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Labouring language: the changing vocabulary of childbirth

Stork and bundle

Expectant parents don’t generally have a lot of spare time for idly perusing the dictionary, but if they did, they would find that the vocabulary of the event they joyfully anticipate has undergone significant changes over the centuries. Consider, for instance, the verb to deliver. In contemporary use, the mother is often the subject of the verb, and the baby the object (“she delivered a healthy boy”), but this usage didn’t start appearing in major dictionaries until the mid-20th century.

The original usage, from Middle English, was passive; a woman was delivered of a child.  When active use first arose, the midwife or doctor was the agent, and the woman the object: “they sent, and beg’d I would deliver her” (1676). Today, in contrast, the Oxford English Corpus shows that the most common object in such contexts is the baby, whether a healthcare provider or the mother herself is performing the action. What seems to have taken place is a reanalysis of the central metaphor. Originally, it was an outgrowth of the sense of deliver relating to liberation or rescue (“deliver us from evil”); in the context of childbirth, then, a woman was freed from the burden of her pregnancy. Today, with the child as the usual object, the metaphor is more of something being handed over and presented, like a package.

The noun labour has been used more consistently with reference to childbirth, but its central metaphor of work and effort is less evocative of the experience to which it refers than is the older term travail, which combines work with connotations of painful suffering.  Some archaic English words for childbirth are even more descriptive: in past centuries, a birth was sometimes called a groaning or groaning-time, or a crying-out. In spite of the dolorous terminology, such events were social occasions; the Oxford English Dictionary records quotations such as “he has ordered all the English nobility and gentry to be present at her crying out” (1692) and “she came from a Groaning very cheerfull” (1724). There were even special terms for the refreshments served to guests at the joyous event: groaning-cake, groaning-bread, and even groaning-beer, groaning-drink, and groaning-malt—unfamiliar words which open a window on forgotten customs.

Confined in Our Lady’s Bands

The editors of the first edition of the OED recorded that the ordinary colloquial term for childbirth at the time was confinement. That entry was completed in 1891, and the use of the term has decreased substantially since. Today, this sense of confinement is dated and relatively rare, a relic of a time when almost all births still took place at home and were followed by a period of rest when the new mother was confined to the home—before the hospital became the default birthing venue of the 20th century, with the mother’s recuperation time progressively shortened until, by the 1990s, there were complaints of drive-through deliveries.

The association of childbirth with being confined is very old. It was expressed in the form of bands or binds in the Middle English phrase Our Lady’s bands, or the bands of Our Lady (with reference to Mary, the mother of Jesus).

His…wyfe beyng then newely delyvered of child…so beyng but newe in child bed and in the bandes of Oure Lady, myght not be remeved…oute of the same place withoute jeopardie of hir deth.

1472–3 Rolls of Parliament: Edward IV

The preponderance of terms for childbirth recorded in the OED refer to the mother being in bed, including childbed (c1200), lying-in (c1440), accouchement (1730, from French accoucher, literally ‘to go to bed’), inlying (1734), and downlying (1848). None of these are in common use today, though remnants are still visible. Walking south over London’s Westminster Bridge, you can still see the grand exterior of the General Lying-In Hospital, which closed as recently as 1971 after 150 years and an estimated 150,000 births.

Call the mid-man

The OED records more than 20 terms for a person who attends or assists at a birth, entering English over a period of more than 7 centuries. Considered in chronological order, these words offer a clear reflection of the changes in birthing practices which have been recorded by historians.

Before the 18th century, informally trained female birth attendants—midwives—were the norm, although some male surgeons, wielding new instruments like forceps, assisted at births in London in the 17th century. By the mid-1700s, male birth attendants were becoming increasingly common, especially among wealthier women. Accordingly, the earliest words in the OED, attested from 1300, refer to female attendants, with the first term for a male attendant, man-midwife, arising in 1607. Initially, the terms referring to a male birth attendant, man-midwife and mid-man (1706), still expressed the role in terms of the female model. However, with the word accoucheur (1727) a new nuance emerged, of professional training as well as masculinity.

During the 19th century, standardization of knowledge and training increased, and the treatment of pregnant and delivering women became further professionalized and medicalized. The word obstetrix is recorded in English from 1773 in the sense ‘midwife’ (from the classical Latin). It was only in the 19th century that this same root produced the term obstetrics (1813), referring to a medical specialization, and thence the now-familiar word obstetrician (1826), for a doctor specializing in births. Finally, in the 20th century, with most births taking place in hospitals, a countervailing trend of natural birth, de-emphasizing the use of drugs and medical procedures, arose. In the vocabulary, this is reflected by the emergence in 1969 of the term doula, denoting a person without formal medical training who assists a woman in labour.

From the parsley bed to the cabbage patch

Even when babies were still born at home, there were squeamish adults reluctant to tell older children where their new siblings really came from. The stork as a deliverer of baby bundles is a common image in greeting cards today, but in the 17th century, an English-speaking child would have been more likely to hear that newborns came from the parsley bed. The philosopher John Locke recalled this tale in 1690:

If I believed, that Sempronia digged Titus out of the Parsley-Bed, (as they use to tell Children,) and thereby became his Mother.

   1690 John Locke Ess. Humane Understanding ii. xxvii., p. 162

This nursery story was so well established that parsley bed eventually became a euphemism for the female reproductive system (thereby undermining, one supposes, its obfuscatory effect). Under the gooseberry bush was another supposed source for babies, specifically baby boys. The North American variant of the concept, the cabbage patch, is attested in the OED from the early 20th century, but is probably most familiar now from its adoption in the 1980s as the name of a brand of dolls, the Cabbage Patch Kids.

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The OED is currently undergoing a thorough revision and the online version allows for comparison of the original 1901 definition of labour (“the pains and efforts of childbirth”) and the 2010 revised version, (“the process of childbirth from the onset of uterine contractions to delivery of the fetus and placenta”). Both definitions are accurate, but the differences between them speak to the different expectations and assumptions of our respective eras. While the underlying facts remain the same, it is not only the language of childbirth that is changing, but its lexicography as well.

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