage than good to her charge, through breastfeeding. Protestant writers often described wet nurses as ‘drunkards’, ‘sluts’, or ‘gossips’, corrupted from the inside. Babies could become morally as well as physically degraded by ‘bad milk’, but they were also at risk of neglect, as it was widely believed that only mothers could ‘truly love’ their babies.

Madonna Lactans by Artemisia Gentileschi (1613), at the Galleria Spada in Rome. (Wikimedia Commons)
Madonna Lactans by Artemisia Gentileschi (1613), at the Galleria Spada in Rome. (Wikimedia Commons)

Motherhood and breastfeeding are fascinating topics – I’ve only scratched the surface of this subject in this text. Breastfeeding had long been idealised and associated with the sacred, as we can see in the many depictions of the Virgin Mary nursing Jesus. It was undeniably intertwined with sex and sin, but it was also the mark of a true Christian mother. With the Reformation, breastfeeding gradually changed from a ‘sacred’ duty to a ‘natural’ one, which implied a misogynistic perception of wet nurses as potentially diabolic and ‘unnatural’, a deviant version of motherhood.  Wet nurses could disrupt the social order, by corrupting children and occupying a bigger role within the family than they ought to. Still, for wealthy women who mostly didn’t breastfeed their own children, they were a necessity, even if potentially dangerous.

References:

Jacques Guillemeau, The Happy Delivery of Women (London, 1612).

Henry Newcome, The Compleat Mother: Or An Earnest Perswasive to all Mothers (especially those of Rank and Quality) to Nurse their own Children (London, 1695).

Ambroise Paré, Works (London, 1634).

Thomas Raynalde, The Birth of Mankinde (London, 1598).

Jane Sharp, The Midwives Book (London, 1671).

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‘Unnatural Mothers’: The Surprising History of Abandoned Children

CONTENT WARNING

Discussion of Violence against Children.

When I was around four years old, I was terrified of the tale of Hansel and Gretel. How could a mother just abandon her children in the woods, even if the family had nothing to eat? Somehow that seemed even worse than the fact that a grandmotherly figure would trap those same children and try to eat them. It’s probably telling that I never thought much about the father in the story. In the Brothers Grimm version, he protests at the idea of leaving the children: yet the mother does it anyway. In any case, in a patriarchal society in which mothers are constructed as loving and caring, her abandoning the children was much more shocking.

Hansel and Gretel are welcomed into the witch’s hut, by Arthur Rackham (1909). Credit: Wikimedia Commons
Hansel and Gretel are welcomed into the witch’s hut, by Arthur Rackham (1909). Credit: Wikimedia Commons.

Two decades later, I came across Elena Ferrante’s L’amore molesto (Troubling Love) when I was studying Italian. I was struck by the visceral, ambivalent, deeply felt story of the relationship between a mother and her daughter. Ferrante would go on to publish several other novels, including the famous series My Brilliant Friend, in which she continued to investigate motherhood, in all its beauty and ugliness. Again, I was equally disturbed and enthralled by these ‘unnatural’ mothers who had such complicated feelings towards their children.

In my research, I found several stories of ‘wicked’ mothers, who killed or abandoned their children. I will write more abound infanticide another time, as it is a fascinating topic in its own right. (You can read a little bit about its connection to midwives here and in artistic representations here.)  And don’t even get me started on stepmothers! For now, though, I’d like to think about early modern mothers who chose to abandon their children, as I find their ambivalence intriguing. Fairy tales such as Hansel and Gretel are a good starting point. As the story tells us, it was out of necessity that the children were abandoned: the parents could not afford to feed them.

‘Unnatural motherhood’: Olivia Colman in the adaptation on Ferrante’s The Lost Daughter (2021). Credit: Netflix.
‘Unnatural motherhood’: Olivia Colman in the adaptation on Ferrante’s The Lost Daughter (2021). Credit: Netflix.

This is an interesting clue about the socio-economic reasons behind this abandonment. Historians have long argued that in premodern times, having children out of wedlock was a cause of deep shame, that would earn women humiliation and contempt. So, if you were an unmarried woman who fell pregnant, you might want to hide the pregnancy, give birth in secret, and abandon the baby as soon as possible. Or so the story goes. This is a valid and reasonable hypothesis, and I believe it explains the situation in which many people found themselves. Yet it is not the only nor, I would argue, the most prevalent reason why children were abandoned.

Let’s go back to Hansel and Gretel, as we all know the story. Their age is never specified, but I would assume they were between four and six years old. The same goes for Little Thumbling and other similar tales: these were not babies. They were not left because the mother wanted to hide their existence. While fairy tales offer plenty of symbolical and psychological explanations (which were later developed by wonderful novelists such as Ferrante), they are also full of real-life concerns. A literal reading of fairy tales can be useful. Children were abandoned because there was not enough bread to feed them. It is not surprising that the number of foundlings increased when economic conditions were dire, when the prices increased (such as the cost of bread), and when winter was particularly long and difficult. Going back to the children’s age, although there were many infants among them, most foundlings were older babies, not newborns. This disproves the idea of secret births out of wedlock being the rule. As I have recently written, newly delivered mothers tended to have a lying-in period of at least a month, during which they did not leave the house, making the abandonment of children difficult. 

A ‘foundling wheel’ through which babies could be left at the Ospedale di Santo Spirito, in Rome. Credit: Wikimedia Commons.
A ‘foundling wheel’ through which babies could be left at the Ospedale di Santo Spirito, in Rome. Credit: Wikimedia Commons.

When parents decided to abandon their children, be that because of the child’s illegitimate status or the family’s poverty, where did they leave them? Again, Hansel and Gretel comes to mind, along with many other stories. Surely their parents didn’t intend for them to be found and cared for in the middle of the woods? It sounds more like they were not to be found. Children (and especially babies) left in the woods or other inhospitable places such as privies or the street were the exception: these were likely attempts at infanticide. If you needed to abandon your child and wished for someone to find and take care of them, there were many better places to choose. Archival documents attest to their being found in churches, hospitals, in front of aristocratic houses, and next to convents: places where they were likely to be quickly discovered and taken care of. Many of these children were clean, healthy, and well-dressed, often accompanied by notes stating their names and whether they had been baptised or not.

If we think of London between the 16th and 18th centuries, the population was rapidly growing. It is estimated that around one thousand abandoned children were found in the city every year. Parishes had their own networks of nurses and foster mothers who could take care of children, but often that was not enough. The foundation of the aptly named Foundling Hospital in London in 1739 (and the several others that followed it) indicates the increase in abandoned children, and how authorities sought to deal with the situation. These children are often easy to find in the archives since many were named according to the parishes where they were found and later baptised. Babies left at Temple Church, for instance, usually had ‘Temple’ as a surname. (It makes you wonder about the adorable Shirley Temple’s family origins, doesn’t it?)

Still, the problem of abandoned children persisted. If we exclude the issue of illegitimate children, there were many socio-economic reasons why people could choose to abandon their children. Extreme poverty, as in Hansel and Gretel’s case, was one of them. But premodern mothers could be unexpectedly faced with difficult circumstances. Widowhood during or right after pregnancy (or when the husband simply left) could make a woman unable to care for her child. In a time in which few legal provisions existed to help these women, what options were there? Yet, if a foundling’s mother was discovered, it was likely that she would face punishment (anything from the pillory to imprisonment). 

An early print of the Foundling Hospital in London Credit: Wikimedia Commons.
An early print of the Foundling Hospital in London Credit: Wikimedia Commons.

Historians are usually quick to say that things are a little bit more complicated than people might think. We also love to say that, actually, this isn’t something new… and then we embark on long monologues. Children were (and are) abandoned by their parents for multiple reasons, including societal pressures such as a woman’s marital state, or deeply psychological and individual reasons. Yet we might miss the forest for the trees when we focus too much on individual mothers. If Hansel and Gretel’s parents had plenty of food for everyone, would they still have left the children alone in the woods? I wonder. If modern motherhood wasn’t so all-encompassing and consuming, would women such as Elena Ferrante’s protagonists struggle so much? I wonder about that, too.

Hansel and Gretel embody many of our societal and individual fears, not least that the people we assume will take care of us might abandon us to our own luck. Yet they also suggest that systemic, socio-economic problems might be behind unimaginably difficult choices such as abandoning a child. Who knows, maybe many of these ‘unnatural mothers’ in our past were simply people who couldn’t find an alternative, who couldn’t afford to feed their children. Maybe we should be sympathetic to those who leave their children in the woods – who knows what they might be trying to save them from?

References:

Patricia Crawford and Sara Mendelson, Women in Early Modern England (Oxford: Oxford University Press, 1998).

Valerie Fildes (ed.), Women as Mothers in Pre-Industrial England (London: Routledge, 2013).

Ralph Houlbrooke, The English Family, 1450–1700 (London: Longman, 1984).

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