Throughout the 19th century, American women experienced vast changes regarding possibilities for childbirth and for enhancing or restricting fertility control. At the beginning of the century, issues involving reproduction were discussed primarily in domestic, private settings among women’s networks that included family members, neighbors, or midwives. In the face of massive social and economic changes due to industrialization, urbanization, and immigration, many working-class women became separated from these traditional networks and knowledge and found themselves reliant upon emerging medical systems for care and advice during pregnancy and childbirth. At the same time, upper-class women sought out men in the emerging profession of obstetrics to deliver their babies in hopes of beating the frightening odds against maternal and infant health and even survival. Nineteenth-century reproduction was altered drastically with the printing and commercial boom of the middle of the century. Families could now access contraception and abortion methods and information, which was available earlier in the century albeit in a more private and limited manner, through newspapers, popular books, stores, and from door-to-door salesmen. As fertility control entered these public spaces, many policy makers became concerned about the impacts of such practices on the character and future of the nation. By the 1880s, contraception and abortion came under legal restrictions, just as women and their partners gained access to safer and more effective products than ever before. When the 19th century closed, legislatures and the medical profession raised obstacles that hindered the ability of most women to limit the size of their families as the national fertility rate reached an all-time low. Clearly, American families eagerly seized opportunities to exercise control over their reproductive destinies and their lives.
