Thursday, September 24, 2009

Question from Pamela - Stillbirths and miscarriages

Why were there so many stillborns and miscarriages during the 1400's and 1500's? Why did so may infants die withing a few months of their birth? It appears that King Henry VIII's wives had much trouble giving him living heirs..Was this true of the general population and of other Kings before and after Henry?? What was the problem??


  1. A simlar set of related questions have been addressed in other threads, but Pamela has posed the central questions in a lovely new way that allows for a more general discussion.

    Approaching Pamela's questions backwards:

    Yes, it is true that infant mortality was very high in the 1400s and 1500s, at all social and economic levels. As has been noted in other threads, it was not unheard of in extreme cases for 3 out of 4 children born to a couple, both royal and "commoner," to die before reaching 5 years of age. Nonetheless, some couples, even some royal couples, were lucky enough that all of their children survived. But on average, somewhere between 1/4 and 1/2 of all children born failed to reach adulthood.

    And it was indeed a matter of "luck," in many ways. People in that era had no accurate understanding of disease causation or of how to treat illness. Indeed, the treatments were often deadly themselves. They did not understand the adage "drink plenty of fluids" and instead bled those suffering from illness, causing dehydration. Nutrition was porrly understood, especially infant nutrition. So when infants got sick with the normal childhood illnesses still seen today, they often died from them.

    In short, people simply did not know what they needed to do to get and stay healthy. And in the absence of that knowledge, it was easier for children, especially newborns with undeveloped immune systems, to get sick and die. It often did not matter if you were a king or a cobbler.

    Regarding the specific question of whether other kings had difficulty producing heirs, this too has been touched on in other threads, but bears summation here. Working backwards:

    Of Henry VII's seven or so known children, four survived infancy.

    Richard III's only child, Edward, died suddenly at age 11, probably from disease.

    Of Edward IV's ten legitimate children, daughter Margaret died as an infant, son George at age 2, and daughter Mary died at age 15. Edward's wife Elizabeth had 2 sons by a previous 9-year marriage who survived to adulthood. She seems not to have had other children by that marriage.

    Henry VI had only one son, who died in battle at age 18. Henry's wife Margaret is not known to have had other pregnancies.

    Henry V had only one child (Henry VI). His wife had no other pregnancies by him, though she went on to remarry and had two sons during her 5-year marriage to Owen Tudor.

    Henry IV had six children over a span of thirteen years by his first wife, all of whom survived to adulthood. He had none by his second, though that second wife had nine children by a previous marriage, 3 of whom died in infancy and one who died at age 18.

    So, among the kings of England between 1399 and 1509, they had a combined total of 26 children, of whom 8 died from non-violent causes before adulthood. That is an infant-child mortality rate of 30%, or about the average seen in the total population at that time.

  2. It may also be worthy to note that Henry VIII's first two wives were under considerable stress to give him heirs, which may have been a contributing factor to some of their miscarriages and premature births. Katherine of Aragon especially would often fast from food as a religious observance, thinking this would help her get pregnant. From our standing point today we know this would have done more to harm than help to her. And, as PhD Historian points out, people just didn't know that much about how to be healthy and didn't have much medical knowledge back then. Even when a child was born alive people knew there was a good chance it might die in the near future. Part of the reason Henry VIII married three more times even after he had a legitimate son was because he "needed" to have more sons should Edward have died.

  3. There is an article by Carolyn M. Cash on pregnancy and childbirth in Tudor times at:

    While it focuses on Henry VIII"s first three wives and his daughter Mary it also shows the risks of septicemia faced by all women during those times.

  4. The other side of the question is the health of the mother. As Jacque pointed out, understanding of prenatal health was also an issue. The ever-present specter of death in child bed was a risk every woman lived with, royal or not. Although huge strides have been made in understanding both pre-natal health and infant care, we still have a long way to go.

    The following quote, from a contemporary queen, puts this discussion in perspective:

    Her Majesty Queen Rania Al Abdullah

    "Last year, 60 million women around the world gave birth without professional care.

    More than half a million of them died.

    Think, for a moment, about that number. One woman. Every minute. Every day."

    Pardon for the 400 year leap forward, but I can't help imagining a time in the future when a group of historians are discussing why in the early 21st century we had such a 'primitive' understanding of child birth and newborn health care.

    And just for perspective's sake, my great-great-aunt and uncle were bled during the post WWI influenza epidemic. Which opens the question of how far and how fast have we come from the methods of the 16th century?

  5. If I may tread after KB and tread on dangerous ground by waxing political, it is worthwhile to note that the U.S., which domestic conservative politicians like to claim (incorrectly) as having the best healthcare system in the world, ranks 180th in infant mortality rates out of 224 countries. Stated another way, the US infant mortality rate is higher than that of 44 other nations. Sweden, Japan, France, Germany, Australia, Spain, Great Britain, Canada, and even Cuba. among others, all have fewer infant deaths per 1000 live births than does the US. The US rate in 2009 is 6.26 deaths per 1000 live births.

    So yes, as KB notes, it is worth asking how far we have really come since the 16th century and how far we really have yet to go.

  6. Another contributing factor could have been the fact that women were confined during the later stages of pregnancy. Surely it would have gotten very stuffy in the confinement room/s and with no fresh air women might have gotten stressed.

  7. In response to the notion that the U.S. has one of the highest infant mortality rates in the world: I recently found a reference to the Organization for Economic Cooperation and Development (OECD) who discourages comparison of world-wide infant mortality rates because they are all registered differently.

    Some countries count any baby born over 1 pound, others count babies over 12 inches long, others register babies born after 26 weeks of pregnancy, and in the US we count any baby born alive after 22 weeks, I believe. That would mean we would have more babies dying just because of the way we count live births.

    Half of infant deaths are due to preterm birth, and a report by U.S. News and World Report in 2006 showed that once you adjust for birth weight our babies the US infant mortality rate is comparable to Norway’s, which we all know is one of the lowest. The high preterm birth rate is probably due in part to higher use of fertility drugs in this country than in other countries.
    The World Health Organization, which put the comparison together showing the U. S. at 29th, is a bias organization.

  8. You know what I trip out about? The fact that we have come so far in sexual activity throughout pregnancy. Think about how different it would've been for all if they had this knowledge! Less mistesses...more babies probably?

  9. Can the deaths, miscarriages and poor health have anything to do with the R factor and or STDs?

  10. They did lots of things we'd never do while pregnant and abstained from things we wouldn't give a second thought. By today's standards these women drank heavily while pregnant granted that pretty much anything was safer than the water back then.

    But let's look at Catherine of Aragon. It's not uncommon even today to lose a first pregnancy and then go on to have healthy children. So the first could have just been bad luck. Then there is the son who lived only 52 days. This could have been due to illness or SIDS. By all accounts the baby appeared healthy at birth and then died suddenly a little over a month after his birth. So at this point were still looking at sheer bad luck. Now with the exception of Mary it would seem Catherine suffered numerous late term losses. Seems she would make it to the 7th or 8th month or even full term only to suffer a stillbirth or premature labor and the death of a preemie. The death of a baby born premature at that time in history is pretty much a given as they did not have the means to save a premmie. It would seem that Catherine suffered from something that made it difficult for her to carry to term that caused her to go into premature labor somewhere around the beginning to middle of the 3rd trimester. Could have been hormonal, due to her fasting while pregnant, due to a genetic disorder or disease, or something as simple as a weak cervix. We'll never know but it would be interesting to know if her lost babies died before or after labor started.

    With Anne I truly think it was stress or the RH factor.


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