Utopia, you are standing in it!

Medical progress contributed more than people realise to women’s liberation. The key area of progress was far fewer deaths in childbirth as the chart below for Australia shows. Deaths from childbirth disappeared from mortality statistics in the 1940s and 1950s.

Source: Australian Institute of Health and Welfare via Sydney Morning Herald This chart shows how you will probably die, and it’s changed a lot in 100 years.

The next key area of medical progress was fewer disabling injuries subsequent because of childbirth that kept women out of the workforce for several years if not permanently. In Gender Roles and Medical Progress, Stefania Albanesi and Claudia Olivetti say

Consider a typical woman born around 1900. She married at 21 and gave birth to more than three live children between age 23 and 33. The high fetal mortality rate implied an even greater number of pregnancies, so that she would be pregnant for 36% of this time.

Health risks in connection to pregnancy and childbirth were severe. Septicemia, toxaemia, hemorrhages and obstructed labour could lead to prolonged physical disability and, in the extreme, death. In 1920 one mother died for each 125 living births. At a rate of 3.6 pregnancies per woman, the compounded risk of death from maternal causes was 2.9%.

For every death, twenty times as many mothers were estimated to suffer different degrees of disablement annually. Many maternal conditions had very long lasting or chronic effects on health, hindering women’s ability to work beyond their childbearing years.

Death in childbirth and serious complications from childbirth been forgotten in modern memory. So much so that there can be an entire year in New Zealand when no child nor mother dies in childbirth. When that does happen, there is a coroner’s enquiry.

The implications of medical progress around childbirth for female life expectancy has been equally forgotten as Albanesi and Olivetti explain

The development of bacteriology, the introduction of sulfominydes and antibiotics, and the diffusion of blood banks dramatically decreased the death rate from sepsis and hemorrhage. More specific interventions, such as the standardization of obstetric practices and the increased availability of pre-natal care, reduced the incidence of hypertensive disorders of pregnancy and obstructed labour, a causal factor for many forms of post-partum disability.

These developments lead to a stark decline in maternal mortality and a rise in the female-male differential in life expectancy at age 20 from 1.5 years in 1920 to 6 years in 1960.

At the beginning of the last century, the burden of childbirth and breastfeeding simply made it impossible for married women to work in any significant number as Albanesi and Olivetti explain

In addition, due to the lack of reliable alternatives, most infants were exclusively breast fed. Women would then be nursing for approximately a third of the time between age 23 and 33.

Since the average time required to feed one child ranges between 14 and 17 hours per week, with a 40 hour workweek, mothers would be nursing for 35%-43% of their potential working time in childbearing years.

Not surprisingly given this burden, few married women worked. Only 5.4% of married women aged 25 to 34 were in the labour force in 1900.

There was an extraordinary reduction in the number of years lost in disablement after childbirth in the early and mid-20th century as Albanese in Olivetti’s explain

…the years lost to disabilities associated with maternal conditions declined from 2.31 per pregnancy in 1920 to just 0.17 in 1960.

Medical progress  around childbirth is the most important force driving the rise in the participation of married women during childbearing years and post-childbearing between 1935 and 1965. The health burden of giving birth is now measured in weeks rather than years.