ELI5, what happened in the old days when a mom was past due and didn’t get induced?

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Did the baby just die inside the mom and then the mom died as well?

In: 9

Before ultrasound and blood testing for hormone levels, they didn’t have as precise expectations for due dates, or any way to monitor how the baby was doing in utero, like fluid levels. So it would be very difficult to know if the baby was “past due” in the same way we refer to it now. They knew within about a month, if the mom had been keeping track of her period.

Most of the time, labor would eventually start on its own, and the majority of those past-due births would proceed normally. It would be riskier and you would have a higher rate of fetal and maternal mortality than we have now, but labor and birth in primitive conditions were extremely dangerous for all kinds of reasons.

Most of the time, if the baby died in utero, the mother would still go into labor and have a stillbirth. If for any reason, the labor was not progressing, they could perform a Caesarian section, but as far as we know this was always fatal to the mother before the year 1500 – that’s the first record we have of both mother and baby surviving a C-section.

If the baby died and labor failed or they were unable to remove it surgically, the mother would also usually die of sepsis.

There is a rare situation called a lithopedion or “stone baby.” If a fertilized egg escapes the fallopian tube and implants in the abdomen, that is usually a life-threatening situation for the mom. The baby will die because there is not enough blood supply, and most of the time the mom will also die of sepsis if the dead tissue is not removed.

But rarely (like only a couple hundred in recorded history) the mother’s body will encapsulate the fetus and calcify it so it does not decay. Women can carry them for years without ever knowing they were pregnant, because they continue having periods.

About 10 years ago, an elderly woman in Central America had an X-ray that revealed she’d been carrying a 4-pound lithopedion in her abdomen for 40 years.

First of all back then they didn’t know they were late. Pregnancy and testing wasn’t nearly as well understood as it is now, while imaging (ultrasound) was non-existent.

Complications from a late pregnancy are the result of your baby being too big. The baby may cause a lot of damage on the way out, or may get stuck in the birth canal.

Complications from that for the mother and child could lead to infections, very slow recoveries, permanent damage, or death.

Today we have C-sections and forceps to try to get the child out. Forceps were first used in the 1700s, while C-sections didn’t become *routine* until the 20th century.

One thing a lot of people don’t realize is that the natural infant mortality rate for humans is upwards of 20%. Prior to the 1940s in North America if you have 5 kids there was a very good chance 1 or 2 of them would have died.

Dying in childbirth was also very common, at around 1.5%.

What changed was the development of widespread access to medical care.

My own Grandmothers lost 3/7 and 2/7 children respectively, not including suspected miscarriages.