Death Before Birth : Fetal Health and Mortality in Historical Perspective

Considering its importance, the history of fetal health and mortality remains a neglected area. Medical historians have tended to focus on maternal mortality and professional conflicts between midwives rather than on the unborn, while among the social scientists demographers and epidemiologists have until recently devoted most of their attention to infants and children. Death before Birth redresses this imbalance, redirecting attention to the fetus. A study of fetal health from the seventeenth century to the present day, it is the first book to offer an historical perspective on the subject and to combine both medical history and epidemiological and demographic research, using long-term and comparative perspectives, including a strong international comparative element, across both Europe and North America. The book not only provides an account of how fetal health and the risks facing the unborn (miscarriages, abortions, stillbirths etc) have changed, it also offers an interpretation of the causes, one that focuses on the role of obstetrics and the epidemiology of maternal infections. Along the way, it pays detailed attention to a host of related themes, such as varying cultural practices in the recognition of stillbirths; the age pattern of mortality risk between conception and live birth; comparative trends in late-fetal mortality and their causes; fetal mortality and obstetric care during the eighteenth, nineteenth, and twentieth centuries; and the contrasting approaches of the pathologists and "social epidemiologists" to the causes of fetal death. The book concludes with a study of the "fetus as patient," focusing on issues surrounding the legalization of abortion in many Western countries and the public health challenges of persistently high mortality in less developed countries. Contents......Page 10 List of Figures......Page 12 List of Tables......Page 15 List of Abbreviations......Page 17 1. Introduction to fetal health and mortality......Page 20 Definitions......Page 33 Measurement......Page 46 Influences......Page 49 Biometric analysis of infant mortality......Page 54 Fetal survival......Page 60 Conception-to-first-birthday survival: a model......Page 65 Historical implications......Page 71 Advanced states......Page 75 Late states......Page 88 Les ondoyés décédés and les faux mort-nés......Page 96 Speculations on the causes of decline and convergence since 1930......Page 101 Fetal mortality in developing countries......Page 104 Historical estimation......Page 108 5. Midwifery and fetal death......Page 121 Midwifery before 1750......Page 123 Midwifery practice according to Dr William Smellie......Page 139 Midwifery after Smellie......Page 152 Specialist studies of fetal development and abortion: Whitehead’s surveys and Priestley’s Pathology......Page 161 Diseases of the fetus and infant......Page 171 Fetal necropsy......Page 179 Social obstetrics......Page 184 The classification of causes......Page 197 7. Arguments from medical history and demography......Page 208 How should fetal mortality be explained?......Page 209 Arguments from medical history......Page 215 Arguments from demography, etc.......Page 228 Smallpox in pregnancy......Page 232 Maternal syphilis......Page 251 Combined causes......Page 254 8. Induced abortion and the fetus as patient: a continuing paradox......Page 257 Bibliography......Page 276 B......Page 304 C......Page 305 E......Page 306 H......Page 307 K......Page 308 M......Page 309 P......Page 310 S......Page 311 T......Page 312 Z......Page 313 "Considering its importance, the history of fetal health and mortality remains a neglected area. Medical historians have tended to focus on maternal mortality and professional conflicts between midwives rather than on the unborn, while among the social scientists, demographers and epidemiologists have until recently devoted most of their attention to infants and children." "Death before Birth redresses this imbalance, redirecting attention to the fetus. A study of fetal health from the seventeenth century to the present day, it is the first book to offer a historical perspective on the subject and to combine both medical history and epidemiological and demographic research, using long-term and comparative perspectives, including a strong international comparative element, across both Europe and North America. The book not only provides an account of how fetal health and the risks facing the unborn (miscarriages, abortions, stillbirths, etc.) have changed, it also offers an interpretation of the causes, one that focuses on the role of obstetrics and the epidemiology of maternal infections."--Résumé de l'éditeur Introduction to fetal health and mortality Definitions, measurement, influences The prospects for survival from conception to childhood Comparative historical trends and variations Midwifery and fetal death Fetal pathology and social obstetrics Arguments from medical history and demography Induced abortion and the fetus as patient : a continuing paradox.