One of the more sobering aspects of the ‘Bodies Under the Library research has been the mother and infant burials that are recorded in the Tombstone Records for Square Church. Being born, and giving birth, was a dangerous business. After that, being a small child in the 1800s with all the attendant deadly diseases to navigate, was the next hurdle to overcome.

In the nineteenth century, the maternal mortality rate was approximately 5 per 1000 births, 0r 0.5%. The exact number of women who died from childbirth over the course of the century is difficult to estimate as causes of death were not always accurately recorded, particularly before the introduction of civil registration in 1837. Even after civil registration, the cause of death listed on death certificates did not always indicate if a woman was pregnant or had recently given birth.[1] Deaths due to abortion were sometimes deliberately obscured. 

In the nineteenth, and through to the mid twentieth, century the main causes of maternal mortality were puerperal fever (most cases were caused by the bacteria Streptococcus pyogenes), haemorrhage, convulsions, and illegal abortion. Puerperal fever was initially believed to be caused by ‘infectious vapours of the air’. The medical profession eventually accepted (after much denial) that this infection was being transmitted to women from the midwives and doctors attending births and took action to prevent this transmission, including compulsory hand washing and the use of gloves, masks, and antiseptics.

Convulsions likely referred to the conditions eclampsia and pre-eclampsia which became less deadly following the introduction of a national system of antenatal clinics in the 1920s by Dr Janet Campbell, a medical officer at the Department of Health.

Increased understanding of the importance of asepsis and antisepsis, advances in medicine and midwifery (including professional training and certification for midwives) and the availability of legal abortion and contraception led to a dramatic decline in maternal mortality from the mid-1930s.

In Halifax, the Medical Officer’s reports[2] provide local mortality statistics for infants and for adults by age and sex. Although the reports in our collection date from 1875 onwards, things had not improved much for mothers and infants since the beginning of the century.

In the period 1875-9, infant mortality in Halifax was 173 per 1000 births, compared to the national average of 145 per 1000. The higher rate in Halifax could perhaps be explained by the poor living conditions of the working population and industrial pollution. By 1900-4, the infant mortality rate was 132 per 1000 births in Halifax and 143 per 1000 births nationally. Infant mortality rates fell gradually through the first half of the twentieth century, with improvements linked to public health initiatives, and an increase in living standards and improved access to medical care for working class people.

Causes of death for infants listed in the Medical Officer’s reports for Halifax in the nineteenth century include dentition (teething), ague (fever), premature birth, accidents of childbirth, convulsions, apoplexy (used to describe any sudden death that began with an abrupt loss of consciousness, often stroke) and quinsy (infection of the tonsils). In this period, the causes of death in infants were not always properly understood. Fever was widely considered to be a normal symptom of teething, as were convulsions and diarrhoea. If a child developed these symptoms whilst teething, their care givers may have considered this normal, and if they then died the cause of death would be listed as teething.

The Archaeological Excavation of Square Chapel Burial Ground, carried out by Archaeological Services WYAS, contains further evidence that many children in Halifax did not survive beyond early childhood. The osteological (bone) evidence suggests that this may be at least in part due to nutritional deficiencies, with skeletal remains indicating infants who had suffered from scurvy and rickets.

20% of the excavated female skeletons were young adults (18-25), whose deaths may well have been linked to pregnancy and childbirth. There were no male skeletons in the young adult category.

Of the non-adults excavated from Square Chapel, a quarter were infants (1-12 months), over a third were young juveniles (1-6 years). There were also six foetuses and one neonate (birth-1 month)[3]. This underrepresentation of foetuses and neonates suggests that they were either interred elsewhere, or that their mortality was lower than the infants and young juveniles who succumbed to childhood diseases and inadequate nutrition. The nutritional deficiencies present in infants and young juveniles suggests that the environmental factors that the infants were exposed to were significant. Bottle feeding prior to routine sterilization of feeding equipment was dangerous, as was weaning onto pap (a mixture of flour and water) as it lacked necessary vitamins and minerals.