A Good Birth Medieval Lives: Birth, Marriage, Death

This programme contains very strong language.

In December 1441, a 19-year-old woman named Margaret Paston

was staying with her mother-in-law here in Norfolk.

Her young husband was away in London,

and she wrote to ask him to buy her a new girdle,

a decorated belt to wear over her gown.

She said ruefully, that she'd grown so shapely

only one of the girdles she already owned would still fit round her.

But there was a good reason for her changing shape.

She was six months pregnant with her first baby.

And that meant Margaret, like all other expectant mothers

in the medieval world, was about to face the greatest danger

she would probably ever encounter.

She knew she'd need help in facing it,

but the help she'd need wasn't the presence of doctors,

it was the presence of God.

They say the past is another country,

they do things differently there.

But just how differently did the medieval world approach

life's great rites of passage - birth, marriage and death?

The way we handle these fundamental moments of transition in our lives

reveals a lot about how we think and what we believe in.

For the people of the Middle Ages, this life mattered,

but the next one mattered more.

Heaven and Hell were real places,

and the teachings of the Catholic Church

shaped thoughts and beliefs across the whole of Western Europe.

But by the end of the Middle Ages, the Church would find itself

in the grip of momentous change,

and the rituals of birth, marriage and death

would never be quite the same again.

For medieval women approaching the moment of labour and birth,

like 19-year-old Margaret Paston,

there were no antiseptics to ward off infection

or anaesthetics to deal with pain.

And male doctors were not allowed into the female space

of the birthing room.

What Margaret knew was that the pains of labour

were the penalty for the original sin of humankind.

So, to get through them, she needed the help of the saints

and the blessing of God himself.

So what was the medieval way of birth?

Margaret was a member of the Paston family.

They came from Paston village and by the 15th century,

they had estates across north-eastern Norfolk,

as well as a fine townhouse in Norwich.

And they lived in one of the richest

and most cosmopolitan parts of the country.

Norwich was late medieval England's second city.

But they weren't aristocrats.

They were as ordinary, or extraordinary,

as any other well-to-do family.

But what makes them unique, and why we know so much about them,

is that we still have their letters.

It's a remarkable stroke of luck that we have them,

because almost no private letters survive from this period.

Most of the Paston Letters have ended up here,

in the British Library, and they form the earliest great collection

of private correspondence in the English language.

More than a thousand documents survive,

spanning three generations of the family.

We don't know what the Pastons looked like,

and most of the houses they lived in are long gone,

but thanks to their letters, we can still hear their voices.

I've been working on the letters for 25 years,

but because they've been in print for a long time,

I very rarely get to see the real thing,

so this is thrilling,

because the Pastons feel like my medieval family.

That's because these letters give us glimpses of a human experience

that speaks across the centuries.

Today, birth is openly discussed.

We go to classes to prepare for it, it's debated in the media,

and childbirth even appears on television as entertainment.

But in the Middle Ages, birth was a much more private experience.

So we're very lucky to have one surviving letter

in which Margaret Paston talks about her first pregnancy.

Margaret wrote this letter at the point

when her pregnancy was becoming public knowledge.

She was getting so big, which is why she needed a new girdle,

that she couldn't keep the news secret any longer.

"I may no longer live by my craft," she says.

"I am discovered of all men that see me."

By now, of course, her pregnancy was completely certain,

but it wouldn't have been for some time.

There were no pregnancy tests,

so women had to rely on physical symptoms,

which would then be confirmed by the "quickening",

the point at about four months when the mother could feel the baby

moving in the womb for the first time.

Margaret clearly wants her husband home with her.

"You have left me such a remembrance," she says,

"that makes me to think upon you

"both day and night when I would sleep."

Anyone who's ever been pregnant will know that feeling all too well.

But that's all we know.

There are no other details in the letters, literally nothing,

to tell us what her experience of labour and delivery were.

And that's because, in medieval England,

the process of birth was hidden behind closed doors.

The experience of this fundamental rite of passage

was very rarely written into the historical record.

So to get a glimpse of this hidden history,

to open the door into the medieval birth chamber,

we have to piece together fragmentary clues.

And we can start with one small group of women

whose experience of birth has left its mark in the pages of history.

Royal women.

Because when a queen gives birth, it isn't just a personal matter,

it's a matter of national importance.

After all, a royal baby might grow up to rule the country.

And the significance of a royal birth was never greater

than when a dynasty hung in the balance.

In 1485, after years of civil war in England,

known as the Wars of the Roses, Henry VII had won the crown

and married Elizabeth of York.

But to ensure a peaceful future they needed a baby - an heir.

So now, at the age of just 20,

Elizabeth was pregnant for the first time,

and the future of this brand-new dynasty rested on her shoulders.

Everyone - king, queen and country -

was well aware of the significance of this imminent birth.

Three weeks earlier,

Elizabeth and Henry had moved their court to Winchester,

the ancient capital of England,

which was thought to be the site of Camelot,

the legendary court of the heroic King Arthur.

And it was the birth of a new royal Arthur

for which England was now waiting.

Just before the baby was due, an elaborate service was held

here in the ancient cathedral.

This was the ritual through which the Church

asked God's blessing on a woman approaching her confinement.

And Elizabeth, like Margaret Paston half a century earlier,

knew that God's help would be vital for the ordeal that lay ahead,

because no matter how powerful you were in life,

birth in the Middle Ages was a dangerous business.

Elizabeth was led in a magnificent procession to attend Mass

here in the cathedral, surrounded by the lords and ladies of the court.

And then, with the prayers of the assembled company

ringing in her ears, she withdrew into her inner chamber,

and the curtain was drawn across the door.

The next time she emerged, if she survived, she would be a mother.

These days, if we talk about a confinement,

we mean the actual process of childbirth.

For a medieval woman, like Elizabeth,

its meaning was much more literal.

A few weeks before the birth was expected to take place,

Elizabeth "took to her chamber".

From this point onward, tradition dictated that she would be

attended only by women, because men were banned from the birthing room.

The inner chamber was smothered in tapestries,

and only one window was left accessible

to let in a sliver of light.

Letting in too much light, it was believed,

might damage the baby or strain the eyes of the labouring mother.

The tapestries were richly patterned,

but they didn't depict dramatic scenes

which might upset a woman in labour.

As one contemporary said,

"Imagery is not convenient about women in such case."

The floor was laid over and over with carpets,

and the effect was to make the whole room almost womb-like.

Dark, warm, quiet and enclosed.

But all the comforts a royal treasury could provide

couldn't protect Elizabeth from the dangers of childbirth,

so she'd need spiritual comfort too.

Holy relics stood ready on an altar

to bring the protection of the saints

for what she now had to face.

At this point in contemporary accounts of Elizabeth's labour,

the doors of the birthing chamber are firmly closed.

The next we hear is that at about one in the morning

on the 20th September 1486,

Elizabeth of York gave birth to a boy, the first Tudor heir.

And this baby, born in "Camelot", was named Arthur.

And with the birth of this little boy came the birth of a dynasty,

one of the most famous in English history - the Tudors.

The royal couple had invoked God's help before and during the delivery,

but the Church's influence on birth began much earlier,

before the baby had even been conceived.

For rich and poor, the great and the humble,

the Church shaped ideas not just about birth,

but about how birth came about.

And that meant sex and the workings of the female body.

And there were two women who dominated the Church's teaching

on the subject of birth.

Mary, the Virgin Mother of Christ,

and Eve, the mother of mankind, who was most definitely not a virgin.

This divided image of womanhood had a huge impact

on the way medieval people understood the process of birth.

And the Church's teaching was communicated not just through

the sermons people heard in church every Sunday,

but through the pictures they saw on church walls all around them.

Once, every medieval church was covered in paintings

designed to help people understand their faith.

Now this church, St Agatha's at Easby in Yorkshire,

is a rare survivor.

This 13th-century painting depicts the Old Testament story of Creation

which was crucial to the Church's attitude to birth,

because birth could only ever follow sex,

and sex was tainted by the Fall.

Everyone knew the story of Eve.

She was created out of Adam's rib to be his companion.

But when she gave in to the serpent

and took the forbidden fruit from the Tree of Knowledge,

she caused the Fall from the Garden of Eden

and brought shame to mankind.

So women, the daughters of Eve, were weak in the face of temptation

and driven by unruly sexual appetites.

As the disapproving angel in this painting makes clear,

they were a constant threat to the higher spiritual values of men.

There were some in the Church who saw "godly" sex in marriage

as a joyous thing, but many saw it as a necessary evil.

All believed it should be confined to marriage

and intended for the purpose of procreation.

And the Church could be very prescriptive

when it came to restraining this most basic of human urges.

If we put together all the various rules

in early medieval penitentials -

handbooks for priests taking confession -

people would have found themselves forbidden to have sex

during Lent, Advent, Whitsun week and Easter week,

on feast days and fast days,

Sundays, Wednesdays, Fridays and Saturdays,

or on their wedding night.

And you couldn't have sex during pregnancy, menstruation

or breastfeeding, during daylight, if you were naked,

or, perhaps easier to follow this one, if you were in church.

But there were ways in which the Church's teaching on sex

potentially had a more positive impact.

It was believed that men and women both had to produce seed

in order to conceive,

so godly sex, for the purpose of procreation,

meant that women needed to have an orgasm.

It seems unlikely that anyone ever actually followed

the Church's detailed prescriptions about sex to the letter.

But what's certain is that women continued to get pregnant.

And when they did, the Church told them to expect a world of pain.

In the Book of Genesis, God thundered at Eve,

"I will greatly multiply thy sorrow and thy conception.

"In sorrow, thou shalt bring forth children."

In other words, the risks and the pains of pregnancy and birth

were direct consequences of the Fall,

and all women inherited this burden of shame.

So while children might be a blessing,

the physical process of pregnancy and birth

was one of suffering caused by sin.

That knowledge can't have helped Margaret Paston's nerves

as she waited to deliver her first child.

But would she find any more help in the medical world?

Oxford has been a university town since the Middle Ages,

but back then, all academic study was pursued

within the cloistered world of the Church.

So the people who studied medicine were themselves clerics.

So at the heart of the medical understanding of conception,

pregnancy and birth, was a deep irony.

These ideas were the preserve of men, who, in theory at least,

were celibate and would never themselves father children.

But that didn't mean they weren't fascinated by reproduction.

Medieval scholars produced over 150 texts

on the subject of Gynaikeia, the Greek word for "women's matters".

The basis for many of these was a text

which became known as the Trotula.

It was a text which was supposed, uniquely,

to have been written in part by a female healer in 12th-century Italy,

and it combines folkloric remedies

with a more academic understanding of birth.

Many English versions of the Trotula texts were made in the Middle Ages,

and this brilliant manuscript is one of them,

now kept here in the Royal College of Surgeons.

Some of the chapters deal generally with women's health,

but some relate specifically to conception and birth,

including this one about an art that's been lost to modern science -

how to choose the sex of your baby.

"If she desire to have a man-child,

"they must take the womb of a hare and the cunt

"and dry it, powder it and drink it with wine.

"If the woman desire to have a maid-child,

"let her dry the stones of a hare," the testicles,

"and do the same thing."

I'm not entirely sure this would work,

but at least wine was involved.

So, thanks to texts like the Trotula,

among academics, at least,

there was a received wisdom about conception and childbirth.

And it's possible to get a sense of that from an encyclopaedia

that was compiled in the 13th century by a friar

named Bartholomeus Anglicus - Bartholomew of England.

He started his career here in Oxford before travelling to Europe

where he wrote his encyclopaedia.

It still serves as a wonderful handbook of medieval thought.

So he says in his chapter on babies,

"The little child is conceived and bred of seeds

"with contrary qualities, and he is fed and nourished

"in the mother's womb with blood menstrual of so vile matter

"and unstable,

"man taketh his nourishing and feeding from the beginning."

Men like Bartholomew were relying

on the most authoritative medical texts available,

but they were based on very little contact with women

and very little real understanding of how women's bodies worked.

And that male perspective on medieval women

is revealed in an amazing manuscript known as the Wellcome Apocalypse.

I went to see it at the Wellcome Collection in London,

with the female expert on medieval medicine, Carole Rawcliffe.

..15th century. It's a sort of manual for life and death,

because it takes you from the end of the world, through how to die,

through knowledge about the body, and then into vice and virtue.

And like Bartholomew, it has theology and medicine

all in one package?

You can't separate them in this period, it's impossible to do that,

bearing in mind of course that many physicians are priests.

Am I right in thinking from all that,

that the right way to be was to be male?

Women are seen as rather botched and bungled versions of men

from this standpoint. It's a very male one, you know!

Physically and intellectually?

Physically and intellectually,

because they're not developing as well as men.

This is an extraordinary diagram of the female body.

Could you just help me understand how it works?

Women are effectively men inside out,

so their organs haven't developed outside their body.

And so the vagina, which is here, is an inverted penis and so on.

You're really looking at a set of reproductive organs

that haven't developed properly,

that mark women as being inferior beings.

-Ovaries which are, presumably, instead of testicles?

-Yes, yes.

And there's a real sense too that women are not only imperfect

but also unclean.

Bartholomew refers to menstrual blood as "vile matter",

even though it's what the foetus is nourished by.

The idea evolves that women are poisonous

or slightly toxic at this time.

Her gaze, for example, can make fruit die,

tarnish mirrors and even killing children in cots,

which, you know, explains cot death.

But this is coming to us from clergy,

and ordinary people who knocked around in ordinary life

would not necessarily have ideas like this.

What happens then when we get to the point of birth?

There's all this sophisticated knowledge analysis of anatomy,

of conception and how the whole thing works -

is the door of the birthing room shut to male physicians?

The actual hands-on business in the birth chamber

was largely a female one, and it was a matter of decorum

to leave it to women, because many of these people are priests,

so it's not something that they should be dealing with.

Given the limitations of medical knowledge

and the fact male doctors wouldn't even enter the birthing room,

women were on their own when it came to giving birth.

It was direct experience, experience from within the delivery room,

that shaped women's views of birth.

And some of those experiences could be extreme and traumatic.

One woman who knew that more than most

was King Henry VII's mother, Margaret Beaufort.

In 1455, Margaret Beaufort, heiress to a powerful Lancastrian dynasty,

was married at the age of 12 to 26-year-old Edmund Tudor.

12 was the earliest age at which the Church allowed girls to marry,

but even then it was considered young

to be married in the fullest sense,

so consummation was often put off for a couple of years

to make sure the bride was physically ready.

But Margaret was such a valuable heiress,

and her husband so keen to secure his hold on her inheritance,

that he made her pregnant straightaway.

If being pregnant at 13 wasn't terrifying enough,

six months into the pregnancy, her husband, Edmund, died of the plague,

leaving Margaret a widow.

When she went into labour, she wasn't yet 14,

and as a contemporary pointed out... "Not a woman of great stature.

"She was so much smaller at that stage."

It was a traumatic delivery,

but Margaret did give birth to a healthy boy, the future Henry VII.

But despite two more marriages, she never conceived again,

and it seems likely that this labour, at such a young age,

left her irreparably damaged.

40 years later, Margaret found herself in a position

to influence the proposed marriage of her nine-year-old granddaughter

to the 18-year-old King James IV of Scotland.

Because of her own experience, Margaret argued against the match.

Her views are made very clear in a letter by her son, Henry VII.

"My mother is very much against this marriage.

"If the marriage were concluded, we should be obliged to send

"the princess directly to Scotland.

"In which case, they fear the King of Scots would not wait

"but injure her and endanger her health."

So, who did women have to turn to in traumatic deliveries?

Who was there to help them cope with even a straightforward birth?

The answer was a woman with very particular skills.

The midwife.

There's a clue about how important the role of the midwife was

to labouring women in Margaret Paston's letter to her husband.

It was a little unnerving

that the local midwife had a chronically bad back.

"Elizabeth Peverel hath lain sick 15 or 16 weeks of the sciatica."

But Margaret had been reassured by a message

that she would nevertheless...

"Come hither when God sent time,"

even if she had to be "pushed in a barrow".

So what might Elizabeth Peverel have done

to help Margaret during her labour?

This image from a 16th-century manual for childbirth,

called The Birth Of Mankind, of course,

shows what it calls The Woman's Stoole.

It's what we might call a birthing stool,

used to help a woman deliver

in the sometimes more comfortable upright position,

rather than lying down.

And in this one, the woman is supported from behind

in an embrace familiar to anyone who has attended an ante-natal class.

These are practical and helpful suggestions for a normal delivery.

And in the Trotula manuscript in the Royal College of Surgeons,

there are some other clues about what a midwife might do

if the situation became more challenging.

There's a section concerning the delivery of the baby.

Here...

we have some wonderful pictures of the various ways

the foetus might present, with instructions about what to do

if it's in any of these rather acrobatic positions.

Here the baby is upside-down, as it should be, but its head

is... "Too much and too great, so that it can't come out.

"In which case," the text says,

"The midwife should anoint her hand with butter or with oil

"and make the mouth of the privy member's large

"and bring him out with her hand."

The manuscript makes it sound straightforward,

but what would a modern midwife think?

BABY CRIES

Janette Allotey is a midwife and chair of Departu,

a group that studies the history of childbirth.

When you're reading about medieval midwives,

is there a huge gulf separating your experience from theirs?

Or do you feel there are common threads

stretching over the centuries?

I think if I was speaking to you now as a midwife,

I can empathise and I can understand

where the midwives are coming from when they describe births.

And, you know, basically,

women still give birth the same way,

so the mother would look to the midwife for direction

and she would be supported by the other women that were there.

That's the main thing, really - having confidence

in birth and in the midwife.

That can be said today as well.

So the differences between then and now are, perhaps,

more extreme in the medieval texts

-than they are in what the midwives were actually doing?

-Yes.

And I think if the midwives could have access to the medieval texts,

they may disagree with a lot of what was in them.

The images actually don't bear much of a resemblance of reality.

Erm...

the foetuses look like little adults

and they're in very roomy uteruses, with very thin walls.

They are totally theoretical examples of what might happen,

the positions they might get in,

and also the descriptions of how to manage these foetuses

in these difficult positions.

Some of them are not actually very practical at all.

There is very little detailed instruction on how

to actually do these things.

It says you can turn the baby around, push it up,

move it around, and if you speak to any midwife or obstetrician,

and they'll say it is not that easy.

In a baby at term, there is very little room in the uterus,

and it is a muscle - it's contracting all the time.

You can't learn midwifery from books.

Midwives had practical experience,

but in some difficult births, without the help of modern medicine,

experience wouldn't be enough.

Who else could save a labouring woman?

Once again, the Church stepped in, because God might help

where man, or woman, couldn't.

Here in Winchester College, there's a 12th-century manuscript

which records the miracles that were believed to have happened

through the intervention of St Thomas Becket.

After his murder in Canterbury Cathedral in 1170,

Thomas rapidly became one of the most popular saints in England.

He was called upon in all sorts of desperate situations.

And this manuscript offers one of the rare moments

where we actually catch a glimpse inside the medieval birthing room.

Here at the beginning of the manuscript

is a beautiful illumination of the saint himself,

Thomas Becket, and then page after page in Latin

of miracles performed through his intervention.

And the one we are looking for is here.

It's a story told by a priest called Henry,

Henricus, who came to Thomas's shrine at Canterbury,

and there he told brother William about a woman from his parish

who had had a difficult labour.

Tellingly, we know the names of both the priests

but not the woman or the midwives who attended her.

Henry explains that the baby's head didn't come out first.

Instead, one arm emerged and then it swelled up

to the size of a man's leg -

"grossitudine gambe virilis".

For a day and night, she laboured in great distress,

but nothing the midwives could do made a difference.

In despair, she began to make her will.

And because her life was in danger, Henry, the priest, was called.

Priests were literate and might have some medical knowledge,

but in this case,

all he could suggest was cutting off the baby's arm.

Until he remembered that he had some water, aqua,

from the shrine of Thomas Becket,

and as soon as the woman drank it,

the arm disappeared back into the womb, and the baby began to turn.

When the baby was finally born, it was already dead...

..but the mother's life was saved,

and that, in a complex and dangerous birth like this one,

was a miracle.

So despite the fact the Church taught that childbirth

should be painful to pay for Eve's sin,

one powerful thing it could also do was bring comfort and hope

into the delivery room.

And that spiritual reassurance

could even take the form of physical objects.

In the Museum of London, there's a jet bowl,

which is a remarkable survivor from the medieval labour room,

and it fascinates archaeologist Roberta Gilchrist.

The material itself of jet was regarded by medieval people

as holding special properties.

One of the things that it could do

was to ease a woman's pain in childbirth.

And we know that this very, very special material

wouldn't have been used for ordinary bowls.

There's no way this is tableware - nothing else survives like this -

but it was turned on a lathe, like a piece of wood.

It is very similar to a wooden bowl.

But the size of this, and the way you can cup it in your hand,

suggests that this might have been used for even drinking from.

I think what we have here is a very special thing...

of an object that's used in childbirth,

possibly from the kit of a midwife,

who would have travelled from birth to birth

and would have used this in the birthing room

to serve a liquid of some kind to the woman.

And the liquid would take up the special powers of the jet,

so she would ingest the jet,

and this is believed to help her

with the childbirth.

This is extraordinary, then, because it's so hard to get inside

the birthing room in the Middle Ages.

Does this give us a sense of a wider range of practices

that midwives would have employed?

Well, there are all sorts of things that are in organic materials

that don't survive.

We know that they would have been using parchment amulets

and girdles and placing them on the woman.

They would have been chanting using special charms.

They would have used other materials like amber,

and coral would also have been brought in.

All of these were regarded as natural objects

with special properties that could help people.

How would the Church have felt about a bowl like this?

Would it have disapproved?

No. This is an interesting thing.

This is what we call now "natural magic".

Magic which draws on the properties of the natural world.

The Church wouldn't have disapproved of natural magic,

because it can draw on any demonic agency or intermediary agency.

This would have been regarded as part of God's Creation.

God creates the universe, God creates animals

and gemstones and rocks and minerals,

which are believed to have special properties.

It is absolutely consistent with the Church.

So a midwife, with the Church's blessing, might use a jet bowl

to comfort a frightened woman in labour.

And that woman would need as much comfort as she could find,

because she would have no pain relief in childbirth,

and the possibility of dying was very real.

Perhaps these fears were preying on Margaret Paston's mind

as she wrote to her husband, urging him

to return from London to be by her side.

"I pray you that you will wear the ring with the image of St Margaret

"that I sent you for a remembrance till you come home."

St Margaret was not only her own namesake

but the patron saint of pregnant women and childbirth.

We have no way of knowing what Margaret Paston had with her

for comfort during her labour and birth,

but it might have been something like this.

This is a rare and truly remarkable document.

It's a real privilege to be looking at it.

It's a 15th-century prayer roll, and on it is a poem

in French telling the story of St Margaret.

St Margaret might seem like an odd choice for women in labour.

She was a virgin martyr who died around the turn of the 4th century,

but before her martyrdom, she was swallowed by the dragon.

Here he is in the poem.

She was then disgorged from the beast's belly

when the crucifix she was holding got stuck in his throat.

So the idea was that babies would be born as safely as St Margaret

had been delivered from the dragon's stomach.

But the really moving thing about this roll

is how fragile it is,

and that's because it was made to be used

as a birth girdle to be placed around a woman in labour.

Who knows how many deliveries it's seen,

but this roll brings us as close as we can get

to the experience of medieval birth.

Whatever Margaret Paston did during her labour, it worked.

She safely gave birth to a baby boy and named him John after his father.

It might be easy now to dismiss the comfort of a prayer roll,

a jet bowl or water from a shrine

as little more than superstition.

But we shouldn't be too quick to dismiss

the effects of psychology on the physical process of birth.

Lucyann Ashdown spent years as a midwife specialising in home births

and delivered hundreds of babies, one of them mine.

She is now a priest in rural Wales, and this combined experience

has given her a clear idea

of how effective special objects can be during labour.

Birth is very powerful,

and it feels as though it's a power outside yourself.

But it's not...in one way. In one way it is, in another way it isn't.

And particularly, you know, in the West, we're used

to having quite a lot of control over our lives.

Things we don't understand tend to make us feel anxious.

So even if we're taking a very rational

and scientific approach to this,

there is a way in which faith

could be very practically useful in overcoming fear?

Definitely.

We know scientifically, if we are going to use scientific information,

we know that fear is not good to have around in any high quantities,

although at the very end for the birthing itself,

it's quite helpful, because it helps the baby to come out.

Essentially, it's not an emotion you want with any degree of power.

We also know that in medieval birthing rooms,

there were quite often relics or other holy objects

-or prayer rolls.

-Yeah.

It's... I think, I don't know.

Maybe the term would be a transitional object, I don't know.

You know, you would definitely, you would have people...

I remember there was one woman,

her lounge wall, had one side of it,

the birthing pool would have been here and the wall there.

It was covered in photographs

and covered in kind of affirmations.

Erm...

That's one aspect I've seen.

People work quite hard at setting up the space.

It might be about the colour of the fabric, or candles

or familiar objects or photographs of family.

Then there would perhaps be more explicably spiritual things,

which might have mirrored, say, a rosary,

so you might have women who have had a blessing ceremony

and been given beads by different women who have attended that.

Those kind of, erm...

..symbols that are comforting,

you don't necessary understand the full impact

of what that means for that person.

I think it does connect

with what you were saying about the medieval practices.

Again, even if we are being quite sceptical

of the faith behind all of that,

-still the placebo effect can be very powerful, can't it?

-Mmm.

I'm not even...

I'm not sure I'm incredibly comfortable with the word "placebo",

because I think there's something more subtle and deeper about that.

Clearly, in the medieval period,

the kind of capriciousness of gods and demons, or whatever,

was probably more present than it is in some ways now.

The fear would still be great now.

Perhaps we focus it more around psychological elements.

I think there are connections that we've, probably, inadvertently...

we're tapping into without knowing.

The presence of God and his saints was vital

during the perils of labour,

but they were still needed even after a successful delivery,

because the dangers didn't stop.

In a world with no defence against infection,

the days and weeks after a birth could be a vulnerable time

for both mother and baby.

And one of the best ways to give thanks for a baby's arrival,

and to ask God for his continued protection,

was to go on pilgrimage.

And one of the most important sites of pilgrimage in England

was the shrine at Walsingham in Norfolk.

It was a site particularly associated with childbirth,

because it contained a replica of the Holy House of Nazareth

where the Angel Gabriel visited Mary to tell her she would give birth

to the son of God.

And in January 1511, a very special pilgrim came here

to thank God for the safe arrival of his son.

For the young King Henry VIII,

having a son and heir to continue the Tudor dynasty

was an all-consuming ambition.

And after two years of marriage, his wife, Catherine of Aragon,

had given birth to a son on New Year's Day.

Henry lost no time in setting out to Walsingham as a pilgrim.

Henry walked the last mile to the shrine barefoot.

It's an extraordinary image.

The great King Henry VIII making such a show of humbling himself.

But it's a telling sign

of just how dangerous and unpredictable childbirth could be.

Henry and Catherine knew that all too well,

because they had already lost one child, a stillborn daughter.

But now Henry had a male heir.

The Tudor dynasty was secure,

and England erupted with joy at the news of the royal birth.

Henry was elated.

When he arrived here at Walsingham,

he kissed the holy relic of the Virgin's milk

and made offerings at the shrine.

And then he went back to London to celebrate with a lavish tournament,

where he jousted as Sir Loyal Heart in front of his beloved wife,

the mother of his son.

But even a king couldn't be sure of heaven's favour.

The celebrations had come too soon,

because ten days later, tragedy struck.

Henry and Catherine's longed-for baby was dead.

The royal couple were heartbroken.

The Queen... "Like a natural woman," said one chronicler,

"made much lamentation."

The Church recommended patient submission

to the workings of God's will.

But this can have offered little comfort in the face of such loss.

Though many babies died before, during or after birth,

the fact that it wasn't unusual

didn't make their families' grief any less.

In 1454, Margaret Paston was pregnant for the fifth time.

She wrote to her husband, John, about some errands he wanted done

and asked him to buy her some dates and cinnamon,

and she added, "I pray you, if you have another son,

"that you will let it be named Henry,

"in remembrance of your brother, Henry,"

a brother who'd died in childhood.

Losses stayed with families,

and losing babies, common though it might have been,

was clearly not taken lightly.

Touching evidence of the traces of this grief

has been found by Roberta Gilchrist, during her work as an archaeologist.

You get infants buried in houses,

rather than on consecrated ground.

Certainly, one of those had a whelk shell

and also a spindle wool, used for weaving, buried with it.

That suggests their parents really didn't want to let them go?

Well, you could interpret it in various ways.

I think that it may have something to do with

keeping an infant in the family.

You could also say these are very poor families

who couldn't afford to pay the priest or pay a burial fee.

It could be a combination of things.

The fact that these are carefully prepared burials.

One of them is lying on its side, in a sleeping position.

They're not casual, or heartless, disposals -

they're very careful constructions,

and that could possibly... we could conjecture,

that these are mothers that want to keep their children close to them.

So despite the fact that losing children

was such a common experience,

it wasn't taken lightly at all.

No. It obviously had a huge emotional impact.

Roberta has also found cases where emotion might override

the Church's teaching about the significance

of the sacrament of baptism.

We have a number of burials excavated of women who died in childbirth,

some of them with the foetus still intact.

And although that's very upsetting for us to consider,

the important thing there is that medieval people were actually

going against Church ordnances to do this.

Because if a woman died with a child that had not been baptised,

the convention was supposed to be that the child was removed

from her womb, because it couldn't be buried in consecrated ground,

because it hadn't been baptised.

But, clearly, medieval people couldn't face that,

and the sympathy for the mother and the child prevailed,

so they certainly burying women and child intact.

The medieval Church taught that it was essential for a baby

to be baptised before it died,

because an unbaptised soul was barred from heaven.

Today, we think of baptism as a chance to celebrate a new life

and name the child.

These were elements of a medieval baptism,

but the main purpose was something quite different.

A newborn baby hadn't lived long enough to commit

any sins of its own.

But like all of humanity, it was born in a state of original sin.

And baptism was the sacrament that removed that stain,

bringing newborns into the Christian fold

and, if the worst should happen, opening their way to heaven.

Normally, that holy ritual would be carried out by a priest,

but, of course, a priest was a man

and therefore barred from the birthing room.

So, because death was never far from birth in the medieval world,

the Church was forced to make

one truly extraordinary concession to midwives.

In an emergency, if a baby were dying in the delivery room,

they could perform a baptism.

It was the only time a woman could ever administer a sacrament.

So, in extreme circumstances, a midwife could hold

the power of eternal life in her hands.

The 14th-century cleric John Mirk wrote a rhyming set

of instructions for parish priests, which included

a homily on how a midwife should christen a baby.

"Though the child but half be born,

"Head and neck and no more,

"Bid her spare, never the later,

"To christen it and cast on water."

And he told them what they should do if more drastic action were needed.

"And if the woman then die,

"Teach the midwife that she hie

"For to undo her with a knife

"And for to save the child's life

"And hie that it christened be,

"For that is a deed of charity."

In other words, a midwife should perform

what we would call a Caesarean -

thankfully, given the lack of anaesthetics,

only if the mother had already died.

Even if the baby breathed for only a minute or two, it was enough time

for a midwife to perform this vital sacrament

and save the baby's immortal soul, if not its mortal life.

Given how sacred this responsibility was,

the Church needed to know that these women

could be trusted with such power,

and by the 16th century,

midwives even had to be licensed by the Church.

And the issue of good character still plays

a part in the role of midwives today.

Women were given Episcopal licences if they were going to be midwives,

which is an interesting connection, for me,

about what sort of character of person they were.

And, still now, when you qualify as a midwife,

your midwifery lecturers and your clinical placement have

to send a statement saying that you are of good character.

So there's something there about the kind of person you are,

but there was a more sinister edge which was worrying

about women in general.

So fear of female mystery and the power of birth.

So, you know, if a baby had died, you could be accused of infanticide,

so there's something about that midwife being trusted

to witness that.

And then, you might want to hand your baby over to the devil,

so you might pray incantations over to that effect.

So you need, again, a woman of good character

that can witness to the space being held in a Christian way.

In medieval England, from conception, to labour,

to the celebration of a new life,

the Catholic Church shaped

the way birth was understood and the ritual that surrounded it.

But suddenly, in England, the power of this Church was broken.

And this radical change in England's religious landscape

would reach into the very heart of the birthing chamber.

Ironically, it was a birth, or the lack of one,

that helped to spark this Reformation.

The death of Henry VIII's son after his pilgrimage to Walsingham

was just the first of many miscarriages

and stillbirths that Henry and his queen Catherine had to endure.

They had one surviving daughter,

but by 1527, Henry was convinced that the only way that he could

continue the Tudor line was to divorce his ageing wife, Catherine,

and marry the woman who, he believed, could give him a son.

But when the Pope refused to grant Henry a divorce,

Henry chose to break from Rome

and make himself head of the Church in England.

As Henry's Reformation gathered pace,

monasteries were destroyed,

churches whitewashed, and altars and icons smashed.

But the effects were also felt in the most private

and intimate of life's rites of passage - birth.

In the summer of 1535, Henry VIII's chief minister,

Thomas Cromwell, sent out his men to confiscate fraudulent

and superstitious objects that monasteries exploited,

he claimed, to extort money from gullible believers.

Among them were the many relics,

images and holy objects that were lent out to give spiritual support

and comfort to women in labour.

By the beginning of 1538,

the dissolution of the monasteries was well under way,

and, on Cromwell's orders, their relics and images were stockpiled

here in Chelsea, ready to be destroyed,

including those taken from the shrine at Walsingham.

Rumour had it, they were still working miracles, even in storage.

The old beliefs about the ways in which the saints might

protect women in childbirth hadn't vanished overnight,

but suddenly the comforts they offered

had been snatched from women's hands.

Not only that, but the new Church was soon telling midwives,

and the women they tended, what they could and couldn't do.

The reformist Bishop of Salisbury, railing against

"intolerable superstition and abominable idolatry",

told midwives...

"To beware that they cause not the woman,

"being in travail, to make any foolish vow

"to go in pilgrimage to this image or that image after her deliverance."

A labouring woman could no longer wrap herself in a prayer roll

or put her faith in water from a shrine.

Instead, she was... "Only to call on God for help."

This religious upheaval had been driven by Henry's

determination to marry Anne Boleyn.

But she too failed to give him the son he longed for, and soon,

she lost her head.

By 1537, Henry was married to his third wife, Jane Seymour.

That autumn, she was heavily pregnant,

and as she went into confinement at Hampton Court,

the task of producing a male heir fell to her.

The ritual of Jane's confinement was much like that of the queens

who'd gone before her -

she retreated to her rooms with great ceremony,

surrounded by her women.

But there were signs of the changes that were coming.

Just outside her door, three royal physicians -

Doctors Butt, Owen and Chamber - were standing by.

In time, male doctors would force their way into the female

world of the delivery room.

But Jane's physicians were still outside.

Medical science had yet to replace the spiritual comforts

that the Reformation had done its best to do away with.

Jane went into labour on the 9th October 1537.

Two exhausting days later, her baby was still not born.

At last, at two in the morning on Friday 12th October,

Jane Seymour gave birth to a son.

Letters had already, optimistically,

been prepared, in which the queen announced that,

"By the inestimable goodness and grace of almighty God,

"we be delivered of a prince."

Three days later, Jane was well enough to sit in state,

with Henry at her side, as her son was carried here

to Hampton Court's Chapel Royal for his magnificent christening.

The prince was named Edward, and three days after that,

he was proclaimed Prince of Wales and Duke of Cornwall,

the traditional titles for the heir to the English throne.

It had taken Henry 28 years and three wives,

but at last he had his heir.

But the cost was high.

He had swept away the Church of Rome from medieval England,

and the mother of his son would pay the ultimate price.

As the celebrations at the royal birth continued,

Jane herself was ailing.

A week and half after the birth, Thomas Cromwell was told,

"There is no likelihood of her life."

Jane died on the 24th October 1537.

She was 28 years old, and she'd survived

the birth of her first and only child by just 12 days.

Cromwell blamed those who had cared for her.

They had... "Suffered her to take great cold,"

he said, "and to eat things that her fantasy in sickness called for."

It seems more likely now that she had developed septicaemia

or suffered a fatal haemorrhage.

The truth of the matter was that

although the religious comforts that accompanied a medieval birth

might be stripped from the labour room,

the reason why they were there in the first place

couldn't be so easily removed.

As Jane's death proved, whatever ritual surrounded it,

birth was still a very dangerous business.

Henry remained in mourning for three months,

until the Feast of the Purification of the Virgin Mary.

But it was the sorrows of Eve -

the dangers that faced women

who could not expect a miraculous birth -

that had taken his wife from him.

For a queen as much as a peasant, no matter what the doctors knew,

and no matter what ritual the Church prescribed,

the experience of childbirth remained eternally unpredictable.

The scientific revolution that would transform our understanding

of the process of birth, and replace God with science,

was still more than a century away.

But the medieval way of birth

with the comfort of relics and the help of the saints

was gone for ever.

The Reformation had reached right into this most domestic

and secret of life's rituals.

Next time, I'll be looking at life's

next great rite of passage - marriage.

In the medieval world,

you could get married in a pub or even a hedgerow.

But the Church tried hard to impose order

on this matrimonial free-for-all.

So how far did it get in controlling

those most unpredictable of human emotions -

love and lust?

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