WARNING: This post is about infant and child mortality in the late 19th and early 20th century. While I am approaching this subject from a historical and medical perspective, I am a mother, so I understand how difficult and triggering this can be for some people. I do not intend to bring distressing feelings in my articles, only to give these little ones a moment of recognition in order to honor their memories.
It is a generally accepted fact that nobody enjoys talking about the death of young children. I see child graves a lot in my journeys through cemeteries. As a mother, I grieve for the parents who lost the little ones when I see the tiny stones. Even though this isn't a favorable subject, I feel like the littlest of souls deserve to have their stories told, no matter how short they are.
Many of us have had to comfort friends or family who have suffered a miscarriage. The term "rainbow baby" refers to a baby born to a mother following a miscarriage and is frequently seen in social media posts by moms celebrating their miracle baby. Awareness is being raised about women's health and issues that make pregnancy dangerous such as endometriosis and polycystic ovary syndrome (PCOS). Even something like high blood pressure during pregnancy (preeclampsia) can result in hospitalization and early delivery. I know that last one from experience as my son was born two weeks early for the same reason! Even with our knowledge of these risks today, it's hard to imagine the world in which our ancestors lived where infant and child mortality rates were high and it was an adequate concern for women about whether or not they would survive childbirth.
Early writings of American women in the 18th and early 19th century indicated that women often anticipated pain and suffering with childbirth and even celebrated a successful delivery by recognizing the survival of the mother (Doyle). The United States joined European nations in the mid 1800s in expanding urbanization, which resulted in closer living quarters. The practice of sanitation was not considered routine until the turn of the century. Ventilation and water quality was poor, contributing to the spread of diseases such as typhoid fever in adults and milk hygiene was unheard of prior to the 1860s with the introduction of the pasteurization process. During this time, specifically during the Industrial Revolution, the family structure was changing and more and more women were leaving the house for work. This resulted in a decline in breastfeeding by as much as 50-70% in some cities (Currier and Widness). Infants were either not being fed adequately or they were being bottle fed with a possibly contaminated milk supply. Milkborne diseases included tuberculosis, typhoid and scarlet fever, diphtheria, and strep throat.
The mortality censuses were taken every ten years between 1840 and 1880. Each census would document deaths from the previous year. The North Carolina mortality census provides a sketch on the diseases that were claiming lives during this time. The volume I looked at featured thirteen mountain and foothill counties from western North Carolina, including the county in which I live: Alexander County. The most deadly disease for adults in this region between 1850 and 1880 was tuberculosis. Other deadly diseases included typhoid fever, diphtheria, dropsy (fluid retention), and pneumonia. Although not one of the top five causes of death (COD), childbirth was a highly ranked COD for women during this time. The number one COD for infants (children under the age of three) was croup. Today, croup is a common respiratory virus spread through airborne particles. My son has had croup twice and while it is a scary time for parents, it is far less deadly than it was in 1880. Behind croup, the next leading COD for infants was premature birth or stillbirths. Other deadly diseases included diarrhea, cholera, and diphtheria, all of which were most likely caused by contaminated milk or water and lack of proper hygiene.
By the turn of the century, some diseases were becoming less common due to medical ability to control the spread. Smallpox, once a deadly virus which claimed a staggering number of Native Americans because of their lack of immunity during the Colonial period, was kept at bay by the mid 19th century by the development of the vaccine. An antitoxin for diphtheria was discovered in the 1890s, but wasn't widely accepted until well into the 20th century. A mortality census taken by the federal government in 1900 indicated that the top five leading causes of death in infants were cholera, pneumonia, premature birth, atrophy (weak body), and enteritis (inflammation of intestines). Additional maladies included inanition (malnutrition), meningitis, and whooping cough.
The government mortality stats of 1935 reflect the changes in society as better hygiene practices become standard. Digestion-related diseases are no longer the leading cause of death among infants, but rather that has shifted to premature birth, bronchitis, and pneumonia. There is also a significant difference in the number of stillbirths in North Carolina cities versus rural areas. The stillbirth rate is much higher in the rural farm towns even thought the population is higher in the cities. This is most likely due to the fact that city residents had quicker access to hospitals and doctors. Rural families were usually left with local midwives as the only delivery option, many of whom did not practice adequate sanitation habits or were not fully medically trained. We also start to see an increase in death records at this time. In North Carolina, the law required the use of death certificates beginning in 1913. Other states mandated death certificates earlier and some later than that date. A death certificate was issued to any infant whose gestation period had surpassed five months. Any pregnancy earlier than five months was considered a miscarriage and no death certificate was required. These vital records usually provided a burial location, even if no stone was placed. Many infant graves are unmarked, but the death certificates in North Carolina give us an idea of how many are buried in each cemetery.
The above reported stats are mostly for white families. Conditions were worse for Black or immigrant families and therefore the statistics show a higher mortality rate among these populations. The Green Street Cemetery that I have talked about in Statesville, North Carolina has hundreds of graves of infants and children who died in the historic African American community. Hundreds. Most of them are unmarked.
PAUSE.
I've just given you, my readers, a lot of facts. Statistics. Numbers. Although this information gives us a good background and context with which to understand history, my main point in writing this article is that these "numbers" are so much more than mere statistics. These were little children. The most innocent of creatures and the most tragic of life lost. Now I want to take us out of the mindset of research and digits, and focus on the souls at rest.
Some of the most beautiful imagery can be found on older headstones, particularly those belonging to a child. The most traditional symbol we find on the graves of children is that of the lamb. The lamb has always been a Biblical symbol of innocence. The "blood of the lamb" referred to the death of Jesus Christ and it was he who said "Let the little children come unto me." That verse is often found as an epitaph on stones. Lambs can be found carved into the stone on its face or on top. Unfortunately, the ones placed on top can often be broken or damaged. Another symbol found on graves is the image of flowers or a bouquet. Flowers signified the shortness of life, a hand gripping a bouquet symbolized a life taken, and broken blossoms represented mortality.
Some children's parents were able to afford stone markers. Stillbirths usually did not result in a process of naming the baby as it does today. Even infants under a year might only be noted on the stone as the infant son or daughter of the parents' initials. Some do have names. Others have no stones at all.
I was scrolling through Facebook one day when I came across the story of an abandoned baby who was found near Michigan Bar in California on August 29, 1921. The Ione Public Cemetery posted the story on social media and explained that no one knew who the baby's family was or how they died, but they presume it was a stillborn. The death certificate did not confirm the gender of the baby. The body was brought to Ione Cemetery following the coroner's inquest. They do not know the exact location of the burial as it was unmarked, but more than a hundred years later, a marker finally stands in memory of this little angel. Blast It Monument Etching did the work and engraved an image on the stone. You guessed it, a lamb. Now this little soul can be remembered forever by all who visit the cemetery. Today is August 29, 2024. It's been 103 years since this baby was found. Today we honor their memory. Today we share their story.
Almasy, S.L. (1994). North Carolina mortality census 1850, 1860, 1870, 1880. Kensington Glen Publishing. Joliet, Illinois.
Currier, R.W. and Widness, J.A. (2018). "A brief history of milk hygiene and its impact on infant mortality from 1875 to 1925 and implications for today". Journal of Food Protection, 81(10), 1713-1722.
Doyle N. (2023). "When I Think of It I Awfully Dread It": Conceptualizing Childbirth Pain in Early America. Bulletin of the history of medicine, 97(2), 227–254.
Miller, M.J. and Crooks, P. (1990). Time is, time was. Delmar Printing. Charlotte, North Carolina.
Preston, S.H. and Haines, M.R. (1991). Fatal years: child mortality in late nineteenth-century America. Princeton University Press, 3-48.
United States Census Bureau (1912). Mortality Statistics: 1910. Government Printing Office. Washington D.C.
United States Census Bureau (1937). Birth, Stillbirth, and Infant Mortality Statistics: 1935. Government Printing Office. Washington D.C.
Walls, H.B., Greenburg, B.G. and Donnelly, J.F. (1958). North Carolina fetal and neonatal death study. Am J Public Health Nations Health 48(12),1583–1595.
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