Not far from Newcastle’s imposing Central Station, a narrow street named Rosemary Lane leads towards the Church of St. John. In the graveyard here, in 1824, a young woman named Mary Stephenson was buried. She had been a patient at the nearby Newcastle Lying-in Hospital, which was established in 1760, and at the time of Mary’s death was located on Rosemary Lane. In 1826, the hospital moved to New Bridge Street, to a building designed by renowned Newcastle architect, John Dobson. Dobson’s building still stands today, not far from the Laing Art Gallery, although maternity services were transferred to the Princess Mary Maternity Hospital in 1923.
The original purpose of the Newcastle Lying-in Hospital was to provide maternity care for poor married women. It was one of several such institutions established in the eighteenth century, although the first outside of London. Its establishment reflects philanthropic practices common in Britain – particularly prior to the founding of the NHS in mid-twentieth century. Philanthropy was viewed by many as a Christian duty, and this is reflected in the words which appeared above the charity box in the entrance to the hospital: ‘Because there was no room for her in the inn’. This charity, though, did not extend to unmarried mothers: as with other institutions of its kind, the founders were insistent that care was to be offered to respectable married women only. For unmarried pregnant women, the workhouse was often their only option. These were strict rules, and procedures were in place to ensure that only women meeting these criteria were admitted. An account of the lying-in hospital from the 1820s states that ‘Every woman desiring admittance into the hospital must produce a certificate of her marriage, including the time and place of marriage’. Admittance was also restricted to those with a ‘fixed residence’, so destitute women were unable to access the care provided and would also often forced to resort to the workhouse.
Mary Stephenson was one of many thousands of women in Newcastle in the nineteenth century whose circumstances led them to give birth at the hospital. In fact, Mary attended the hospital on three separate occasions. Her case notes are amongst those included in the surviving documentation from the hospital, held by Tyne and Wear archives. They reveal very few details of her life, but nonetheless they do offer an insight into the maternal experiences of some poorer women in nineteenth-century Britain. Stephenson’s case was a particularly tragic one. She suffered from a distorted pelvis, which made it difficult for her to give birth. This condition was not unusual, particularly amongst the poorer classes, and was often cause by rickets – a disease associated with poor diet and lack of sunlight. One work, published in 1855, commented on ‘the frequency of rickets among the poor classes’ in Newcastle at this time, citing the city’s ‘large poor population, crowded together in its imperfectly drained streets, […] many narrow, dark, and ill ventilated courts and wynds, stagnant cess-pools and drains, and over-populated houses’. It was in these areas in particular, the author noted, that there was a high incidence of rickets. The disease could lead to severe distortion of the skeleton, and in some cases make it impossible for sufferers to deliver live children. Caesarean sections were rarely performed at this time as they posed too much of a risk to the life of the mother, so in cases of difficult labour, destructive operations (craniotomies or embryotomies) were often performed on the child in order to enable delivery, as Mary’s experiences evidence.
Mary was first admitted to the Newcastle Lying-in Hospital in July 1820, to give birth to her second child. Her first child was born around 1813, when Mary was around twenty years old, and was delivered via craniotomy, so didn’t survive. Her second child, a daughter, was born prematurely at seven months. Doctors sometimes resorted to inducing labour early in cases such as Mary’s in order to increase the chances of a live birth. Mortality rates for premature babies were high, and, it is possible – even likely - that Mary’s daughter did not survived for long. Her third labour, in 1822, also ended in a craniotomy – performed at the Newcastle Lying-in Hospital. When she was admitted to the hospital for the final time in 1824 to deliver her fourth child, a positive outcome therefore seemed unlikely, particularly as she seems to have ignored the advice of doctors to induce labour early and the pregnancy was full term (a decision which suggests her previous premature child did not survive and she was not willing to take the risk again). Against the odds, though, she delivered a live daughter, and initially the doctor’s notes suggest she would make ‘a favourable recovery’. Two days later, however, she developed symptoms of puerperal fever – a condition, sometimes known as childbed fever, caused by infection following childbirth. Her condition deteriorated rapidly, and she died on 13 th February 1824. She was buried in the nearby church yard the following day, with the hospital covering the costs of the burial.
Mary’s death was not unusual. Maternal mortality rates remained at approximately 0.5% throughout the nineteenth century. Her experience of infant loss was similarly relatively commonplace: infant mortality was high, particularly within the first year of life. Stillbirths were also not uncommon: one nineteenth-century statistician estimated a stillbirth rate of 3%. As a poor woman living with a disability, Mary’s individual risk of maternal death, stillbirth, and infant loss was considerably higher than average: her distorted pelvis increased the risk of difficult births, which in turn increased the risk of both maternal and infant mortality. The lives of women such as Mary Stephenson were largely undocumented. The archives of institutions such as Newcastle’s Lying -in Hospital offer us glimpses into histories and stories that would otherwise be lost, providing a brief window into the lives behind the statistics.
Jessica Cox is a Senior Lecturer at Brunel University London. She is currently writing a book on maternal experiences in nineteenth-century Britain.