The midwife did not simply attend to physical requirements of the labouring woman.
Also the midwife must instruct and comfort the party, not only refreshing her with good meat and drink, but also with sweet words, giving her good hope of a speedful deliverance, encouraging and enstomaching her to patience and tolerance, bidding her to hold in her breath so much as she may, also striking gently with her hands her belly above the navel, for that helpeth to depress the birth downward.
Good meat and drink included specially sustaining broths or caudles as well as strong beer. Midwives also knew how to support the perineum: ‘And if necessity require it let not the midwife be afraid nor ashamed to handle the places, and to relax and loose the straits (so much as shall lie in her) for that shall help well to the more expedite and quick labour.’11
As labour went on, care was taken to refresh and sustain the labouring woman:
If her travail be long the midwife must refresh her with some chicken’s broth with the yolk of a poached egg and a little bread, or some wine or strong waters, but moderately taken, and withal to cheer her up with good words and stroking down her belly above her navel gently with her hand, for that makes the child move downwards. She must bid her hold in her breath as much as she can, for that will cause more force to bring out the child.12
Midwives were prepared to take action in cases where the child presented feet first or sideways: ‘If the head of the child do not come forth first, the midwife then must turn the child that the head may come forth first, and let the midwife anoint her hand with oil olive.’ If the midwife did not succeed in manually turning the child, both mother and child remained in ‘great peril’. If the contractions looked as if they were weakening, various herbal preparations would be used to provoke them. ‘Also if the woman be in extreme labour, let her take the juice of dittany a dram with the water of fenugreek, or else take of Serapine an ounce, and drink it at three times with the water of cherries, and keep the woman moderately in a temperate heat.’13
When the child was fully born the umbilical cord was cut. Sympathetic medicine required that it be cut short for girls and long for boys. The newborn Susanna would have been held by the fire and bathed in warm water, and the vernix removed by the application of a mixture of oil, milk and warm water. The end of the cord was anointed, the cord knotted and a band tied around the belly to hold the knotted end of the umbilical cord in place. Over Susanna’s head would have been tied a biggin, under which would be placed a compress to protect the fontanelle and keep the brain warm. And, unless Ann was an exceptional mother, Susanna would have been tightly swaddled, on a board, with her arms bound to her sides.
Ann meanwhile would have first had to expel the afterbirth and might even have been made to sneeze to bring it away faster. If sneezing failed, stimulants would have been prescribed. Then she would have had her belly rubbed with oil of St John’s Wort, and been swathed in linen. She would not have been allowed to drift off to sleep, but kept awake for four hours, and given broth or caudle to rebuild her strength. For two days she should eat no meat and then be encouraged to nibble white meat and sip spiced wine to bring her to her full strength. She would not have been allowed to give her baby the breast because it was thought that ‘those unclean purgations cannot make good milk. The first milk is naught…’13 The baby would have been fed on weak warm water gruel through the narrow end of a cup made out of a sheep’s horn.
As Ann had borne a girl she was expected to remain confined within her house for forty days. ‘If the child be a boy she must lie in thirty days, if a girl forty days, and remember that it is the time of her purification, that her husband must abstain from her.’14 The most dangerous time in the infant’s life was its very first day. Once they had both got through that, Ann had only to keep Susanna safe from thrush, infectious diseases like smallpox, measles and chicken pox, whooping or ‘chyne’ cough, the yearly visitations of epidemic disease, nutritional deficiencies like rickets and scurvy, and infestations of intestinal worms, lice, fleas and itch mites. Ann was the more successful in protecting Susanna because she breast-fed her, as all mothers of her class did.
The fountains of the earth are made to give water and the breasts of women are made to give suck. Every beast and every soul is bred of the same that did bear it, only women love to be mothers and not nurses. Therefore if their children prove unnatural they may say, ‘Thou followest thy mother for she was unnatura first in locking her breasts from thee and committing thee forth like a cuckoo to be hatched in the sparrow’s nest.’ Hereof it comes that we say ‘He sucked evil from the dug’, that is, as the nurse is affected in her body or in her mind, commonly the child draweth the like infirmity from her, as the eggs of a hen are altered under the hawk. Yet they which have no milk, can give no milk, but whose breasts have this perpetual drought? Forsooth it is like the gout. No beggars may have it but citizens or gentlewomen.15
When forty years later Susanna and her husband decided to write an epitaph for Ann in which her feeding of her daughter from her own breasts is lauded, they were consciously or unconsciously suggesting that she had always been a gentlewoman, for whom to consent to suckle her own child was to do something unusual, even heroic. In being everything to her tiny daughter, Ann did what every countrywoman of her class did, right or wrong. If Susanna had suffered from strabismus, Ann would have licked her eye straight.
Women who had recently given birth could not attend the church ceremonies until they had been purified or ‘churched’, so Susanna would have been carried to the church on the first Sunday after her birth by the midwife, there to meet her godparents. Her father would have been allowed to witness the ceremony but he played no part, and he was under no obligation to attend. According to the first prayerbook of Edward VI, with the child would be brought the chrisom, a white linen cloth which would be laid upon her after she had been dipped in the font and before she was anointed with chrism. If she died before her mother was churched the chrisom would be her winding sheet; if she was spared her mother would bring it as an offering when she came for churching. The second prayerbook makes no mention of the chrisom and deletes the prayer that should accompany the laying of it on the child, but we know from contemporary images and grave portraiture that infants who died within the first weeks of life are usually portrayed wearing it. Though the child would no longer have been anointed with holy oil and spittle and salt, she would still have been wrapped in white linen as a sign of her new status as a baptised Christian. Then the midwife and her godparents would have carried her back home to a party, to which Ann’s gossips would have brought cakes and ale.
During the forty days of her lying-in, Ann would have had to do nothing but rest and play with her baby, while Will or his deputy carried out the household chores. On the forty-first day of Susanna’s life, Ann would have gone to Holy Trinity to be churched.16 Churching may have been a humiliating ritual, but it was also an occasion for great cheer. The best ale was laid on in quantity. This was one occasion when husbands waited on their womenfolk, pouring their ale and cutting their meat. The women meanwhile talked.
Many women, many words; so fell it out at that time, for there was such prattling that it passed. Some talked of their husbands’ frowardness, some shewed their maids’ sluttishness, others deciphered the costliness of their garments, some told many tales of their neighbours, and to be brief, there was none of them but would have talk for whole day.17
Ann probably breast-fed Susanna for about a year. Even before she had finished weaning her, she was pregnant for the second time. Lactation is nowadays known to suppress ovulation;18 this effect is often reinforced by an embargo on sexual intercourse with a wife who was breast-feeding, but seldom in Britain, where it was considered unfair to the husband. The pattern of births in Stratford in the 1580s as revealed by the parish records shows us that, except in cases of infant death, births to each mother were usually two years apart, implying a year’s breast-feeding with a new pregnancy beginning soo
n after weaning. For some reason Katherine Duncan-Jones assumes that Ann continued breast-feeding all through her second pregnancy and even considers that ‘she may have attempted to feed all three children’.19 Certainly the nurse in Romeo and Juliet weaned Juliet at the age of three, by putting wormwood on her breast, not a method that could be used by a woman with other babies to feed.20
Ann had no way of knowing in 1584 that she was pregnant with twins.
It may be discerned but with some difficulty that a woman will have more than one child by their heavy burden and slow motion, also by the unevenness of their bellies, and there is a kind of separation made by certain wrinkles and seams to shew the children are parted in the womb, and if she be not very strong to go through with it in her travail, she is in danger, both she and her children.21
Just how dangerous twinning was can be seen from the Holy Trinity registers. Robert Bearman has counted thirty-two sets of twins baptised at Holy Trinity between 1560 and 1600; he looked to see how many of these infants were buried within three months and came up with eighteen sets of twins surviving. However, the burial register also contains records of twins who were never publicly baptised, including some who were buried as nameless. This gives a higher total for only eighteen sets of survivors. Even then we can’t be sure that more of these children did not die outside the parish, as twins are more likely than other children to be put out to nurse. All we can say with certainty is that no burials are recorded for them at Holy Trinity.
Jane Sharp believed that the mother had a better chance of surviving the birth of identical twins.
If the twins be both boys or both girls she will fare the better. Yet one is found by frequent examples to be more lusty and longer-lived than the other; be they both of one sex, or one a boy and the other a girl, that which is stronger increaseth, but the weaker decays or fails by reason of the prevailing force of the other.22
If her mother’s family had a history of twinning Ann might have expected it but, as we don’t know what her mother’s name was, we have no way of investigating the matter. There is some evidence in the family history that twins were not uncommon among the Hathaways. In the Holy Trinity parish register for 1561 the burial of two individuals both called ‘Richardus filius Richardi Hathaway alias Gardner’ is recorded on 29 March and on 1 April. This is usually interpreted as reflecting the burial of newborn twins, one of whom inherited his father’s name from the other.23 Rose, daughter of Ann’s kinsman Thomas Hathaway, bore twins in 1602. Sixteenth-century gynaecologists were not at all sure how multiple births came about.
[That] twins are begot at the same act of copulation is held by all ancient and modern writers, for the Seed (say they) being not cast into the Womb all at once divides in the womb and makes more children. Another reason they give is that the womb when it has received the seed shuts so close that no more seed can enter.
The truth of this belief is obvious to us today but the sixteenth century was not so sure:
nor do all authors agree that twins are begotten at the same time, for all the Stoic philosophers hold that they are begotten at several times and, if you read the treatise of Hermes, he will tell you that twins are not conceived at the same minute of time, for if they were conceived at once they must be born at once, which is impossible.
The notion persisted that women could conceive by successive acts of intercourse: ‘All authors allow of a superfetation, that is, the woman may conceive again when she hath conceived of one child before she be delivered of that…’ For moralists the conclusion was obvious; superfetation was caused by the persistence after conception of inordinate sexual desire in the woman.
Some say it is a virtue and a prerogative given to women, but they are those that call vice virtue. The truth is that Adam’s sin lies heavy upon his posterity…and for this the curse of God follows them and inordinate lust is a great part of this curse, and the propagation of many children at once is an effect of this intemperance. Hippocrates forbids women to use copulation after conception but I may not wrong the man so much.24
Ambrose Paré was of the opinion that identical twins were conceived by a single act of copulation and fraternal twins by superfetation.
Marital love was expected to be chaste not only in that it did not allow of sexual activity with any other partner, but also because it restrained sexual activity within marriage. In the epithalamium in the Old Arcadia (1590) Sir Philip Sidney banishes lechery from the bride bed:
But thou foul Cupid, sire to lawless lust,
Be thou far hence with thine empoisoned dart,
Which though of glittering gold shall here take rust,
Where simple love, which chasteness doth impart,
Avoids thy hurtful art
Not needing charming still,
Such minds with sweet affections for to fill,
Which being pure and plain,
O Hymen long their coupled joys maintain.
Ann would have heard as often as any other parishioner at Holy Trinity the dissuasives against whoredom in marriage. If married love is to be pure chastity, a wife must comport herself with a certain reserve, as Imogen did with Posthumus, showing that though she chose him for herself it was for esteem of him rather than base desire.
Me of my lawful pleasure she restrained,
And prayed me oft forbearance, did it with
A pudency so rosy, the sweet view on’t
Might well have warmed old Saturn, that I thought her
As chaste as unsunned snow.25
Those who believe with Greenblatt that Shakespeare felt revulsion for his wife’s body might want to believe too that he was shocked and disconcerted by the birth of fraternal twins, and ready to believe that her prolonged agony during the birth was the direct outcome of excessive lust, his or hers or both.
Even in the twenty-first century stillbirth and death within the first week of life are four times more common in twins than in singletons; the incidence of cerebral palsy is five times higher in twins. Twins are more likely to be born premature and to be of low birthweight, and their mothers run an elevated risk of pre-eclampsia and other complications of pregnancy. Nowadays the presence of twins in the uterus is first detected by ultrasound and from that point on the growth rate of twins in utero is carefully monitored, but in 1585 the matter was managed rather less well. Until she was heavily pregnant Ann may not have suspected that she was carrying an extra burden. The Stratford wise women, who had their own ways of detecting the presence of twins, may well have taken special care of her, advising her to rest, and to eat more than pregnant women usually should, so that her babies would be born robust and willing to compete for equal shares of her milk. And perhaps no special care was taken of her at all, so that she did not know until she had endured the pains of one birth that she was going to have to go through it a second time.
Philip Barrough, licensed as a surgeon by the University of Cambridge in 1559, is one of few sixteenth-century practitioners whose published work makes any mention of multiple births. Chapter lxiv of Book iii of his Method of Physic, first published in 1583 by Shakespeare’s friend Richard Field, deals with ‘sore travail in childbirth’. Difficult labour can ensue ‘if they be two or more, and all do rush suddenly into the neck of the matrix’. ‘If there be two or three or more children, and do thrust together into the neck of the matrix, you must drive back the rest into the bottom of the womb, and bring that out first that seemeth to be most ready.’26 Jane Sharp’s advice is similar: the midwife delivering twins should have prepared the birth canal ‘with oil of almonds or lilies and a whole egg…beaten and poured into the passage to make it glib’ and ‘enlarge the part with her hand’.
Now sometime it chanceth the woman to have two at a burthen, and that both proceed together headlong…then must the midwife receive the one after the other but so that she let not slip the one whilst she taketh the first. If both come forth at once with their feet forward, then must the midwife be very diligent to receive first the o
ne and then the other…When one cometh headlong, the other footwise, then must the midwife help the birth that is nearest the issue, and it that cometh footlong (if she can) to turn it upon the head…taking ever heed that the one be not noisome to the other in receiving forth of either of them.27
The twins were born in the dead of winter. We don’t know who came first, but we may guess that it was Judith. She was the twin who would survive to adulthood and old age. Hamnet may have been visibly smaller and weaker. Ann would not have been able to tell at first if he was afflicted with cerebral palsy or any of the other ill effects of a prolonged struggle in the birth canal. The double labour would have exhausted her perhaps to the point that her survival too hung in the balance. Birth was dangerous at the best of times; in Ann’s time between 125 and 158 births per thousand proved fatal for the mother.28
If the babies were premature, as twins usually are, and of low birthweight, Ann would have faced a struggle to keep them alive. Of the three other sets of twins born in Stratford that year Mary and Joan, daughters of John Goodyear, christened on 21 February, were buried the same day. William and Catherine, son and daughter to Master William Court, baptised on 10 April, apparently survived. David Bewser’s twins William and Frances were buried unchristened on 12 May.
Ann’s babies were taken to be christened on 2 February. Their godparents were probably Hamnet and Judith Sadler, who lived at the corner of High Street and Sheep Street, next to the Cornmarket. Hamnet Sadler, nephew of Stratford alderman Roger Sadler who was bailiff in 1560 and 1572 and died in 1578, was, like his uncle, a baker. We are usually given to believe that, because Hamnet Sadler witnessed Shakespeare’s will, the Sadlers were William’s friends rather than Ann’s, as if the woman who lived a few doors down from them and saw them every day was creeping around Stratford with a bag over her head. I think we may be sure that Ann and Judith Sadler were lifelong friends. As Judith Staunton of Longbridge, Judith Sadler was an heiress in her own right. She married Hamnet in Longbridge in about 1579. Her first child was christened John on 20 September 1580, and buried two months later. Her second, a girl christened Jane, was born a year later almost to the day, and her third, Margaret, was christened two years after that. When Judith and her husband met their newborn namesakes in the cold, dark church on 2 February 1585 she was pregnant for the fourth time. A second son, christened Thomas on 26 August, would live for a month.
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