The issue of maternal and child mortality: the German sense of the tragic

The Perceptions of Pregnancy blog, like the Researchers’ Network, aims to reach beyond boundaries and borders, and to facilitate an international and interdisciplinary conversation on pregnancy and its associated bodily and emotional experiences from the earliest times to the present day. This week, Associate Director of the POP Network writes about the ways 18th century art reflects cultural attitudes toward pregnancy and medical intervention in birthing rooms.

Death during childbirth did not respect age or social class; it occurred more often than recently married women liked to think about. The same could be said of child mortality: if a child survived childbirth the perils of the diseases of early life awaited. In the German Territories of the Holy Roman Empire, the promotion of large families was central to the process of recovery after the Thirty Years’ War. Especially in rural communities this was seen as central to economic recovery even though it was a risk for the mother. This was a social belief supported by state policy, academic publications, and popular literature that would continue well into the 19th Century. .

Each country, each society has a specific perception of life and its events especially visible in the management of birth. The paintings from the Sittenbilder tradition (customs paintings or morality paintings) as well as Romantic literature reveal not just different sets of values (such as the mother as the central educational figure in the home) but more importantly different attitudes towards life’s many events. German culture was pervaded by a pessimistic view of childbirth manifested in artwork that fed into official discourse in favour of the birthing houses. This sense of the tragic was also visible in German literature and was part of the Jena movement, particularly during the Romantic period, though it was not completely missing from the Classicism that followed.

Image1

Emblematic of distraught emotions are classics such as Goethe’s Die Leiden des Jungen Werthers (The Sorrows of Young Werther) and the first part of Faust. It is also visible in paintings of the period such as the image above (1) that shows a man mourning the death of his wife during childbirth with a dark billowy figure clearly symbolising death carrying away the dead child. While England was not devoid of literature that spoke of the horrors of childbirth, such as Tristam Shandy, these horrors were seen as less the result of inevitable accidents of nature, as the product of the mechanisation of birth through the introduction of imperfectly trained man-midwives into the birthing chamber.[1] Significantly, Image 1 is totally devoid of a birth attendant, the viewer is only offered the figure of the mourning husband, the dead wife and child, and death, the presence of which signals something uncontrollable in the tragic event. In British society the death of a mother was often attributed to excessive intervention on the part of poorly trained practitioners, something that could only be avoided by further institutionalising and masculinizing the birthing room. In Germany, too, maternal death was the reason given for increasing state intervention in the birthing room, but not for its institutionalising or masculinizing. This was largely due to the belief that maternal death would occur regardless of the location of the birthing room. A mother was just as likely to die at home as in a birthing house, but training in hospitals would increase the possibility of reducing those deaths that were due to unnatural complications.[2]

This difference in tone is also reflected in paintings from such different nations as Hungary (2) and France (3) that, like the British, reveal a more positive outlook. These examples, also chosen from the 18th Century collection of the Berlin Archive for History and Art, show a celebration of birth rather than its more tragic consequences. The family of the recently born twins in the Hungarian family scene (2) congregate in the birthing room to celebrate.[3] The same is true of an image found at the Wellcome Trust in an edition on Birth in Art that shows a French aristocratic family celebrating the birth of a son.[4] In both cases the birth attendant is present and aiding with other household duties, such as food preparation in the Hungarian scene, or holding the child in the French home. In both the family is centre stage with the father figure present alongside mother, children, other family members, and the birth attendants. While the different social classes portrayed in these images might lead one to conclude that the joy in the second image was more attached to inheritance and the importance of having a son for the benefit of the estate, the joy in both representations of birth transcends social class. Images such as these bring the reader closer to the world of the eighteenth century by allowing a view of the centrality of family and the way in which, prior, to institutionalisation, birthing agents would enter the home, becoming a part of network that brought a child to the world and prepared him for interaction with the community into which he was born.

Marystella Ramirez Guerra is a PhD candidate at RWTH Aachen, Germany, and an Associate Director for the Perceptions of Pregnancy Researchers’ Network.


Image 1: Tod in Kindbett (Death in childbed), author unknown, from the Leipzig Museum of Art, ca. 1800

Image 2: Father with Twins, Farm family from the Hungarian countryside ca. 1789

Image 3: C’est un Fils, monsieur (It’s a boy, sir), Jean Marcel Moreau (1741-1814)

[1] Bonnie Blackwell, “Tristam Shandy and the Theater of the Mechanical Mother”, ELH, vol. 68, 1 (Spring 2001) pp. 81-133

[2] Geheimrath Hauck, Tagebuchblatter; Sig. 1062 0010 Charite Direktorium, Archiv der Humboldt Universität (AHU)

[3] Archiv für Kunst und Geschichte, Teutonenstraße 22, Berlin-Zehlendorf, https://www.akg-images.de/CS.aspx?VP3=SearchResult&VBID=2UMESQEUQE3RB&SMLS=1&RW=1440&RH=816#/SearchResult&VBID=2UMESQEUQEGPX&SMLS=1&RW=1440&RH=816

[4] Volker Lehman, Geburt in der Kunst: von Antik bis zur Gegenwart, Verlagsanstalt Braunschweig

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