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Women and Reproduction in the United States during the 19th Century  

Shannon K. Withycombe

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.

Article

Tullia (2), daughter of Cicero, d. 45 bce  

Harriet I. Flower

Cicero’s and Terentia’s daughter Tullia was born around 78 bce, shortly after her parents were married. Since her brother Marcus Tullius Cicero, her only sibling, was about 13 years younger and Tullia married young, she essentially grew up as an only child in the home of Rome’s leading orator. We do not know if any other siblings died as infants. She was surrounded by a loving and stable family and a large household of slaves. Her uncle Quintus Cicero and his wife Pomponia, sister of her father’s best friend T. Pomponius Atticus, were also a regular part of her life. Her mother’s half-sister Fabia was a Vestal Virgin. Tullia may have been brought up by a pious mother to practise Rome’s traditional polytheistic religion. Terentia also had a wide circle of friends and acquaintances amongst Rome’s elite women. Tullia received an excellent education and loved reading. She also enjoyed public entertainments, such as the games held at Antium, where Cicero owned a villa for a while.

Article

female life-course  

Kelly Olson

The female life-course in ancient Greece and Rome ideally followed a set path, a path which would look different depending on one’s rank, status, race, and geographical location. Women of the upper and middling classes in Athens and Rome, however, were supposed to progress through childhood and marry almost immediately after puberty, producing children in their turn, raising them, and perhaps becoming widowed before dying in what people today would consider the prime of life.

The female life cycle changed according to rank, status, race, and geographical location across the Mediterranean. Thus, an urban slave-woman’s life cycle would have looked significantly different from that of a married citizen woman, as would that of a lower-class woman, or a foreign woman living in Athens or Rome, which in turn may have been very dissimilar to (for instance) a woman living in a rural Roman province. What follows is what is known of the life stages of a middling-to-upper-class woman, since this is where literary and artistic sources pool.

Article

Women and Medicine in Early America  

Rebecca Tannenbaum

Women from all cultural groups in British North America—European, African, and Indigenous American—played a central role in medicine in early America. They acted as midwives, healers, and apothecaries and drew on a variety of cultural traditions in doing so, even as they shared many beliefs about the workings of the human body. Healing gave women a route to authority and autonomy within their social groups. As the 18th century opened, women healers were able to enter the expanding world of capitalist commerce. Anglo-American women parlayed their knowledge of herbal medicine into successful businesses, and even enslaved midwives were sometimes able to be paid in cash for their skills. However, as academic medicine took more of an interest in topics such as childbirth, women practitioners faced increasingly bitter competition from professionalizing male physicians.

Article

Motherhood in Early America  

Nora Doyle

Women’s lives in British North America and the early United States were fundamentally shaped by the experiences of childbearing and childrearing and by the ideologies of motherhood that emerged from a range of cultural contexts. Most women in this period became mothers, either through choice or coercion, but their experiences of childbearing and motherhood differed sharply depending on their cultural background, social status, and experience of freedom or bondage. The history of motherhood was marked by significant continuities as well as change over time. For most women, motherhood was fundamentally defined by the physical rigors of pregnancy, childbirth, and breastfeeding, and these experiences remained central across generations. Motherhood comprised a range of roles, activities, and areas of expertise, and as a result many women enjoyed considerable authority as mothers within their families and communities; this too remained constant. Changes to childbearing, motherhood, and maternal ideology occurred gradually and unevenly and affected women from different backgrounds in distinct ways. The incursions of European settler colonialism and the later expansion of the new United States, for instance, brought growing instability to Native American communities and threatened to undermine Native women’s power as mothers, though they formulated strategic responses to preserve their authority. The second half of the 18th century saw changes to women’s experiences and to feminine ideology in Anglo-American society. Middle-class and elite White women precipitated a fertility revolution that resulted in steadily declining family size; in contrast, enslaved women of African descent generally experienced increasing rates of fertility in the 18th century, and their childbearing experiences were shaped by the commodification of their reproductive labor. At the same time, a gradual transition began in the realm of childbirth as some middle-class and elite white women called on male physicians to manage their births. Meanwhile, this same era also saw a significant ideological shift as motherhood gained new significance in Anglo-American culture, making the image of the ideal white mother the most potent symbol of feminine virtue and influence.

Article

Reproductive Health, Fertility Control, and Childbirth in Africa  

Susanne M. Klausen

Fertility has long been highly prized in Africa, especially in societies where economic production depended mainly on human labor power. In addition to their role as future workers, children were crucial for, inter alia, securing lineages, providing social security, and ensuring spiritual safekeeping. Women were therefore expected to produce offspring. For them, bearing children was elemental to their social identity, security, and status; failing to reproduce could be calamitous. For both women and their husbands, infertility was often stigmatizing, but women usually bore the brunt of blame for involuntary childlessness and therefore could suffer especially devastating social consequences, such as divorce and ostracism. Managing fertility involved a wide range of reproductive practices. Africans believed infertility was caused by supernatural forces; consequently they sought assistance from spirit mediums and traditional healers to help women achieve or maintain fecundity. Postpartum women practiced birth spacing to ensure infants’ health, achieved through sexual abstinence and prolonged breastfeeding. Because premarital pregnancy was often a serious violation of social norms, youth were typically taught ways to avoid conception while engaging in premarital sex play. Women procured abortions using a variety of methods, including ingestion of plant-based concoctions and extreme manual pressure to kill the fetus. Childbirth, though feared for the risk involved, was typically a welcomed event although the social context for birth varied according to culture and social organization. In some societies, midwives attended women, whereas in others, solitary birth was the ideal. The reproductive politics and practices of precolonial societies informed those of the colonial era, which in turn helped shape postcolonial Africa. Western incursions into African societies had uneven effects on indigenous practices related to reproductive health, fertility control, and childbirth. While some indigenous ideas and practices persist, others, such as post-partum sexual abstinence, have been severely undermined.

Article

Childbirth and Breastfeeding in 20th-Century America  

Jessica Martucci

By the end of the 19th century, the medical specialties of gynecology and obstetrics established a new trend in women’s healthcare. In the 20th century, more and more American mothers gave birth under the care of a university-trained physician. The transition from laboring and delivering with the assistance of female family, neighbors, and midwives to giving birth under medical supervision is one of the most defining shifts in the history of childbirth. By the 1940s, the majority of American mothers no longer expected to give birth at home, but instead traveled to hospitals, where they sought reassurance from medical experts as well as access to pain-relieving drugs and life-saving technologies. Infant feeding followed a similar trajectory. Traditionally, infant feeding in the West had been synonymous with breastfeeding, although alternatives such as wet nursing and the use of animal milks and broths had existed as well. By the early 20th century, the experiences of women changed in relation to sweeping historical shifts in immigration, urbanization, and industrialization, and so too did their abilities and interests in breastfeeding. Scientific study of infant feeding yielded increasingly safer substitutes for breastfeeding, and by the 1960s fewer than 1 in 5 mothers breastfed. In the 1940s and 1950s, however, mothers began to organize and to resist the medical management of childbirth and infant feeding. The formation of childbirth education groups helped spread information about natural childbirth methods and the first dedicated breastfeeding support organization, La Leche League, formed in 1956. By the 1970s, the trend toward medicalized childbirth and infant feeding that had defined the first half of the century was in significant flux. By the end of the 20th century, efforts to harmonize women’s interests in more “natural” motherhood experiences with the existing medical system led to renewed interest in midwifery, home birth, and birth centers. Despite the cultural shift in favor of fewer medical interventions, rates of cesarean sections climbed to new heights by the end of the 1990s. Similarly, although pressures on mothers to breastfeed mounted by the end of the century, the practice itself increasingly relied upon the use of technologies such as the breast pump. By the close of the century, women’s agency in pursuing more natural options proceeded in tension with the technological, social, medical, and political systems that continued to shape their options.

Article

Black Women and Maternal Death  

Valire C. Copeland and Betty Braxter

The upward trend in the number of Black maternal deaths between 2005 and 2020 warrants an in-depth assessment of risk factors associated with the increased maternal mortality rate in the United States for this subgroup population. The risk factors are multifactorial and, in part, have been organized into several categories: demographics, social determinants of health (SDOH), medical conditions, and the quality-of-care interventions by health systems providers. In addition, the overall trends, causes, and solutions to decrease maternal mortality current rates reflect the social inequities in our society. Black maternal deaths have been rising in recent years due to complex causes which stem from structural and systemic health inequities. In part, unvaccinated pregnant women were at greater risk of severe illness and hospitalization and even death if they were diagnosed with COVID-19. While Black Americans were disproportionately impacted by the pandemic, the disparities in maternal mortality predate and extend beyond the pandemic. In part, and together, the leading causes of pregnancy-related deaths include cardiovascular disease, other medical conditions and infections, cardiomyopathy, blood clots in the lung hypertensive disorders related to pregnancy, adverse pregnancy outcomes, racial bias of providers, and perceived racial discrimination from patients. In addition, an overview of nonmedical factors referred to as SDOH, which intersect with health status outcomes, will be discussed. An overview of Black women’s maternal mortality and morbidity, factors contributing to poor maternal health status outcomes, and intervention strategies at the provider, health systems, and policy levels are provided. Social workers in health care systems function as health care providers and clinicians. Therefore, contributing medical and nonmedical issues are factors to consider for a holistic perspective during engagement, assessment, and intervention. The terms Black women and Black birthing persons are used interchangeably.