Women’s Voices from a Norfolk Asylum

The 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 Julie Jakeway introduces her new book that explores the lives of women sent to the Norfolk Country Lunatic Asylum in the nineteenth century.

My book, Manifestations of Madness, Women’s Voices from the Norfolk County Lunatic Asylum, features female patients in Norfolk Lunatic Asylum diagnosed with gender-specific causes of insanity during the period between 1851 and 1870. Biological factors were highlighted in the nineteenth century to explain the incidence of insanity in women, and the debate concerning the female malady, as it was termed, continues to be of interest in the twenty-first century. Victorian psychiatrists held the view that ‘women were more vulnerable to insanity than men because the instability of the reproductive systems interfered with their sexual, emotional and rational control’.[i]

Following childbirth women are vulnerable to moods that today are recognised as postnatal depression but in the Victorian era these unexpected moods, ranging from ‘baby blues’ to more serious postnatal melancholia, meant many women were diagnosed with lunacy and admitted to the asylum. The causes of their ‘lunacy’, often aggravated by malnourishment and hard labour, led to a period of confinement and were recorded in layman’s terms variously as confinement, childbirth, pregnancy and so on.  My research focuses on the personal history of patients diagnosed with gender-specific causes of insanity through a series of case studies from within the asylum. 

Whilst women’s issues at significant times in their lives were being recognised by the medical profession in the nineteenth century, treatment differed between the classes and middle-class women were more likely to be cared for in their own homes, and frequently advised to avoid unnecessary strain such as reading or writing, activities that were considered over-taxing to their brains.[ii]  Working-class women on the other hand, frequently undernourished and physically exhausted, were provided with more basic needs by the county asylums, which was sometimes enough for their recovery.

This recognition of women’s vulnerability postpartum resulted in an increased rate of admissions amongst women featuring the specifically female events of accouchement, lactation, parturition, and puerperal fever. Their case notes suggest their physical condition was frail and the substantial demands of parturition and lactation further drained their strength, already weakened by hard labour and malnourishment.

The image depicts the Norfolk County Lunatic Asylum today.
The Norfolk County Lunatic Asylum. Photo by Julie Jakeway

There were other gender-specific causes of insanity in addition to those directly linked with childbirth: amenorrhoea (lack of the menstrual cycle); hysteria (removed from the medical vocabulary in 1980); menorrhagia (excessive menstrual bleeding); uterine disturbance (irregular menstrual bleeding), and the menopause which was usually termed the change of life or climacteric in that era. Together these accounted for a significant percentage of female patients at Norfolk Lunatic Asylum in the twenty-year period between 1851 and 1870. The speed with which some patients recovered their mental and physical health within the asylum is quite astonishing, bearing in mind there was rarely, if any, medication involved in their treatment. This success seems to confirm the sentiments of William Hills, medical superintendent, recorded in the Annual Report of 1863:

‘The earlier patients are placed under medical [care] the better; in cases of insanity, this rule is of vital importance, as the neglect of it, converts a curable condition into a chronic one requiring permanent residence.  The average residence in the asylum of those, who recovered, is about 5 months, the longest was three years.’[iii]

The provision of regular meals, comfortable accommodation, bathing facilities and clean clothing met the basic needs of those patients who were living in dire conditions, and this was sometimes enough to restore their mental, as well as their physical, health. Four shillings (£16.04 is the equivalent based on www.nationalarchives.gov.uk/currency-converter July 2020) was allotted for each patient’s food each week, twice the amount that Norfolk farm labourers were able to spend.[iv] However, as well as those restored to health by the usual asylum regime of therapeutic treatment, there were instances in this new field of medicine where the diagnosis was flawed and patients’ outcomes did not end as happily.

The high proportion of gender-specific causes assigned to women patients meant the label of ‘women’s problems’ as the cause of their mental disorder was a useful classification when no other explanation was apparent. The focus of my book is the women whose lives, through poverty, debility and the stresses of everyday life, brought them to the asylum for a period of refuge, and how their lives evolved in the years that followed. I have included twenty-one case studies in Manifestations of Madness which follows the patients’ lives after their discharge from the asylum.

Today mental health problems remain as prolific as ever: depression, stress, anxiety; an inability to cope with the requirements of modern living. Physical exhaustion and starvation are less likely to be diagnosed as causes of mental illness nowadays yet the pressures of daily living continues to affect our society: intense media pressure has been identified as just one contemporary cause of anxiety and distress.

Julie Jakeway, educated at Carew School, Ealing, went on to study at the Guildhall School of Music and Drama for a Licentiate Diploma in Drama.  She taught at Lonsdale School, Norwich, before working as a team leader in local government.

Her dissertation for an MA in Local History from Leicester University was on the subject of the Norfolk County Lunatic Asylum.   Her subsequent research into the personal histories of the female patients of the asylum in the period between 1851 and 1870 led to the publication of Manifestations of Madness, Women’s Voices from the Norfolk County Lunatic Asylum in 2021. The book is available from bookshops, Amazon and Poppyland Publishing at: https://poppyland.co.uk/products/B79685

[i]       E. Showalter, The Female Malady: Women, Madness, and English Culture, 1830-1980 (London, 1985), p. 55

[ii]      Charlotte Perkins Gilmore, The Yellow Wallpaper (London, 2009), p. 4

[iii]     Norfolk C.R.O. SAH 28, Annual Report, 1854-73

[iv]    A. Digby, Pauper Palaces, (Routledge & Kegan Paul, London, 1978), p.23

Birthing Lessons from the Past

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 Julia Gruman Martins introduces a new Being Human event that encourages us to think about the connections between the history of birth and modern practices.

In a quick Internet search, pregnant people are faced with a wealth of information about how to make childbirth easier: dimmed lights, a warm environment, the use of soothing smells such as lavender, relaxing massages, affirmation words, breathing techniques, how to stay nourished, and calming sounds are often mentioned. In addition, people are told how movement and different positions can facilitate the delivery and how birth partners may help. From the NHS website to the many experts who offer their services, be they midwives or doulas, these are recurring aspects of how to make childbirth better and safer: an easier, happier, and ultimately more empowering experience to the one giving birth.

Yet many of these elements are frequently met with resistance by several in the medical establishment and other institutional settings, criticised as ‘new-age’, feminist-inspired, ‘hippie’ trends. Moreover, many of the arguments against these practices (even though most of them are evidence-based) give us the impression that the campaign for a change in how people give birth proposes a radical break with how babies were traditionally born, a rupture with the status quo.

However, as medical historians have shown, the many male-dominated, sterile, ultra-lit delivery rooms of hospitals of the present are new in the history of childbirth.

Going back to the early modern period, a delivery room would be warm, dimly lit, and perfumed with medical herbs. The birthing woman would probably be attended by a midwife and surrounded by female friends and relatives – her ‘gossips’. She would be offered sustenance in broths and fortified wine and would be advised on different positions depending on her body type and the way the baby was positioned. Skilled midwives could even manipulate the baby in the womb to facilitate the birth.

Yet this is not how most people imagine babies being born during the time of the Tudors – in large part thanks to the sensationalised way childbirth is represented in period films and TV series. These media make pregnant people glad to be giving birth in the 21st century, thinking of this barbaric past as something alien to them.

However, there is much that we can learn about how to make childbirth better today from the way women gave birth in the past. It is not a matter of comparing what was ‘better’ or ‘worse’ then (although a strong case could be made regarding pain relief options for birthing people today!). We should resist the temptation to see the past as ‘other’ in the same way we should avoid idealising it.

There are many continuities in the history of midwifery and childbirth, even though the way we perceive the body has changed (such as our current understanding of hormones and their role in birth). For instance, a seventeenth-century midwifery manual advised that ‘you must lay the woman in a dark place, lest her mind should be

distracted with too much light’.1 The room should also be kept warm since the delivering woman ‘must be kept from the cold air…and therefore the doors and windows of her chamber in any wise are to be kept close shut’.2 Today, birthing people are told that turning off overhead lights and using candles can help the room feel less clinical, keeping it warm and snug and helping the ‘love hormone’ oxytocin flow, facilitating birth. The reasoning behind this recommendation might have changed, but people are still advised to create a womb-like environment to give birth.

Therefore, by studying the history of childbirth, we can understand how we got to where we are today. But we can also add nuance to our debates. We can find continuities in the way people give birth throughout history – not just ruptures. It is possible to learn from how early modern people gave birth and what aspects we can adapt to childbirth today. Therefore, rethinking childbirth considering history can be very helpful in our fight for better and safer practices today.

Interdisciplinarity is critical in this process, yet as medical historians, we can often become disconnected from the realities of giving birth today – even those of us who are mothers! To make childbirth better for all of us, we need to broaden the conversation, including midwives, doulas, pregnant people, historians, physicians, massage therapists, and birth partners.

This November, join us in rethinking childbirth, comparing how people gave birth 500 years ago and today. We will discuss the sharp contrasts between the early modern and the 21st century delivery rooms and the surprising continuities between them, from the lighting to the role of birth partners. It will be an informal conversation between a historian and a practising doula, followed by a Q&A with the audience. Available to book on Eventbrite via the link below.

500 Years of Childbirth

Logo for the Being Human festival. Two profiles overlaid.

An Experience of Home Births in Rural Ireland: 1883 – 1903

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 Kim Burkhardt explores her great-great grandmother’s experiences of birth in rural Ireland.

Harriet Susannah Ellis – the fifth of twelve children (plus an older half-sister from her father’s first marriage) – was born February 5, 1863 in Co. Sligo, Ireland. Her family moved around Ireland – seemingly possible due to the country’s new railroad system – as her father transferred from one teaching job to another. Her family moved to Co. Wicklow, south of Dublin, when she was seven. 

Harriet and James Chartres Bookey went to Dublin from rural Ireland (from Co.  Wicklow) to get married on September 5, 1882. Both were the children of professionals; Harriet’s father was a school master; James’ father was a doctor. Their fathers had served together on the parish vestry in their Church of Ireland parish in County Wicklow in 1870. Her parents and many of her siblings had left Co. Wicklow – due to her father’s next job transfer – prior to her marriage. She and an older sister had remained in Co. Wicklow (she was a teenager when her father accepted his next job).

After their apparent “elopement trip” to Dublin, Harriet and James returned to briefly to Co. Wicklow, then lived in the tri-county area of Counties Wicklow, Wexford, and Carlow until emigrating to North America in 1913. Four of their older surviving children – adults, by this time – emigrated ahead of them, one at a time. Harriet and James – with another five of their ten surviving children (still children) – then followed the first four emigrants to Vancouver, Canada.

Ireland’s 1911 census records indicate that Harriet had thirteen pregnancies, with ten surviving children. Genealogical research uncovered birth certificates for twelve of her children (information presented in the chart below created for her descendant’s genealogy book). Given that registering stillbirths in Ireland didn’t start until 1995 (it is still optional), it’s uncertain whether the thirteenth birth certificate simply wasn’t found or if that pregnancy involved a miscarriage or a stillbirth. 

table created by Kim Burkhardt

All of her children were born at home. For the twelve birth certificates identified, midwives were present for all but the first three births. The midwives who attended the births of Harriet’s later children – and who then submitted birth certificates for those children – spelled Harriet’s name in a variety of ways (see chart).

Harriet was twenty years old when she gave birth to her first child in Co. Wexford, eleven-and-a half months after getting married. It was an unattended home birth. The child – a male who wasn’t named – only lived two hours. In what must have been devastating for Harriet following this unattended birth in her first year of marriage, Harriet herself completed both the child’s birth certificate and the child’s death certificate, reporting that the child was “weakly from birth, no medical attendant.” This first child’s birth and death records are shown below:

When genealogy was underway, we pondered whether a medical attendant at the birth might have been able to save this child; if, for example, a midwife had been present or if her father-in-law – a doctor (and, by this time, the husband of Harriet’s older sister) – had been present at the birth.

Harriet gave birth every one to three years over the course of twenty years. When one of the youngest children was born, it was born late in the evening when the other children had already gone to bed. The midwife brought the newborn into a bedroom of some of the children, asking those children if they wanted to meet their new sibling; one sibling, named Florence (who recalled this story when she was a centenarian), recalled that she and her siblings all shouted “NO!” and they pulled their blankets over their heads!  Given that her last child was born twenty years after her first child…and her last child was home until adulthood, Harriet ultimately spent forty years raising children. Harriet’s husband – who was seven years older than her – died in 1919 in Vancouver when their youngest child was sixteen, so Harriet finish raising children as a widow.

Harriet had come from a large family; she was the fifth of twelve children (plus an older half-sister from her father’s first marriage); her husband James was the youngest of eleven children. She mirrored this pattern having thirteen children, ten of whom lived (two of the children who died did so in their first three months of life, we don’t know whether the third was alive at birth). Harriet and James’ siblings, however, did not have large families. Five of Hariet’s siblings had no children, one sibling had children but we don’t know how many, one sibling had four children, two siblings had five children each. Thus, Harriet’s large brood was an outlier among her siblings.

Kim Burkhardt, M.B.A is one of Harriet’s great-great granddaughters. She co-wrote  Harriet’s biography (2016) with Brian Ellis, Brian Ellis being a grandson of Harriet’s youngest brother. The full biography tells the story of her, including more about her experience of raising children. Her biography can be ordered online at  https://harrietsusannahellis.wordpress.com/. She is now writing the biographies of all four of her maternal great-great grandmothers. These for great-great grandmothers were born in the 1840s – 1860s – one born in Ireland, one born in Canada, two born in the United States. Three of these women became widows while still raising children, the fourth died of Tuberculosis – thus leaving her husband a widower with children still at home; in no cases did these widow/widower spouses remarry until after their children were grown (Harriet was the only one to remarry at all; she remarried at the age of seventy-one). (see:  https://womenofyesteryear.com/ )

Forget Leaving Room for Jesus: Fornication and Community Control in Transitional New England

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 month, Frances Norman, a final year undergraduate student at the University of Hertfordshire, shares some insights into pre-marital sexual behaviour and pregnancy in the Atlantic world.

In July 1791 Sally Peirce ‘Swore a Child’ on Jonathon Ballard, the son of Martha Ballard, an eighteenth-century New England midwife who recorded her life across almost 10,000 diary entries. [1] Sally’s child was born in October of the same year and she and Jonathon married in January 1792. The eighteenth-century was a transitional period for sexual control across America and within New England, which was more sexually restrictive than urban areas of the country. [2] Sally’s pregnancy offers insight into premarital sexual relationships, as well as the role of community and familial control in courtship, pre-marital relationships, and the wider policing of sexuality.

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Black Mothers Matter: Social Media can Shift the Agenda for Black Maternal Health

On 25th May 2020 the murder of George Floyd, a 46-year-old Black American man, by police officer Derek Chauvin, sent social media into an uproar that reignited the Black Lives Matter Movement. The use of the global hashtag ‘#BLM’ was everywhere: through television, newspaper and social media news headlines. A week later, on Tuesday 2nd June there was a viral ‘blackout’ on Instagram, where ’28 million users posted a plain black square along with the hashtag #blackouttuesday’ to support the black community.1 

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Pregnancy Loss: A Note on Language

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, to coincide with Baby-loss awareness week, Karolina Kuberska writes about the importance of language in discussions about pregnancy loss. 


There are many difficult aspects to the experience of pregnancy loss; even the most articulate people may struggle to capture the emotional chaos or to accurately describe what it is that they have lost. While distinctions are made by professionals working in medicine and English law between miscarriage (up to 23 weeks and 6 days), stillbirth (from the 24th week), and terminations, these categories may not readily translate into how some people perceive what has happened to them: that their baby has died or that they have lost future hopes and dreams.

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Open the womb to receive seed again

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 Amy Kenny explores why superfetation was removed from The Comedy of Errors.

“Open the womb to receive seed again”: Removing superfetation from The Comedy of Errors

In the source material for The Comedy of Errors, Alcmena becomes pregnant with twins fathered by two different male suitors, a medical condition known as superfetation.[1]  Those familiar with The Comedy of Errors will recall no such plot twist in Shakespeare’s play.  So what accounts for the change in dramatizing gestation? What can this switch suggest to us about the play’s portrayal of pregnancy and twins?  Throughout the early modern period, multiple births were often considered suspicious because they played on the cultural anxiety surrounding gratuitous female sexuality.  If a woman could commit adultery even while pregnant, fathers feared the paternity of their heirs.

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