Birthing Pains

Anyone who has spent time around Russians knows they tend to look to their elders for wisdom and guidance. So it is that on most any Russian internet forum for women, participants actively share and accept the experience and advice of one another’s babushkas. We are not just talking about questions like how to cook real borshch or syrniki, but also how to treat any common ailment, or how to deal with a crying baby.

In fact, when it comes to questions of health in Russia, the conventional wisdom passed down by our ancestors is often assigned as much weight as the opinions of doctors. Since our babushkas managed just fine before doctors came along, their knowledge of health and childrearing is assumed to be exceptionally wise.

In fact, they didn’t do fine at all.

In matters of reproductive health and neonatal care, our babushkas had a rough time of it.

Today, at least in the developed world, the death of a child is a rare occurrence and a tragedy. But just two generations ago, things were very different.

Among my four grandparents, born in the 1930s in Soviet Russia or Belarus, three had a sibling that died in early childhood. One generation earlier, in the 1900s, my great grandmother had eight children, but only four survived through infancy. And this was close to the statistical average for this era. In Moscow Province at the turn of the twentieth century, 516 out of every 1000 children died before the age of five. That’s right, a mortality rate of 51.6 percent.

Needless to say, the last century has seen dramatic changes in Russian maternal and infant care. But how did things look before these changes, in the Russia of a century, or a century and a half ago?

Pregnancy

Late-imperial Russian ethnographers, physicians, priests, health inspectors, and rural officials all agreed that in Russian villages – where the majority of the population lived and where most babies were born – pregnancy was not seen as a condition that exempted women from physical labor. In fact, most often it coincided with the hardest and most exhausting work of the summer months:

As is well known, in many cultures, the appearance of a child is seen as a blessing... The Russian people view a pregnant woman the same way they view any woman – as a relentless, irreplaceable round-the-clock worker. A Russian peasant woman works during her pregnancy just as she does any other time, yet the most difficult time of her pregnancy usually coincides with the time of the most difficult labor. It is common knowledge that the birthrate in Russia is highest in summer, as a result of conception in the fall, which in turn has to do with peasant’s increased prosperity in the fall, a greater freedom at this time from intense labor, and the resulting increased number of marriages... Consequently, given that the majority of births are in June and July, the greatest burden obviously falls upon pregnant women during the most difficult period of their pregnancy, and all the more so as men leave to look for work in nearby towns. And if we imagine a pregnant woman working from early morning to late at night in the fields, to which she sometimes must walk 2-3 or more versts*, working at something that is like gardening, mowing, reaping, or, for example, weeding, thinning and harvesting beets, doing all this either bent over beneath the scorching sun, or in the rain, with no food other than bread, onions and water, then it is clear to anyone that not every woman will endure this without consequences for the child.[1]

Preparing for the birth. A pregnant woman steps over the legs of her husband. The popular belief was that this ritual helped with a difficult childbirth and accelerated the delivery, because it redeemed any sins of the husband that were hindering the labor.

Making pregnant women work was particularly common in poor or less well off families, or in families with few able-bodied members, and, in particular, where the pregnant woman was the only woman available to do chores. She often worked right up to the point of giving birth, and it was a rather common occurrence in villages for a woman to give birth immediately after arriving home from work, or even while she still toiling in the yard, milking cows, weeding the garden, washing clothes, or mowing hay. This was a consequence not just of the actual need for women’s labor, but also of the general attitude to female health:

Aside from the often pressing need to work, come what may, one reason for this phenomenon is the widely held opinion that women incapable of working prior to giving birth are “gentlewomen” [барыня] and “mollycoddles.” [неженкa]

“A village woman has no time for boasting or babbling, she must work.” This is the firmly set opinion in the countryside. A peasant sees his wife first and foremost as a laborer, and often they are brought into a family for their extra pair of hands, and thus pregnancy cannot excuse them from work. Another factor is that a certain portion of peasants often have a crude and sometimes remarkable indifference to pregnant women. “What good’s a child from a woman? If only she grew a cow in her belly and that leapt out!” village jokers sometimes crudely declare. Even men beating women who are with child is a far from uncommon phenomenon in the country.[2]

A century or more ago, knowledge about the course and risks of pregnancy was limited, and there was no scientific method for estimating when a baby might arrive. Pregnant women relied on a range of popular beliefs and superstitions, most of which sound rather strange in our modern age. Here is what Popov found during ethnographic studies in the provinces of Vologda, Kaluga, Orel, Novgorod and Smolensk.

There are a multitude of omens that foretell a pregnancy, protect a child during its course, and determine the child’s sex, etc. If a woman accidentally puts on a dress inside out, she will invariably give birth to a boy or girl that year. The same is true if a wife steps on her husband’s pants, if her ears are itchy, or if she sees a crane in her dreams. When pregnant, she should not bump against the leg of a dog, cat, or pig, or else she will have pain in her legs and spine; and she should not step over a yoke, or she will get an abscess on her legs. If a pregnant woman sees carrion and spits, then her newly born child will have bad breath. And if she looks at a fire and scratches herself somewhere, the child will have a birthmark on that same spot, as if it had been burnt... A pregnant woman should not look at deformed persons or stare at the blind: these disabilities may be transferred to her fetus. She must not put a piece of bread inside the bosom of her dress, lest the child grow up to be a dullard, must not sew on holidays, lest she stitch up the child’s eyes or mouth, and it will be born blind or dumb. She should also not brush her hair on holidays, since the child will be lice-ridden, nor do this on Fridays, as it will be a difficult birth... If the pregnant woman has a pointed belly, she will give birth to a boy; if it is wide, she will have a girl. A woman who prefers herring during her pregnancy will have a boy, but if she prefers beets and radishes, it will be a girl.[2]

Childbirth

In villages, the general custom was to keep the act of childbearing shrouded in secrecy – it was assumed that the more people who knew about the impending labor, the more painful and difficult it would be. The best way to limit negative consequences was for only older female relatives or midwives to know about the coming birth. Women even tried to conceal their pregnancies from their husbands and other family members, especially young girls, inventing some pretext for leaving the home and secretly delivering the child in the bathhouse, cellar, barn, or stable.

This custom also meant that often, especially in the busy summer months, babies were born in completely unsuitable places – in the field, the woods, or on the road – and that expectant mothers waited until the last possible moment before summoning the midwife. And village midwives did not have any sort of professional training; they were just wise women, almost sorceresses, experienced in childbirth, herbs and spells.

Thus, it is usual for midwives to help during births. They are valued for their experience, for their skill at handling expectant and new mothers, for their knowledge of incantations that protect their patients from “the evil eye,” their knowledge of healing remedies, and so on. For some reason little heed is given to the fact that the midwives themselves have few children, or none at all, though those with many children are preferred: “I myself birthed a horde of children,” this or that babushka may claim to enhance her credentials... I have never met an instance of a girl or young woman practicing midwifery. Midwifery not based on one’s own childbearing, on, shall we say, personal experience, is not respected in the village.[3]

Educated observers lamented the unpopularity of professional midwives and physicians in the village and warned of the dangers of lay midwifery, that it could harm women rather than help them. The most frequent concern was midwives’ belief that the natural course of childbirth is too slow and that it should always be accelerated with pushing, squeezing, shaking, jumping and so on.

It would not be an exaggeration to say that peasant births, in the majority of cases, occur in such circumstances, and with the application of such primitive, almost barbaric, techniques, that any educated person’s heart aches with compassion – the more so that there are few knowledgeable midwives in the provinces, and the people avoid doctors, believing that the art of midwifery is “women’s business”...

The position from which peasant women give birth varies rather widely, so it is difficult to grasp which is most typical. Nonetheless, it is more usual to give birth in a vertical than a horizontal position...

Apparently, it is especially common in folk midwifery to utilize various crude mechanical manipulations that have as their goal squeezing, shaking, or by whatever other means, removing the fetus from the womb of the unlucky mother, who is justly called the unfortunate martyr. Aside from the universally favored hanging and shaking of the mother in all manner of ways, they apply pressure on her stomach and knead it. The midwives do not stop at anything in their zealous desire to complete the delivery: they force the mother to blow into an empty bottle, strain, jump over a bench, and so on, give her things that make her vomit and sneeze, giving direct and indirect assistance to the abdominal muscles, frightening the poor sufferer in various ways, even hanging her upside down.[4]

In cases of difficult childbirth, husbands could also be subjected to unpleasant procedures: they were given something foul to eat, or had to walk around the village, or might even be ritually beaten by the midwife “for the suffering of their wives.”

The first and most important thing after delivery was to steam and wash the mother and the baby in the banya or a traditional Russian oven. The banya was prepared immediately after delivery. The course of treatment usually included three steam baths and, if the situation allowed, the woman and her child spent three days in the bathhouse. According to popular beliefs, the banya helped to restore the mother’s normal physiological processes while protecting her and the baby from the Evil Eye. Whatever the case may have been, confinement to the bathhouse did free the mother from work in the household and fields. After her third steam bath, however, she was supposed to return to her duties.

Interestingly, Russian attitudes toward childbirth showed surprisingly little trust in nature. On top of the fact that midwives tried to speed up deliveries through various “manipulations” of their charge, there was a belief that every child was born defective in some manner, and midwives used the time in the bathhouse to “correct” the new baby.

After the baby has been washed and cleaned, it is “straightened out.” Attempting to make the head more rounded, the women squeeze it from top to bottom or side to side, from chin to crown, use two fingers to press down or pull up on a nose that is too wide or flat, and push together, bend and bind bowed legs... Often a newborn is confronted with other rather unhygienic practices. To ensure that the child is healthy, lively, and enjoys the love and affection of its father, after its birth it is wrapped in its father’s dirty shirt or pants. Sometimes they do without the shirt, for dressing in it before christening is considered a sin, and replace it with a piece of canvas, with a hole in the middle for the head. Sometimes the child is kept uncommonly hot, wrapped in a sheepskin blanket and placed in a warm oven twice a day for six weeks, for fear of colds; even in summer they don’t take them outside and, for the first six weeks after christening they are even afraid to wash or bathe the child.[2]

The life of the newborn and its mother in the bathhouse. At left, the midwife “corrects” the newborn child.

After all this, as medical anthropologist Yegor Pokrovsky noted in 1884, “it is obviously difficult for the Russian newborn to start his young life in good health.”

Infant Care

As noted above, Russia was traditionally afflicted with an extremely high infant mortality rate. And this was not just a sign of the times in general.

If we compare current child mortality rates in Russia with those of other states, the result throws into sharp relief the sad condition of our society. For example, for every 1000 children born each year in Ireland and Norway, on average 900 survive; in Sweden and Scotland that figure is 880; in Japan, 872; in Denmark, England, and Finland, 850; in France and Switzerland, 830; Prussia, 792; and Austria, 750. But in European Russia no more than 700 survive.5

Infant mortality rates, however, varied widely across the Empire. In and around Kursk, Nizhny Novgorod, Moscow, Perm, Samara or Vologda, one of every three or four children died in the first year of life, whereas in the Baltic provinces or those of Minsk, Poltava and Volyn, one out of every seven or eight did not survive. Remarkably, mortality among Orthodox children was twice that seen among adherents of other religions in the Russian Empire, including Catholics, Protestants, Jews, and Muslims.

Most contemporary researchers attributed the high rates of child mortality to childcare and nutrition practices. A key difference was that, while long periods of breastfeeding (as the sole source of infant nutrition) were common among most confessional groups, Russian Orthodox women did not breastfeed their babies long enough and introduced other poorly suited foods into the child’s diet in the very first weeks of its life, convinced that breast milk alone was insufficient.

Childcare devices from the 1880s. From top left, a baby crib in the shape of the manger, Tula region; crib with curtains and foot-activated rocking string, Kostroma region; walker device that helped toddlers learn how to stand.

Immediately after birth, almost everywhere among all groups of the Russian population, the newly born child is given a pacifier, that is a rag wrapped around a bit of chewed up bread or some similar substance... As Russians understand it, nearly every child is born with a so-called “internal hernia” (colic) that seriously upsets the child in its first days of life, and it must therefore be exorcised from the very start. The best remedy for this is the pacifier, especially one with black bread and salt. Incidentally, in some localities they immediately give the child a pacifier filled with carrots, beets, apples, biscuits, cakes, walnuts, or chewed oatmeal. Sometimes the pacifier is soaked in milk, vegetable oil, sugar, and honey water. In some places in Perm Province, there is the custom from the first days of life to give a pacifier filled with wort, mash and kvas, which is especially common in families that do not have cows... By five or six weeks, supplementing breast milk has become regular and required for every child. In many cases, peasant women rush to supplement children’s diet early, in the belief that their milk is insufficient for a six-week-old child, and therefore it will always be hungry on breast milk alone...

All across Russia, as soon as a child is fortified in strength, which normally happens around 4-6 months, they begin to give it all manner of strange food: potatoes, shchi from pickled cabbage, kasha, scrambled eggs, peas, beans, and in the south, baked pumpkin, beans, sour cream, mash, kvas, mushrooms, berries, cucumbers, etc.[6]

Romantic Views of Village Family Life

According to medical reports, the main cause of death among Russian babies was digestive disorders, commonly referred as “children’s diarrhea.” This is not surprising, considering what children were given to eat.

Only after the age of one did contagious diseases start to play an important role in mortality rates. There were also some seasonal variations and, interestingly, cold Russian winters were not at all a negative factor. On the contrary, children born in the winter months had much higher survival rates than those born in summer, when inadequate nutrition was aggravated by the lack of maternal attention, since mothers had to work and did not have as much time to feed or care for their children.

At no other time is a child so deprived of the mother’s breast, and at no other time does it extract from that breast such low quality milk, as in July and August, for the mother, in even the best households, must go back to work in the fields on the third day after giving birth. She cannot bring the child with her, and returns to it only late in the evening. And if the field work is more than 10 versts from home, then the mother must be away from the child for three or four days in a row every week. In some households the mother goes back to work the day after giving birth... The mother, leaving early for work, swaddles the child, perhaps even wraps it in a clean diaper. Soon after the mother leaves, the 8-10 year old daughter who has been left to watch over the child, and who does not really understand the importance of her tasks, understandably wants to run and play in the fresh air. Such a “nanny” will leave the child alone and the child will often lie in a dirty diaper all day... I saw children less than a year old, left entirely alone for an entire day, yet, so that they did not die of hunger, pacifiers were tied to their hands and feet. I sometimes brought children milk: either because all of their other daytime food had been eaten by other animals, or because they were left to suck juice, kvas and water, in which had been dissolved some rather unfresh farmer’s cheese... Flies and mosquitoes, hovering around the child in swarms, keep him in a ceaseless delirium of stings.[7]

The social and economic organization of Russian rural life meant that, during harvest at least, there was practically no one in the village to look after the babies except for elderly relatives and young children. Contemporaries describe cases where “nannies” were 6 or even just 4 years old. And older relatives were not always a better solution. In his famous poem “Who Lives Well in Russia?” (Кому на Руси жить хорошо), Nikolai Nekrasov includes a dramatic episode of child neglect when a boy, left under the care of his grandfather, is eaten by a pig.

“Our children should not have diarrhea” A Soviet poster from 1941 (by G.K. Shubina) that takes on what was the main cause of infant mortality in Russia in the 1890s, showing that it persisted as a noteworthy problem into the 1940s. The instructions specify: feed your child exclusively with breast milk until six months, dress the child lightly in summer, wash your hands and baby dishes, protect the child and its food from flies.

Given this difficult situation, most prerevolutionary physicians proposed introduction of nurseries and kindergartens in villages to care for children while their mothers were at work, and also to spread proper knowledge of child care, nutrition and hygiene among parents.

Clearly, complex measures were needed to change the situation. Although certain steps in this direction were accomplished by rural zemstvo organizations in the early twentieth century, the breakthrough in maternal and infant care did not come until the 1930s – when forced Soviet collectivization radically altered all aspects of village life.

Only after World War II did obstetricians and pediatricians reach most rural districts. And it was from these doctors – and not from their mothers or time-honored folk wisdom – that many Soviet babushkas learned about the physiological aspects of pregnancy, the value of breastfeeding, and the basics of infant hygiene and nutrition – all of which now seems so ordinary and commonsensical. RL

* A verst is about equivalent to a kilometer.

SOURCES

1. D.A. Sokolov and V.I. Grebenshchikov, Mortality in Russia and the Battle Against It (1901).

2. Gavriil Popov, Everyday Russian Folk Medicine (1903)

3. Alexei Makarenko, Material on Folk Medicine in Yenisey Province’s Uzhursky Volost, Achinsk District (1897).

4. Vasily Demich, Notes on Russian Folk Medicine (1889)

5. N. Gundobin, Child Mortality in Russian and Measures to Combat It (1906)

6. E. A. Pokrovsky, How Different Peoples Raise Children (1884)

7. F.V. Gilyarovsky Investigation of Birth and Death Rates of Children in Novgorod Province (1866)