I watched The Other Boleyn Girl and haven’t been able to get it out of my mind. It wasn’t particularly fluid (without trying to be punny, I said, “It was choppy.”), but it prompted me to delve into the history of the family of Henry VIII.
What does this have to do with midwifery?
Two of Henry’s wives died in childbirth... and it got me thinking: It’s often said we need to go back to the basics, that birth is normal and natural, that we don’t need all the crap the hospital offers, that most care providers poke around and mess with the perfection of birth. Is this so?
The maternal mortality rate in the United States in 2005 was 15.1 women dying per 100,000 births... 1 in 6,700 women. In Sierra Leone, the country with the worst lifetime risk of maternal mortality, the rate is 1 death for every 8 pregnancies (not women, but pregnancies!). In developed countries, the lifetime risk is 1 in 2800 pregnancies. (I will address MMRs in more depth when I publish the third installment of this piece.)
For every woman who dies, THIRTY are left with permanent damage caused by birth – incontinence, infertility, hysterectomy, severe tears that do not heal properly, etc.
The earliest maternal mortality records come from the late 1500’s in England and because abortion was so forbidden, these would not include deaths by or after an abortion (as today's rates do include). The records show the MMR to be 2350 per 100,000, or 1 in 43 women died. In rural Germany, 1 in 20 women died in childbirth. In Europe, from 1666-1814, 2360 women per 100,000 live births died - 1 woman in 42. From 1700-1829, the rates lowered, starting as 1 in 36 women and changing to 1 in 100.
Did you skim over the statistics? Are you wishing I wasn’t talking about this? Is this too close to home?
Maternal death is so rare and hidden in our lives, it can be easy to push it behind us, leaving it in the shadows and reassure ourselves that “birth is as safe as life gets.”
Birth is saf-ER than it was; that’s a given. It’s saf-ER than in Sierra Leone, but that is just geography. In birth, there is risk and if we ignore it, we are not standing in the whole truth of informed consent – to birth (at all), to birth at home, to birth unassisted. I will examine why birth is safer today in subsequent posts – and, of course, midwives and doctors are going to be a part of the picture.
I encourage you to visualize the above statistics as REAL women... like you or me, like your sisters in on-line support groups, like your biological sister or aunt. These statistics are not just in our long ago past. These are in our here and now today.
One would presume that the women in Henry VIII’s family would have the best of the best care, yes? During that time, ruling families had an MMR of about 1 in 50. Not much different than in the general population.
Charles Brandon was Henry’s childhood friend who grew to be a lifelong confidante; his mother died in childbirth.
Henry VIII’s mother also died in childbirth.
Dipping into infant mortality, Catherine of Aragon, the first of Henry's wives, had six pregnancies and only one (the future Queen Mary I) lived past infancy. The others, all sons, died during their first few weeks of life.
Anne Boleyn, Henry's second wife, gave birth to a girl that lived past infancy (Princess Elizabeth) and then had a stillbirth and also a miscarriage, both boys.
Jane Seymour, his third wife, gave Henry his long-wished for heir, Edward. Jane died two weeks later of puerperal fever/sepsis (postpartum infection). During the pregnancy, Henry's first (illegitimate) son, Henry Fitzroy, died at 17-years old. Fitzroy had been Henry's only possibility for heir to the throne until a legitimate son was born.
Henry's fourth marriage to Anne of Cleves ended in an annulment; she seems to have never had children.
The fifth queen, Kathryn Howard, doesn't seem to have ever been pregnant (or there is no record of one) despite a long history of affairs - which led to her eventual execution.
Katherine Parr was Henry’s last wife... he died while married to her. After his death, she had one child, Mary, and died six days after her birth, also by puerperal fever. This was her only pregnancy of record.
Again, it fascinates me, all these infant and maternal deaths. 1 in 50 women died during that time. One woman dies every EIGHT pregnancies in our world today.
Huge initiatives exist to try and lower the infant and maternal mortality rates not only in our country, but around the world. These include educating midwives, bringing doctors to those that need them, utilizing pitocin to avoid postpartum hemorrhage, having antibiotics in case of infection and providing safe abortions and cesareans to the women who want or need them.
It’s so important to me that UCers, “freebirthers” understand what they are doing when they choose to birth with no care provider. If, after understanding the realities of death in birth, they decide to birth alone, at least they are making an informed decision. Burying one’s head in the sand about the risks is dangerous, not only to the woman and her baby, but to our entire society. We all pay for a member dying.
(Note: Because infant mortality rates are discussed so often, I am not addressing that topic here. But, those of us who work in birth will see at least one baby die during birth or right after. A baby dying isn’t as hidden, although we are certainly not de-sensitized to it. We shouldn’t be.)
Next: Freebirthing - My reactions to the show on Discovery Health.