None of the birth control methods of the 19th century (aside from infanticide and abortion) were particularly effective and none of them were new. Women would sometimes nurse their children for up to two years, which would prolong their infertile period. Withdrawal by the male, douching and vaginal suppositories were around in ancient times and common in the 19th century. In 1838 condoms and diaphragms were produced with vulcanized rubber. It was second in popularity to withdrawal, but was not really advocated as birth control. Rather, it was to be used to prevent venereal disease. The most effective form of birth control was abstaining from sexual intercourse, but this was not acceptable to most spouses.
Attitudes about birth control were changing readily by the mid 19th century. Early suffragists campaigned for voluntary motherhood during the 1870’s, but they advocated celibacy and abstinence for birth control rather than mechanical means or abortion. Many states had made abortion a crime at any stage of fetal development by the mid 19th century and the Comstock Law of 1873 made abortion and birth control illegal in the United States. Also, by this time the medical care of women was passing from midwives to male doctors, most of whom did not respect a woman’s right to terminate or prevent pregnancy.
Over the course of the 19th century, the average American woman gave birth to six children, not including children lost to miscarriages and stillbirths. There was no modern medical care so the women had frequent complications such as lacerations and permanent damage to their bodies. This made subsequent birth even more painful. In addition, most working-class women did not have the opportunity to rest and recover for very long after giving birth. They were expected to resume domestic chores and work, along with mothering the newborn infant.
A midwife usually assisted in births. If the option of a midwife was unattainable financially, the pregnant woman would have to rely on relatives and neighbors to aid in the birth. They were likely to call in a physician only if a crisis arose during the birth. Midwives had a clear and important role in the 19th century.
In 1847, the pain-relieving and anesthetic properties of ether and chloroform were discovered and used in America for childbirth for the first time. This began a new era in childbirth methods. Mothers could be relieved of pain in childbirth. This discovery led to increasing medical dominance in obstetrics, which had been almost exclusively in the hands midwives. It also led to medical and moral controversy that lasted for several decades. On one hand, women were destined to suffer due to the “curse of Eve” and were expected to experience pain during childbirth. On the other hand, humanitarians and the medical society believed that there were very good moral and technological reasons for controlling or eliminating pain in childbirth.