Fertility matters

Alyssa Kennedy and Barbara Brookes

Alyssa Kennedy, studying Medical History, has been examining the late nineteenth century casebooks of the Dunedin hospital held at Archives New Zealand (Dunedin Branch). She chose to examine uterine complaints. Her findings remind us of the different reproductive experience of women in the past.

On 22 September 1883, a forty-three year old woman was admitted to the hospital. She had borne eight children and had had seven previous abortions. It was the eighth abortion (and the fifth in succession), at three months, that led to her hospitalisation. These were probably natural abortions since there is nothing in the record to suggest they were induced. Medical assistance was first sought when the haemorrhaging led to a ‘barely perceptible’ pulse. The doctor plugged the vagina and two days later she was brought to the hospital. Syringing and more plugging of the vagina led to the cessation of the bleeding, she gradually recovered her strength, and was discharged after one month in hospital on 23 October 1883.

On 25 January 1898, thirty-nine-year old Grace Moody from Port Chalmers was admitted to the Dunedin Hospital, complaining of constant vaginal bleeding. Grace was the mother of ten children, her last born in in 1897. The doctors decided to do an internal examination under chloroform. Dr Ferdinand Batchelor found a mass on the surface of the uterus which was removed by curettage. The uterus was then douched and ‘plugged lightly with iodoform gauze’. Douching with formalin continued over successive days until the discharge cleared up and Grace was discharged ‘cured’ on 8 February.

February 1900 saw the admission of forty-five year old Mrs Oliver, mother of eight children. Mrs Oliver had had two miscarriages and, after the birth of one her children fifteen years previously, had suffered a partial prolapse. The prolapse increased with each confinement, so that the uterus was now visible and she was subject to ‘sickening pain’. Dr Batchelor operated and amputated part of the cervix, following that immediately with ‘Alexander’s operation’ for repair of the prolapse. The patient ‘recovered very favourably’.

These cases point to the dangers of the experience of unlimited fertility in the past. Today, few women have eight or ten children, or the ten to sixteen pregnancies experienced by these women in the late nineteenth century. In fact women today are likely to spend many of their thirty years from 15 to 45 avoiding pregnancy altogether. If contraception fails, or they were not prepared, they may well resort to the morning after pill and failing that, a surgical abortion. The existence of effective contraception has made an unplanned pregnancy a personal disaster, compared to the fatalism about pregnancy that existed in the nineteenth century. Abortion is now among the most common surgical procedures that women are likely to have in the course of their lifetime. Estimates suggest that in the United States, 40 per cent of women will terminate a pregnancy by abortion.

In New Zealand, the average age for women giving birth for the first time is now thirty. ‘Fertility’, the Australian Fertility Coalition, warns ‘is ageist.’  ‘Age’, they note, ‘is the most important factor affecting fertility and your chance of having a child.’ By age thirty, they suggest, the chance of conceiving each month is about 20 per cent. At forty, that has fallen to 5 percent.

The promise of effective contraception is that women can control their futures. Talk of contraception, however, has overtaken talk of fertility and time might pass without women realizing that their fertile years are numbered. A friend in her late thirties was surprised when her GP suggested it was time for her to consider having a child. When she asked why, the GP replied  ‘because I see so many women in tears and grieving because they cannot conceive’ – they had left it too long. She followed her GP’s advice and is very grateful for it.

The physical damage of repeated childbearing in the nineteenth century might, in the twenty-first century, be replaced by the emotional stress of infertility as women try to conceive in their late thirties and early forties, having pursued careers based on male working patterns. In New Zealand, with very restrictive parental leave options, women may feel they have little choice.

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Barbara Brookes is co-editor of Corpus.

Alyssa Kennedy is completing a History Degree at the University of Otago, Dunedin New Zealand, and taking HIST 306, Medical History.

References:

• Archives New Zealand Te Rua Mahara O Te Kawanatanga, Dunedin Branch.
• DAHI 20079 D267/7/a Dunedin Hospital Records – [Medical Casebook (indexed)] 1864 1870
• DAHI 20079 D267/2/d Dunedin Hospital – [Medical] Case Book – Dr Copland, Dr Stenhouse [indexed] 1883 1891
• DAHI 20079 D267/4/d Dunedin Hospital – Medical Case Book – Gynaecological – Dr Batchelor 1898 1900

Link: A woman’s age affects her fertility