Conclusion

At the very heart of this book is a deceptively simple question: what was it like to give birth in eighteenth-century England? The answer remains somewhat elusive. My own age and stage of the life cycle has meant that, while researching the birthing experiences of women 200 years ago, I have given birth myself and have also heard about the birthing experiences of friends, neighbours and colleagues. Those experiences range dramatically in their descriptions, neatly encapsulating the challenge of answering this research question. I have participated in the social rituals that surround modern birth. I have been present at baby showers and the newer trend of gender-reveal parties, as well as at christenings and baby-naming ceremonies. I have been part of visiting and gifting traditions, arriving in the days or weeks after a birth clutching gifts of cake and food or toys for older children. I have also participated in older rituals and practices that are recognizable as echoes of the ones discussed in this book. More than once, pensioners in the supermarket or in the street have given me a pound to ‘cross the baby’s palm’. Cards and gifts were delivered by people I had barely ever spoken to but who had watched my increasing size, followed by the line of freshly washed Babygros drying in the sunshine outside my house.

Birth, it would appear, still creates its own communities and social groups. It is these recognizable elements of birthing that makes it such an intriguing topic of historical study. Delivering an infant demands more movement, more effort and more prolonged physical sensation than any other bodily function. As the American midwife Ina May Gaskin, founder of the Farm Midwifery Centre, writes in her Guide to Childbirth, the impact of birthing on women’s lives means that ‘your experience will impact your emotions, your mind, your body, and your spirit for the rest of your life’.1 There is a temptation, then, to assume that contemporary women share the physical experience of birthing with those who gave birth in 1750. It is no coincidence that conferences about the history of birth and midwifery are one of the few academic arenas in which delegates share their personal experiences of their topic, alongside those of their historical subjects. Yet, as scholars, we are aware that this sense of shared experience is illusory. We know that to ‘feel’ is to recognize a sensation in relation to corporeal maps that we have assembled from biological and cultural data that we have been gathering since our own birth.2 The way that sensation is experienced and described is, therefore, dependent on the situation in which we find ourselves, the cultural context in which we have been raised and our own previous experiences. We describe our experiences of birthing in different ways, depending on the person who is listening to our description. The same birth can therefore generate multiple accounts by and for different individuals.

The nature of historical study means that I have relied on many different sources to try to understand the social history of birthing. Where possible, I have placed women’s voices at the centre of my research but this has not always been feasible. Their voices are therefore supplemented by those of their husbands, their neighbours, parish officials and medical practitioners. I have tried to maintain a focus on women’s bodies not as vehicles for the delivery of an infant but as central agents in eighteenth-century experiences of birthing. The birthing body did not just shape women’s experiences of childbirth; it also shaped the rituals and practices of giving birth. By foregrounding women’s bodies and embodied experiences, we can see that birthing in eighteenth-century England was a process lasting between four and six weeks, which consisted of a number of flexible and overlapping stages, dictated by the birthing body. Each stage had its own dangers to be navigated while also being informed by practices and procedures that might mitigate them. The adaptability of these stages allowed the process of birthing to take account of the physical and emotional strength of the new mother and her infant. The same flexibility that allowed the process of birthing in the eighteenth century to take account of physiological and emotional difference also allowed it to absorb social change and the rise of obstetric medicine while still retaining familiar, domestic practices. Indeed, as a framework, the process of birthing was so efficient at managing difference that its phases and rhythms were observed at all levels of society.

This book focuses on a point in history at which understandings of the body, and accordingly of how to treat it, were in transition. By focusing on the birthing body during this period of changing bodily conceptions, this book problematizes the Enlightenment project of professionalization and medicalization. The rise of the accoucheur and what Barbara Duden has called ‘a new body’, characterized by structure and anatomy, certainly changed the way in which the birthing body was written about and how reproductive disorders might be treated.3 But my research has shown that accoucheurs and their new knowledge did not displace midwives even in the birthing chambers of elite women. Midwives remained a consistent and authoritative presence in birthing chambers throughout the eighteenth century, whose haptic knowledge of birthing held its value even as some accoucheurs sought to discredit it. As is evident from the persistence of humoral ways of thinking about the body, the transfer from older to new forms of knowledge was messy and incomplete. The coexistence of these forms in the birthing chamber continued far beyond the end of the eighteenth century. Midwives continued to be present at births even where an accoucheur or obstetrician had been retained. A century later, as politicians debated the terms of the various Midwives Bills presented to them between 1893 and 1902, the General Medical Council noted that women wanted to employ midwives who were embedded in their local communities.4 Central licensing would not work, it was suggested, as women would not trust the recommendations of medics whom they did not know personally. The story of ‘the struggle for the control of childbirth’, as described by Jean Donnison in 1988, was more about coexistence and hierarchy than about displacement.5 In the birthing chambers of eighteenth-century England, continuity and change coexisted.

Space and place are two important themes in this book’s history of birthing. The interaction between the birthing body and the affective environment of the birthing chamber, the disruption and reorganization of domestic space, and the interplay between the household and the neighbourhood all shaped birthing practices and experiences. The birthing chamber was an affective space, and therefore had the ability to shape experience and memory. It had intimate links to domestic space, having been carved from it, and so already carried affective associations that might be further heightened by birthing. The material disruption of the household through the redistribution of domestic space was mirrored by the redistribution of domestic labour. Childcare, cooking and feeding, and cleaning all had to be outsourced until the birthing woman felt well enough to resume her domestic duties. Nor did birthing disrupt only the household in which the infant was anticipated. In the eighteenth century it drew in women from other households – mothers, sisters, friends and neighbours – sometimes for quite considerable periods of time. Birthing thus offers us a glimpse into transient manifestations of family and household based around life-cycle events rather than the more familiar structures of kinship. This book offers us a way of conceptualizing the family as a unit defined by a task or a purpose rather than by living conditions or blood ties.

If the spaces of birthing were transient, taken temporarily from the domestic spaces of the home, the places of birthing were firmly tied to locality. The place in which you gave birth influenced the people you had around you as you laboured. You selected your midwife and her attendants from among your neighbours and women who lived within a reasonable walking distance of your home. Your locality and its links to transport networks might facilitate or prevent your mother, sister or close friends from being present at the birth. Whether or not your midwife was licensed might be dictated by the clergyman who presided over your parish or by the availability of midwifery training facilities nearby. For poor women, locality and the length of time you had lived in a community might dictate the level of financial and practical support you received, both during birthing and in the first months of your parenthood. Locality shaped the sensory experiences of birthing. Remedies, practices and foods were drawn from locally produced ingredients, making the tastes and smells of birthing locally situated. The tendency to train midwives and birthing attendants in the community’s birthing chambers surely led to locally specific practices that were accommodated within the overarching framework of birthing. We have seen in this book how celebrations of a live birth varied across England, and how important it was that those celebrations reflected the place in which the infant had been born. Locality also impacted on birthing at an even deeper level. It inscribed itself on the body, particularly poor bodies, through the nature and environment of local work and employment, the food that was available and the drink that was used to celebrate the birth. The importance of locality encourages us to think in greater detail about the interface between the micro-environment and the body, and how locality impacts the way the body is felt and experienced.

Focusing on space and place brings the sensory nature of birthing into sharp relief. This book is not a sensory history of giving birth, but it does begin to explore the sensory and embodied experiences of the birthing chamber and of the women who were present in it. It shows that the way in which birthing was experienced by the female body is important not only for understanding what it was like to give birth in eighteenth-century England, but also for understanding child-rearing, care practices, socializing and celebration, and for exploring the business of being a woman in this period in greater depth. Moving away from a medicalized framework of birthing allows us to understand the intersection between medicine and the social, material, cultural and physical world of eighteenth-century women. Doing this opens up different perspectives of birthing that have hitherto been overshadowed by the voice of the man-midwife in his widely circulated publications. Thinking about birthing as a social and cultural process rather than a medical event allows for greater depth in understanding the impact of the birthing experience on individual women, particularly traumatic or divergent experiences such as the loss of an infant, physical injury or incapacity, as we saw with William Hey’s patients or the emotional distress of Elizabeth Wilson following the loss of her newborn infant. It has long been established that the body was (and is) experienced within the context of its social relationships, such as household, kin, friends and faith. Exploring the social and cultural elements of birthing in eighteenth-century England allows us a glimpse of bodily experiences, of corporeality and of the self at an important and formative moment in the life cycle.

Another key theme throughout this book is that of negotiation and renegotiation. The process of birthing, while it provided a recognizable framework within which women gave birth, did not create replicable experiences. Each birth was recognizable yet different for the woman giving birth and also for those around her – her midwife, her women, her family and her neighbours. Even where a birthing chamber could be recreated in the same place with the same individuals present, the social relationships that shaped embodied experiences of birthing had to be reaffirmed with each birth, and changing personal circumstances and experiences had to be acknowledged. Practical negotiations were also required as birthing women sought to organize a suitable space in which to give birth, either in their own household or in the households of their friends and family. Linens had to be borrowed or acquired, and family or neighbourly tensions had to be navigated, as women calculated the anticipated date for the arrival of the infant and sought assistance for the birth itself and its aftermath. A midwife had to be selected and her fee agreed. Alongside these intimate and individual negotiations were those that impacted on the development of the medical profession and the location of birth within medical frameworks. The presence of male midwifery practitioners in the birthing chamber may have been negotiated long before the pains of labour were felt but, on their arrival in the birthing chamber, their authority and expertise became a matter for negotiation with the present midwife and her attendants. As this book has shown, the women in the birthing chamber could assert their authority on the basis of their negotiation of their personal relationship with the birthing woman. Located in these individual negotiations were much broader ones on the medicalization of childbirth, the place of the midwife in newly emerging medical hierarchies and ways of conceptualizing and treating the birthing or newly delivered body. This book reminds us that grand epistemological shifts such as the changing nature of medicine and conceptions of the body in the late eighteenth century are often rooted in the much smaller everyday interactions of ordinary people. It therefore highlights the relational elements of place, space, memory and people. Studying the eighteenth-century birthing environment encourages us to see that even ‘natural’ or familiar events and actions are complex and shifting situations that needed to be carefully managed. To begin to grasp the experiences of ordinary people, social and cultural approaches to the history of important life-cycle events need to be situated in their material, environmental and emotional context.

Unsurprisingly, just as epistemological shifts can be seen in the everyday interactions of ordinary people, so can great social change. In a period of social upheaval and migration, the birthing chamber became a central point for society. It drew and redefined the boundaries of society, of who socialized with whom, who borrowed linens from whom and who participated in the associated celebrations and customs. As Keith Wrightson wrote in 1982, ‘shared relationships, concerns, speech, manners, rights and obligations contributed to a powerful sense of place’.6 The birthing chamber brings these shared networks and connections into sharp focus, highlighting the importance of locality to individual experiences of key life-cycle events and also to collective experiences of society, community and neighbourhood. Studying birthing at a regional scale has allowed this book to explain the tenacity of the eighteenth-century birthing chamber and its attendant rituals and procedures. The birthing chamber was a place in which the local networks and associations that sustained individuals and communities came together. Not only was this important for the communities in which the birth took place, but it briefly makes visible these informal interactions which are often difficult to extract from the historical record. The birthing chamber offered communities a space in which to conduct the business of neighbourliness. It is an important route to understanding what I have called the ‘community of neighbours’. This community is hard to find in historical sources, being defined by proximity to the household and by the limits of what can be seen and heard. For all this, I would argue that the community of neighbours is the manifestation of community that was experienced by most people on a daily basis. This was the community that would lend assistance or provide food should a household be experiencing difficulties. It was the same configuration of community that would be watching unmarried girls for signs of pregnancy, that would fetch the parish constable if wrongdoing or foul play was suspected. The community that partook in birthing practices therefore contained the neighbours with whom the birthing woman and her family interacted over the course of important life-cycle stages. By providing space in which neighbours could conduct the business of neighbourliness, I suggest, birthing was an integral and mutually legitimizing element of both community and belonging in the eighteenth century. The birthing chamber was a commonly available neighbourhood space in which communities met, and was therefore an essential but everyday part of communal life. What to modern eyes is an intensely private arena was, in eighteenth-century England, a pivotal space in which local customs and birthing practices were negotiated and renegotiated across lifespans and between generations. The eighteenth-century process of giving birth provided families with an opportunity to uphold or adopt the elements of birthing that mattered to them, and the birthing chamber is therefore an important historical prism, whether in the north of England or elsewhere. For this reason, birthing was firmly embedded in individual lives and families. It was essential to the business of forming and maintaining neighbourliness and therefore at the centre of some of the great social and cultural changes of the period.