Motherhood in the Old South: Pregnancy, Childbirth, and Infant Rearing (review)

82CIVIL WAR history Motherhood in the Old South: Pregnancy, Childbirth, and Infant Rearing . By Sally G. McMillen. (Baton Rouge: Louisiana State University Press, 1990. Pp. 237. $24.95.) Sally McMillen's Motherhood in the Old South expands substantially our knowledge of white, well-to-do women's lives, and prompts a recasting of some of our traditional assumptions. As a particular set of historical experiences, motherhood has received little scholarly attention. Its very universality has appeared to render it indistinct, but few events have shaped white women's lives as significantly as have pregnancy, childbirth, and the care of children. White women in the Old South were pregnant frequently, maternal mortality rates were high, and the lives of those who did survive centered on the care and nurturing of their many children. Such important experiences deserve careful scholarly attention, and Professor McMillen provides this here. The author's study is focused on well-to-do, white women from across the South who lived, wrote diaries, and corresponded in the period from 1800 to 1860. One of the most valuable aspects of McMillen's study is the number and geographical breadth of the sources that form the basis of her work. These range from well-known collections, like those of the Jones family of Georgia and Mary Boykin Chesnut of South Carolina, to those less frequently relied upon, like the papers of the Mordecai, Lenoir, and Cameron families of North Carolina; the Howe and Watson families of Alabama; and several Louisiana families. McMillen writes not only of women but also of the doctors who took increasingly prominent roles in their lives. Relying upon medical advice books, medical journals, dissertations, physicians' account books, and secondary literature, she constructs a narrative that is a well-informed blending of medical and women's history. Medical practice played a less significant role, according to McMillen, in women's pregnancies than in childbirth. Pregnancy was considered a special time but not pathological. Thus the need for doctors was limited, and their assistance was sought only in the direst circumstances. Because pregnancy lowered their ability to fight disease, Southern women often experienced a heightened version of the South's usual experiences with poor health. But, except in the worst cases, well-to-do women relied on themselves, on other women, and on the ubiquitous medical advice literature during pregnancy. In childbirth, however, these Southern women, like women in the urban northeast, began to make more frequent use of physicians. This choice expressed an awareness of status, and a desire to have what was assumed to be the safest, most competent care. This assumption about the nature and practice of obstetrical care is questioned by McMillen. BOOK REVIEWS83 Southern doctors used extremely intrusive procedures, like bleeding, blistering, leeching, and drugging, and these treatments administered during labor often impeded the natural processes of delivery or, because of their severity, endangered the woman's life. It is appropriate for McMillen to emphasize the changes in women's experiences in pregnancy and childbirth; while also documenting the continuation of traditional medical patterns. Midwives, who practiced far less intrusive delivery methods, were still used in many births, and the presence of female friends and relatives to support parturient women remained important. Frequently, the old and the new were merged, but the role of the physician would continue to expand. McMillen catalogs the medical concerns of childbirth and those medical problems resulting from childbirth. She then turns her attention to the diseases of the newborn—cholera infantum, teething, croup and other illnesses all rendered tenuous the lives of infants in the antebellum South. It is from the perspective of these childhood diseases that McMillen delineates the mother's role. Well-to-do Southern women often breastfed their children for reasons that were rooted in tradition, convenience, and emotion, but their breast-feeding practices also helped fend off childhood diseases, especially those caused by the consumption of spoiled milk or food. When, as was often the case, diseases struck the young, their care was the mother's domain. A woman could delegate household responsibilities and the care of healthy children to others, but she viewed the care of a sick child as her special...