Most working class children lacked Vitamin D and because they lived in the cities this effected them even more and thus they were prone to getting rittles. Rittles caused deformities of the bones and in severe cases resulted in dwarfism. This resulted in the malformation of the pelvis, known as the rickety flat pelvis. In other words this meant what when girls became women they had constricted birth canals, thus vaginal delivery was very painful and deadly. The pelvis was too small and the baby was too big to pass through. Consequently, doctors tried to help these women by using forceps. Forceps, as are depicted in the picture above, were invented at the beginning of the 18th century. They were used when labour was constricted. The forceps were dangerous however because they increased the chance of damaging the tissues of women in delivery. But many doctors believed that forceps were a must have because they decreased the amount of time in labour. Some physicians used forceps in half of their deliveries.Other times the baby died inside the mother and doctors had to remove the baby piece by piece. These procedures were usually deadly to mothers. Rittles led to the inventions of perfoators, craniotomy forceps, cranioclasts, and cephalotribes. Each was designed to decrease the overall size of the baby and deliver it through the small pelvis.
High maternal mortality was also caused by improper obstetric practices. Many poor women couldn’t afford a midwife, therefore they were forced to rely on untrained midwives, neighbors, family, or sometimes they even delivered their babies on their own. State funded maternal care did exist, however the quality of care was much lower for the poor than for the middle class.
It was physicians who used forceps the most. Women who went into hospitals to have their babies were often asked to write their name and address on a sheet of paper which was then sealed in an envelope and left under her bed. This letter would be opened if the woman died in child birth, and the news would be brought to her family. However if a woman survived child birth she then proceeded to take the paper with her. This was done because many women came into the hospitals alone. In additon, women who gave birth to their babies in hospitals had a greater chance of dying than those who gave birth anywhere else. Once word got around that many women who gave birth in the hospitals soon perished from diseases women started delivering their babies outside the hospital and then once the baby had been born they would check into the hospital. This greatly reduced the number of maternal deaths. When contractions started women wondered the area outside the hospital and found a quiet place to have their baby. After their baby had been born they swaddled him or her up and went to the hospital.