Let's Revive Childbed Fever! Back to the Future, Part 21

Yay! We're Reviving Childbed Fever! Back to the Future, Part 21

So, among all the other great news lately, there's this: in the two years since Texas banned abortion, rates of deadly sepsis, leading to maternal mortality, have skyrocketed.

Before the twentieth century, "childbed fever" (or "puerperal fever") was the name given to the septic infection that led to many women's deaths: "Before the advent of antiseptic practices—and, later, antibiotics to treat sepsis when it occurred—puerperal fever was almost always fatal. In the 18th and 19th centuries, there were between six and nine cases for every 1,000 deliveries, resulting in a death toll during that span of as much as half a million in England alone. Puerperal fever was far and away the most common cause of maternal mortality and was second only to tuberculosis among all causes of death for women of childbearing age."

Eugène Devéria,

La Mort de Jane Seymour,

Reine d'Angleterre (1847),

Musée de Valence

But now, in one more example of "back to the future," childbed fever is back!

As reported by ProPublica's Lizzie Presser, Andrea Suozzo, Sophie Chou, and Kavitha Surana, "Pregnancy became far more dangerous in Texas after the state banned abortion in 2021."

In their analysis of the life-threatening complications faced by pregnant women in Texas, the researchers focused first on rates of sepsis--infection--for women who were hospitalized after losing a pregnancy in the second trimester. 

Medical treatment is readily available for women in these circumstances: 

The standard of care for miscarrying patients in the second trimester is to offer to empty the uterus, according to leading medical organizations, which can lower the risk of contracting an infection and developing sepsis. If a patient’s water breaks or her cervix opens, that risk rises with every passing hour.

Sepsis can lead to permanent kidney failure, brain damage and dangerous blood clotting. Nationally, it is one of the leading causes of deaths in hospitals.

But in Texas, this medical treatment is now unavailable--doctors and hospitals are unable (or unwilling) to treat women for fear that their treatments will be regarded as an illegal abortion.

And so women are dying. The figures provided by the researchers are stark: In 2021, before the Texas abortion ban took full effect, "67 patients who lost a pregnancy in the second trimester were diagnosed with sepsis--as in the previous years, they accounted for about 3% of the hospitalizations."

But, those numbers have changed dramatically: "In 2022, that number jumped to 90. The following year, it climbed to 99."

Wait. There's more.

ProPublica zoomed out beyond the second trimester to look at deaths of all women hospitalized in Texas while pregnant or up to six weeks postpartum. Deaths peaked amid the COVID-19 pandemic, and most patients who died then were diagnosed with the virus. But looking at the two years before the pandemic, 2018 and 2019, and the two most recent years of data, 2022 and 2023, there is a clear shift:

In the two earlier years, there were 79 maternal hospital deaths.

In the two most recent, there were 120.

This is where we are now--a return not to the twentieth century or even to the nineteenth, but back to the eighteenth century and even earlier. While women have always died of childbed fever--it was recognized by the ancient Greek physician, Hippocrates--the number of cases of childbed fever grew after male physicians began to take over childbirth and delivery from midwives and, in particular, when childbirth moved from home to "lying-in" hospitals in the early modern period. As one example, an "epidemic" of childbirth fever was recorded in 1646 at the Hôtel-Dieu in Paris. (Laura Helmuth's "The Disturbing, Shameful History of Childbirth Deaths" is an excellent place to start reading if you're interested.)

So, you know, who needs all that modern medical treatment. Stuff like up-to-date obstetric care, sanitary practices, and antibiotics. Let's just go with bullshit and misogyny--what's the big deal if a few women die along the way, right?

I've written many entries in this blog noting women who died from childbed fever. Because of the popularity of the Tudors, I'll include a few names here. Jane Seymour, Henry VIII's third wife, is one of the more famous women who died of childbed fever--within two weeks of giving birth to the son that Henry VIII had so longed for, Jane Semour died. Henry VIII's mother, Elizabeth of York, also died of childbed fever, as did the woman who had been his sixth wife (but managed to survive him). Katherine Parr died after giving birth to a daughter, whose father, Thomas Seymour, was Jane Seymour's brother. 

The tomb of Katherine Parr,
St. Mary's Chapel,
Sudeley Castle

I don't usually link to Wikipedia pages--not because I don't value the resource a great deal (I donate regularly, and I suggest you do too) but because it's easily accessible to all. But I am going to link here to the list of notable women who died during childbirth or from complications to childbirth--it's an eye-opener. 

But even as I link you to “notable” women, every woman who suffers a terrible, unnecessary complication is notable to us—a beloved daughter, wife, partner, sister, friend, neighbor, even perhaps a mother already. She is a singular human being. 

Update, 7 May 2025: More data from Kavitha Surana, Lizzie Presser, and Andrea Suozzo at ProPublica:

As ProPublica reported earlier this year, the statewide rate of sepsis—a life-threatening reaction to infection—shot up more than 50% for women hospitalized when they lost a second-trimester pregnancy.

A new analysis zooms in: In the region surrounding Dallas-Fort Worth, it rose 29%. In the Houston area, it surged 63%. . . . 

This marks the first analysis in the wake of abortion bans that connects disparities in hospital policies to patient outcomes. It shows that when a state law is unclear and punitive, how an institution interprets it can make all the difference for patients.

Yet the public has no way to know which hospitals or doctors will offer options during miscarriages. Hospitals in states where abortion is banned have been largely unwilling to disclose their protocols for handling common complications. When ProPublica asked, most in Texas declined to say.

ProPublica’s Texas reporting is based on interviews with 22 doctors in both the Houston and Dallas-Fort Worth metro areas who had insight into policies at 10 institutions covering more than 75% of the births and pregnancy-loss hospitalizations in those areas.

The findings come as evidence of the fatal consequences of abortion bans continue to mount, with a new report just last month showing that the risk of maternal mortality is nearly twice as high for women living in states that ban abortion. 

As devastating as this article is, I cannot recommend it enough.

Update, 13 July 2025: More from ProPublica in the ongoing crisis in Texas for women: "A 'Striking' Trend: After Texas Banned Abortion, More Women Nearly Bled to Death During Miscarriage."

And beyond the effects of the Dobbs decision, women's health care--in particular maternity and childbirth treatment--will suffer as a result of the reduction in Medicare funding, as Jessica Grose makes clear in her New York Times op-ed, "Pregnancy Is Going to be Even More Dangerous in America."

The figures are dire:

Medicaid covers over 40 percent of births in the United States, and an even higher percentage in rural areas. According to an analysis from the National Partnership for Women & Families, a nonprofit advocacy organization, “144 rural hospitals across the country with labor and delivery units are at risk of closure or severe service cutbacks” based on the Medicaid cuts outlined in the bill. That’s in addition to the over 100 rural labor and delivery units that have closed or plan to close since 2020. . . . 

Cuts to Medicaid will have an impact on women across the country regardless of which community they live in. City maternity wards have also been closing, because labor, delivery and infant care are expensive. “Urban hospitals had the highest number of labor and delivery unit closures--299--between 2010 and 2022,” my newsroom colleague Sarah Kliff wrote in December.

A really "beautiful" bill, huh? 

Here's a revealing graph from a 2024 report in The Commonwealth Fund:

Back to the Future, Part 20: "Maternity Care Deserts"

March of Dimes Report: "Nowhere to Go: Maternity Care Deserts Across the US," Back to the Future, Part 20

I've been writing these "Back to the Future" reports since January 2017--for more than seven years years now, women have faced increasingly dire conditions in the U. S. So bad that I added a second series, "When Women Became No Longer Equal." (To view all the posts in these two series, click on the labels, below.) Let's hope that conditions improve after the coming presidential election.

You can download the entire
report by clicking here.

All that being said, the recent March of Dimes report on maternity care offers up more bad news for reproductive health. According to "Nowhere to Go," the reality of "maternity care" is that for many women in the U.S.--more than 2.3 million women, to be accurate--there is no "maternity care" at all. These women live in so-called maternity care deserts, where there is "not a single birthing facility or obstetric clinician." Some 1,104 counties--35% of U.S. counties--are maternity care desserts (p. 3). In addition, over 3 million women live in counties with "limited" access to obstetrical care, hospitals, or birth centers. 

From the report's "Key Findings" (p. 5):

• Living in a maternity care desert is associated with a 13% increased risk of preterm birth;
• Over half of counties in the US do not have a hospital that provides obstetric care; 
• Nearly 70% of birth centers are located within just 10 states. 

And, dangerously, "Fertility rates in rural counties and maternity care deserts are higher than urban and full access counties and are decreasing at a slower pace." 

It should be no surprise that women living in maternity care deserts also receive "inadequate" pre-natal care (page 11).

Much more information and analysis is included in the report, which you can download by clicking here.

From "Nowhere to Go," click here

More Bad News on Maternal Mortality (Back to the Future, Part 18)

The  "U.S. Maternal Mortality Crisis" (The Commonwealth Fund Report, 14 December 2022), Back to the Future, Part 18 

A few days ago, the Commonwealth Fund published a new report on the status of maternal mortality in the United States. Dated 1 December 2022, the comparative study, authored by Munira Z. Gunja, Evan D. Gumas, and Reginald D. Williams II, had a shocking, but not surprising, title: "The U.S. Maternal Mortality Crisis Continues to Worsen: An International Comparison." 

I say "shocking" for obvious reasons. I say "not surprising," because maternal mortality rates in the U.S. have long been exceedingly bad. As Gunja, Gumas, and Williams note, "The maternal mortality rate in the United States has for many years exceeded that of other high-income countries. Data from the Organisation for Economic Co-operation and Development and the Centers for Disease Control and Prevention show rates worsening around the world in recent years, as well as a widening gap between the U.S. and its peer nations."* 

Despite the urgency of the findings, I put off writing about the report--it was too depressing. But, today, the Commonwealth Fund has issued an even more urgent report, "The U.S. Maternal Health Divide: The Limited Maternal Health Services and Worse Outcomes of States Proposing New Abortion Restrictions."**

Together, these two publications present a devastating healthcare reality for women in the United States. 

Just one chart from the Commonwealth's "U.S. Maternal Mortality Crisis" is eye-opening: 

And, as the authors of the study note, "Data show that the maternal mortality rate in the United States — more than three times the rate in most other high-income countries — is getting worse, and the rate for Black women is nearly three times higher than for white women."

As for the "health divide" for women living in the U.S.? It will surprise no one that maternal (and infant) health is far worse in states where abortion has been made illegal or so seriously restricted that it may as well be illegal: "Compared to states where abortion is accessible, states that have banned, are planning to ban, or have otherwise restricted abortion have fewer maternity care providers; more maternity care 'deserts'; higher rates of maternal mortality and infant death, especially among women of color; higher overall death rates for women of reproductive age; and greater racial inequities across their health care systems."

Moreover, "Making abortion illegal makes pregnancy and childbirth more dangerous; it also threatens the health and lives of all women of reproductive age."

Because of course it does. So much for the "we value every single precious life" forced-birth crowd. What a load of crap.

*For data, see this CDC report on maternal mortality rates in 2021. And for earlier discussions of maternal and infant mortality rates in the United States in this blog, click "Global Gender Report" in the labels, below.

**The Commonwealth Fund report is authored by Eugene Declercq, Ruby Barnard-Mayers, and Laurie Zephyrin, Kay Johnson

Update: Here's more on maternal health, if you can stand it, from Axios.

Update, 16 December 2022: And still more, from the Washington Post, "Can Politics Kill You?" No mystery--the answer to that question is yes. The majority of the piece is about the way COVID has taken a heavy toll on Republicans and conservatives, but there's this:

With abortion services no longer legal nationwide, university researchers have estimated that maternal deaths could increase by up to 25 to 30 percent, worsening the nation’s maternal mortality and morbidity crisis. Americans live shorter lives than people in peer nations, in part because it is the worst place among high-income countries to give birth.

Update, 17 December 2022: And even more, from the Texas Tribune's Eleanor Klibanoff, "Why Are Pregnancy and Childbirth Killing So Many Black Women in Texas?" (click here). Here's just a bit:

A decade ago, when Texas first formed the Maternal Mortality and Morbidity Review Committee, Black women were twice as likely as white women, and four times as likely as Hispanic women, to die from pregnancy and childbirth.

Those disparities haven’t improved, according to the committee’s latest report, published Thursday.

In 2020, pregnant Black women were twice as likely to experience critical health issues like hemorrhage, preeclampsia and sepsis. While complications from obstetric hemorrhage declined overall in Texas in recent years, Black women saw an increase of nearly 10%.

Update, 19 March 2023: In a piece titled "US Maternal Death Rate Rose Sharply in 2021 . . . and Experts Worry the Problem Is Getting Worse, CNN reports on the new data just released by the National Center for Health Statistics (see the link in *, above). According to the CDC's Center for Health Statistics, "The number of women who died of maternal causes in the United States rose to 1,205 in 2021. . . . That’s a sharp increase from years earlier: 658 in 2018, 754 in 2019 and 861 in 2020." Check out the report--the graphs will stun you.

And CNN refers to the Commonwealth Fund's report (discussed above), published at the end of 2022: "The US has the highest maternal death rate of any developed nation."

Are we all ready for those "We're Number One" bullshit cheers we here so often? All that "greatest country in the world" claptrap? Yeah, I thought so . . . 

Update, 19 July 2023: Here is Veronica Gillispie-Bell's heartbreaking New York Times op-ed, "More Mothers Are Dying. It Doesn't Have to Be This Way." Gillispie-Bell links to the 3 July "Trends in State-Level Maternal Mortality by Racial and Ethnic Group in the United States" (JAMA 330, no. 1 [2023]: 52-61; for the online abstract, click here.)

Update, 12 September 2023: For ways to address the problem of maternal mortality, see Mara Gay's NYT opinion piece, "America Already Knows How to Make Childbirth Safer" (click here).

Back to the Future, Part 10: Gilead--Are We There Yet?

Back to the Future, Part 10: Making Motherhood Deadly Again (or, Gilead--Are We There Yet?)

In the ongoing effort to "make America great again," here we are with more dismal horrific terrifying what-else-can-we-expect? news for women.

"The U.S. has the highest maternal death rate among the world's developed nations." So, yay?

This great news comes from a study just published by USA Today--but it's probably fake news, right? (You can read the complete story by clicking here.)

The numbers are shocking. In the United States, the rate of maternal mortality is 26.4 deaths per 100,000. Compare that to the rates in Germany, 9 per 100,000; the UK, 8.8 per 100,000; France, 7.8 per 100,000; Canada, 7.3 per 100,000; and Japan, 6.4 per 100,000.

And in those countries, the maternal death rate has been falling since 1990. In the US, by contrast, the rate has been rising. Noticeably.

USA Today graphics

Looking beyond the "most developed" nations, as reported in The Hill, "The United States is home to some of the most advanced obstetric and emergency care found on earth, yet we still rank only 47th for maternal mortality rate globally. . . . "

But wait! There's more: 

While the world has made tremendous strides to improve health outcomes for women and mothers, resulting in plummeting global maternal mortality rates, the United States has actually seen an increase in maternal deaths between 2000 and 2014. We are not in good company—the U.S. is one of only eight nations, and the only industrial nation, that have seen rising maternal mortality rates in recent years [emphasis added].

You can check out data for yourself by looking at UNICEF maternal mortality statistics (updated January 2018).

Update, 25 November 2018: As an important follow-up to these statistics on maternal mortality, I recommend Kim Brooks's New York Times op-ed, "America is Blaming Pregnant Women for Their Own Deaths," which asks the provocative question, "What is it like to face dying during childbirth in the richest country in the world in the 21st century?" (There is a series of terrific responses to the op-ed here.)

Update, 1 February 2026: UNICEF data are constantly being updated. For current information, click here.

(For more fun stories about the current state of affairs, click on the label "Back to the Future," below.)

Oh, Yay! More Great News for Women! 2017 Edition!

The World Economic Forum's 2017 Global Gender Gap Report

The World Economic Forum has just published its annual Global Gender Gap Report. Published every year since 2006, the report "benchmarks 144 countries on their progress towards gender parity across four thematic dimensions: Economic Participation and Opportunity, Educational Attainment, Health and Survival, and Political Empowerment."

Of course, we'd like to believe that women are closing the gap--that, all over the world, despite the obstacles they face, women are making progress. 

Unfortunately, that is not the case. Last year, assuming "[a]ll things held equal," the global gender gap was projected to close in 83 years. But things did not hold equal--today, "with current trends, the overall global gender gap can be closed in exactly 100 years [emphasis added] across the 106 countries covered since the inception of the Report" (viii).

Let's start with the good news, or at least the sorta good news: "On average, the 144 countries covered in the Report have closed 96% of the gap in health outcomes between women and men." This is the "smallest gap," but the numbers remain unchanged since last year. Still, "the gap is larger than it stood in 2006" (25), when the first Global Gender Gap Report was published.

And now, the bad news: 

on current trends, the education-specific gender gap could be reduced to parity within the next 13 years. The widest gender gap, in the political dimension, is also the one exhibiting the most progress, narrowing by 9% since 2006, despite a slowdown in progress this year. On current trends, it could be closed within 99 years [emphases added]. (25)

And now (because that's the kind of woman I am), the worse news:

Some of the most challenging gender gaps remain in the economic sphere. At the current rate of change, and given the continued widening of the economic gender gap already observed last year, it will now not be closed for another 217 years [emphasis added]. This year, the economic gender gap has reverted back to where it stood in 2008, after a peak in 2013. (25)

As for the U.S.? Don't look for them in the "top ten"--that is, the countries which have succeeded in "closing more than 80% of their overall gender gap" (14-15). Those countries? Iceland, Norway, Finland, Rwanda, Sweden, Nicaragua, Slovenia, Ireland, New Zealand, and the Philippines.

Where is the U.S.? It's ranked at 49 among the 144 countries in the global report--right below Bangladesh and Peru, right above Zimbabwe and Jamaica. 

If you want to see the complete list of rankings, look for Table 3 (10-11). And you can see the "country score card" for the United States, found on p. 334.

For my blog post on last year's Global Gender Gap Report, click here.

A Black British Nurse in the Crimea--and Twenty-First Century Outrage

Mary Grant Seacole, a "Pioneer Nurse" (1805-1881, married 10 November 1836)

On 30 June of this year (2016), after a twelve-year campaign, a statue of Mary Seacole was unveiled at St. Thomas's Hospital, London--though not without a great deal of controversy.

Sculptor Mark Jennings' statue
 of Mary Seacole
(photograph by Owen Blacker)

The story of Seacole and her role as a nurse in the Crimea has been largely overshadowed by that of her much more famous contemporary, Florence Nightingale--and, in fact, much of the opposition to recognition of Seacole has come from various Nightingale supporters and organizations, notably the Florence Nightingale Society. 

It's hard to see why these two women and their contributions have been pitted against one another--except, of course, the belief that there couldn't possibly be two accomplished, notable women working in the same profession at the same time in the the same place. 

The conflict seems to reflect a deeply tinged misogyny--obviously recognizing and appreciating one woman would take away recognition and appreciation of the other. The dispute has devolved to ridiculous levels--including objections to Seacole's sculpture being taller than one of Nightingale near Buckingham palace and outcries over the fact that Seacole's statue has been placed on the ground of a nursing hospital founded by Nightingale. (There is surely more than a little racism involved as well in all of this. One detractor scoffed at Seacole, who in 2004 was named the "greatest Black Briton" by a public vote, saying she was "three-quarters white.")

And, I'll add, as a side note, this conflict seems to be related to the persistent praise of a gifted woman as the "tenth Muse"--something I've railed about on numerous occasions in this blog. Obviously there can only exist one exceptional woman at any one time, imagined as an addition to the panoply of nine classical muses--who could possibly regard an accomplished woman as, simply, you know, normal? (For all my musings--okay, ranting--about all the tenth muses I've noted since beginning this blog, click the label, below.) 

I will let you google for yourself if you're interested in learning more about this "controversy" over Mary Seacole--Patrick Vernon's "Rubbishing Mary Seacole" (The Guardian, 21 June 2016), is a good introduction to the whole sorry mess.    

Instead, I'll focus here on Seacole's full and varied life. Born in Kingston, Jamaica on an unknown date in 1805, Mary Jane Grant was the daughter of James Grant, a Scottish lieutenant in the British army, her mother a free, mixed-race Jamaican woman who combined nursing skill and running a boarding house, Blundell Hall. About her mother, Seacole would later write:

My mother kept a boardinghouse in Kingston, and was, like very many of the Creole women, an admirable doctress; in high repute with the officers of both services, and their wives, who were from time to time stationed at Kingston. It was very natural that I should inherit her tastes; and so I had from early youth a yearning for medical knowledge and practice which has never deserted me. . . . [From her,] the ambition to become a doctress early took firm root in my mind; and I was very young when I began to make use of the little knowledge I had acquired from watching my mother. . . .*

Seacole was proud of her heritage--she is proud of the "good Scotch blood coursing through her veins," and she is proud of her brown skin. She later wrote about the difficulties she faced when trying to book passage on an American ship as she was trying to travel back to Jamaica from Panama:

my experience of travel had not failed to teach me that Americans (even from the Northern States) are always uncomfortable in the company of coloured people, and very often show this feeling in stronger ways than by sour looks and rude words. I think, if I have a little prejudice against our cousins across the Atlantic—and I do confess to a little—it is not unreasonable. I have a few shades of deeper brown upon my skin which shows me related— and I am proud of the relationship—to those poor mortals whom you once held enslaved, and whose bodies America still owns. And having this bond, and knowing what slavery is; having seen with my eyes and heard with my ears proof positive enough of its horrors— let others affect to doubt them if they will—is it surprising that I should be somewhat impatient of the airs of superiority which many Americans have endeavoured to assume over me?

As a child, young Mary Grant received an education from a woman she referred to as her "kind patroness" and more practical training from her mother, whom she assisted in the running of the boarding house and with her healing practice. In 1821, she traveled to England visit relatives. After a year she went back to Jamaica, then returned to England, taking with her West Indian spices, preserves, and pickles for trade, this time staying until 1825. In her autobiography, she provides few details about her trips to London--nothing about where she stayed or how she supported herself--though she does note that her companion, a woman whose color was darker than her own, was taunted by Londoners with "rude wit." 

She returned to Jamaica again, this time nursing her elderly patron and working with her mother, at times caring for invalid soldiers and their wives. (She mentions working at the British Army hospital in her memoir.) On 10 November 1836 (the occasion for today's post), she married Edwin Horatio Seacole, an English merchant (said also to be the godson of the great British naval hero, Admiral Horatio Nelson--according to family traditions, Seacole was Nelson's illegitimate son).

Albert Charles Challen's
1869 portrait of Mary Seacole
(National Portrait Gallery)

Within a few years, Mary Grant, now Mary Seacole, suffered a number of personal tragedies: in two short years, 1843 and 1844, Blundell Hall burned down, her husband died, and her mother died.  She allowed herself a short period of grief, then set about rebuilding her mother's business. She made a success not only of the business but of her nursing skills, notably in the cholera epidemic in Jamaica in 1850.

In 1851 she joined her brother in Panama--arriving in time to experience a cholera epidemic that swept through the city of Crucis--her nursing experience, in particular treating cholera, helped. She assisted the rich, who paid for their treatment, and the poor, whom she treated for free. While in Panama, she also opened and ran a hotel. After returning to Jamaica in 1853, she again encountered disease; this time, authorities asked her to help in treating victims of yellow fever. She treated some in her boarding house, others at the British Army camp. 

In 1854 she was on the move again, returning briefly to Panama. In her autobiography she writes of having been compared to the Greek hero (and wanderer) Odysseus, a comparison she does not appreciate--"Some people, indeed, have called me quite a female Ulysses," she writes, adding, "I believe that they intended it as a compliment; but from my experience of the Greeks, I do not consider it a very flattering one." In Panama, she read of the escalation of the war in Crimea and decided to volunteer her services as a nurse.

Seacole left Panama for England, and although she brought with her "ample testimony" of her experiences, the War Office denied her application to be sent to the Crimea. An appeal to the Crimea Fund, a publicly sponsored organization that raised money to support the wounded, was also rejected. 

Seacole decided to fund herself, though she eventually found a partner, a Caribbean businessman named Thomas Day. Seacole's plan was to open the British Hotel, which she described as "a mess-table and comfortable quarters for sick and convalescent officers." (It is this description, I suppose, that leads some of her detractors to claim all she did was serve tea and lemonade while she was in the Crimea.) 

She left England in January of 1855--on her long trip, she writes of encountering men she had formerly treated, who greeted her with cries of "Mother Seacole, Mother Seacole!" During a stop in Malta, she receives a letter of introduction to Florence Nightingale to add to the many letters of reference she had received from British officers stationed in Jamaica.

In Constantinople, she was eventually to meet with Nightingale. She describes their meeting in her autobiography: 

[A nurse says to her,] "Miss Nightingale has the entire management of our hospital staff, but I do not think that any vacancy--"

"Excuse me, ma'am," I interrupt her with, "but I am bound for the front in a few days;" and my questioner leaves me, more surprised than ever. The room I waited in was used as a kitchen. Upon the stoves were cans of soup, broth, and arrow-root, while nurses passed in and out with noiseless tread and subdued manner. I thought many of them had that strange expression of the eyes which those who have gazed long on scenes of woe or horror seldom lose.

In half an hour's time I am admitted to Miss Nightingale's presence. A slight figure, in the nurses' dress; with a pale, gentle, and withal firm face, resting lightly in the palm of one white hand, while the other supports the elbow--a position which gives to her countenance a keen inquiring expression, which is rather marked. Standing thus in repose, and yet keenly observant--the greatest sign of impatience at any time, a slight, perhaps unwitting motion of the firmly planted right foot--was Florence Nightingale--that Englishwoman whose name shall never die, but sound like music on the lips of British men until the hour of doom.

She has read Dr. F—'s letter, which lies on the table by her side, and asks, in her gentle but eminently practical and business-like way, "What do you want, Mrs. Seacole--anything that we can do for you? If it lies in my power, I shall be very happy."

With this "blessing," Seacole traveled on to Balaclava, where she built her British Hotel from scrap materials she could scrounge. The hotel opened in March 1855. Seacole provided meals, comfort, support, and care. As a correspondent of The Times reported in September of that year, "Mrs. Seacole . . . doctors and cures all manner of men with extraordinary success. She is always in attendance near the battle-field to aid the wounded, and has earned many a poor fellow’s blessings."

In her memoir of the Crimea, Lady Alicia Blackwood wrote that Mary Seacole "personally spared no pains and no exertion to visit the field of woe, and minister with her own hands such things as could comfort or alleviate the suffering of those around her; freely giving to such as could not pay."

Seacole was the first British woman to enter the city of Sebastopol after it fell on 9 September, taking with her provisions and visiting the city's hospital, where thousands were dead and dying. (A light-skinned girl named Sarah eventually joined Seacole--many, including Nightingale, alleged she was Seacole's illegitimate daughter, but there is no evidence to support such an assertion.) 

Seacole continued her work in Crimea until the war's end; she returned to England, she would later write, "poorer than I left it." She was declared bankrupt in 1856. But when her plight was made known in the British press, a fund was established, raising enough money to discharge her bankruptcy. The fund was supported by the many soldiers and officers she had treated and tended. 

The cover of Seacole's
1857 autobiography

Undaunted, she hoped to travel to India in 1857 after the Indian Rebellion, but fundraising on her behalf was not successful. In the end, she returned to Jamaica after publishing her Wonderful Adventures of Mrs. Seacole in Many Lands, the first autobiography published by a Black woman in England. 

In Jamaica, Seacole once again experienced financial difficulties. Hearing of her straitened circumstances, London supporters and patrons, including the prince of Wales, the duke of Edinburgh, the duke of Cambridge, and many senior military officers, raised funds for her. 

Although she would return to England in 1870, seemingly to offer her services as a nurse during the Franco-Prussian War, she did not make her way to the front again. She remained in London, dying there on 14 May 1881. 

You can read Seacole's autobiography by clicking here. It is just too bad that if you Google Seacole's name, you'll have to wade through all the crap. Too bad her detractors seem to think that recognizing Seacole somehow damages Nightingale (who herself would attempt to undermine Seacole by insinuating her British Hotel was really nothing but a brothel). 

Too bad more people don't remember the assessment of Sir Howard Russell, the Times war correspondent: "I trust that England will not forget one who nursed the sick, who sought out her wounded to aid and succour them, and who performed the last offices for some of her illustrious dead." His words are now engraved on the sculpture of Seacole.

Why would anyone want to trash a woman like that?

*Update, 15 January 2024: William Dalyrumple and Anita Anand, hosts of The Empire podcast, recently had an episode featuring Florence Nightingale and Mary Seacole. Titled “Tale of Two Nurses,” it is available at all podcast platforms, but I’ll link to a YouTube broadcast here.

The guest on this episode of the podcast, Helen Rappaport, author of In Search of Mary Seacole: The Making of a Black Cultural Icon and Humanitarian (2022), identifies the unique role of the "doctoress" in Jamaica. A doctoress was a local African woman who treated sick African slaves in slave "hothouses" (hospitals), often incorporating herbal medicines, "pharmaceutical skills almost," into a "rich and sophisticated range of treatments." 

More Really Great News on the Gender Pay Gap--This Time on a Global Scale

The World Economic Forum's 2016 Global Gender Gap Report

The World Economic Forum has just published its eleventh annual Global Gender Gap Report--this report has been published since 2006 and measures women's progress in 144 countries. *

Here's one way to make lemonade out of lemons . . . 

In its analysis, the index focuses on fourteen variables in four areas: economic participation and opportunity; educational attainment; health and survival; and political participation.

The differences between men and women are enormous. Over all, women are worse off than men by 31.7%. 

Here's the good news, according to the report. On average, "the 144 countries covered in the Report have closed 96% of the gap in health outcomes between women and men, unchanged since last year, and more than 95% of the gap in educational attainment, an improvement of almost one full percentage point since last year and the highest value ever measured by the Index" (7).

But here's the bad news: 

However, the gaps between women and men on economic participation and political empowerment remain wide: only 59% of the economic participation gap has been closed—a continued reversal on several years of progress and the lowest value measured by the Index since 2008—and about 23% of the political gap, continuing a trend of slow but steady improvement. Weighted by population, in 2016, the average progress on closing the global gender gap stands at a score of 0.683—meaning an average gap of 31.7% remains to be closed worldwide across the four Index dimensions in order to achieve universal gender parity. (7)

And here's the worse news (because I'm a glass-half-empty kind of person): "Out of the 142 countries covered by the Index both this year and last year, 68 countries have increased their overall gender gap score compared to last year, while 74 have seen it decrease. It therefore has been an ambiguous year for global gender parity, with uneven progress at best."

And now the worst news of all: at the rate things are going, it will take 83 years to close this gender gap. But that's for all four areas--the pay gap won't close for another 170 years! Or so . . . 

And don't assume that the U.S. scores high on this index--the U.S. saw a 17 point drop on last year’s score. And it places only 45th in the global table. 

And when it comes to those pesky kinds of unpaid labor--like household tasks and childcare, for example--women still do much more than men.

* This blog post used to contain links to all the relevant data in and quotations from the 2016 report, but as of January 2021, those links no longer worked ("Error establishing a database connection"). However you can still read and download the entire report at the World Economic Forum by clicking here.

Margaret Sanger and "What Every Girl Should Know"

Margaret Sanger (first part of "What Every Girl Should Know: Sexual Impulse" published 22 December 1912)

The American birth-control activist and educator Margaret Sanger (1879-1966) published a twelve-part series entitled "What Every Girl Should Know" in the New York Call between 17 November 1912 and 2 March 1913. 

Margaret Sanger, 1922

In her excellent New York Times article on Sanger, "Margaret Sanger's Obscenity," Gloria Feldt indicates something of the genesis of Sanger's educational column. In response to shocking mortality rates among infants and small children, and women's complete "lack of information about birth control," Sanger, then working as a nurse in New York's Lower East Side, began her sex-education column.

In 1914, she was arrested for violating the 1873 Comstock Act, which criminalized the "publication, distribution, and possession of information about or devices or medications for 'unlawful' abortion or contraception." 

Sanger was indicted, published her attack on the Comstock Act in a new magazine called The Woman Rebel, and fled to Europe. She returned to the United States in 1916 after charges against her were dropped and opened the first birth-control clinic in the United States. (The clinic was closed ten days after its opening, she was arrested for maintaining a "public nuisance," and she spent thirty days in jail.)

For the first part of Sanger's column on "Sexual Impulse," published on 22 December 1912 in the New York Call, click here.* This publication is made available by New York University's The Margaret Sanger Papers Project, whose homepage can be accessed here.**

You can read a 1920 pamphlet, published by Sanger, containing all twelve parts in the series, by clicking here.***

From Sanger's "What Every Girl Should Know": "In conclusion I cannot refrain from saying that women must come to recognize there is some function of womanhood other than being a child-bearing machine. Too long have they allowed themselves to become this, bowing to the yoke of motherhood from puberty to the grave."

The New York Call produced this
response to the U.S. postal authorities'
suppression of "What Every Girl Should Know"

Update, 17 April 2021: For an excellent op-ed on Margaret's Sanger's racist views (and thus her complicated legacy), Alexis McGill Johnson's New York Times editorial, "I'm the Head of Planned Parenthood. We're Done Making Excuses for Our Founder," is available here.

Update, 10 December 2022: For more, you may be interested in an episode of the BBC podcast, The Forum, focusing on Margaret Sanger: "Margaret Sanger: The Mother of Birth Control." The one-hour discussion includes a discussion of Sanger's accomplishments as well as the controversy surrounding her involvement in eugenics. (To listen, click here. As always, the host Bridget Kendall is amazing!)

Update, 30 July 2023: For Grace Haley's informative piece on the Comstock Act and the way it is being deployed by forced-birth activists and politicians today, here is a link to the essay, published at Jessica Valenti's Abortion, Every Day.

*As of December 2021, Sanger's 1912 "Sexual Impulse" is no longer available at the Margaret Sanger Papers Project website. To access an earlier version of the site, preserved by the Internet Archive’s Wayback Machine, clock here.

**As of December 2023, the Margaret Sanger Papers Project continues to exist but the website seems to no longer function—the site describes the archive, but documents and resources are no longer made available online.

***Although I can no longer find the 1912 original online, a later version of "Sexual Impulse," in a later is in What Every Girl Should Know--for the 1920 pamphlet, click here. Chapter IV is "Sexual Impulse."