Article
Reconsidering obstetric death and female
fertility in Anglo-Saxon England
Sayer, Duncan and Dickinson, Sam D.
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Sayer, Duncan and Dickinson, Sam D. (2013) Reconsidering obstetric death
and female fertility in Anglo-Saxon England. World Archaeology, 45 (2). pp.
285-297. ISSN 0043-8243
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World Archaeology
ISSN: 0043-8243 (Print) 1470-1375 (Online) Journal homepage: http://www.tandfonline.com/loi/rwar20
Reconsidering obstetric death and female fertility
in Anglo-Saxon England
Duncan Sayer & Sam D. Dickinson
To cite this article: Duncan Sayer & Sam D. Dickinson (2013) Reconsidering obstetric
death and female fertility in Anglo-Saxon England, World Archaeology, 45:2, 285-297, DOI:
10.1080/00438243.2013.799044
To link to this article: http://dx.doi.org/10.1080/00438243.2013.799044
Copyright © 2013 The Author(s). Published
by Taylor & Francis.
Published online: 14 Jun 2013.
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Reconsidering obstetric death and
female fertility in Anglo-Saxon England
Duncan Sayer and Sam D. Dickinson
Abstract
Little has been written about female fertility and maternal mortality from an archaeological perspective.
Typically debates focus on the physical aspects of childbirth, ignoring an obvious truth: the biggest single
cause of death for women was childbirth. Whether death took place as a result of mechanical malpresentation,
infection or blood loss, the root cause was undeniable. In this article we argue that post-mortem extrusion is
improbable and that young infants and women found buried together are likely to have died together.
However, most deaths would not have been simultaneous and so we build on demographic data to conclude
that the early Anglo-Saxons engaged institutions which controlled female sexuality. Late marriage, cultural
and legal taboos and an emphasis on mature fertility acted to limit the probability of death; however, the risk
to the individual was real and each funerary party was the agent that constructed death ways to manage loss.
Keywords
Taphonomy; coffin birth; maternal mortality; fertility; special burial.
Introduction
Our understanding of Anglo-Saxon burial practices has been revolutionized in the last decades,
developing from an examination of artefact typologies and ethnicities into an established exploration
of the social experience. In part this has grown out of an interest in mortuary archaeology, memory and
deviant burial (Lucy 1999;Price2010; Reynolds 2009; W illia ms 2006). In parallel, archaeological
interpretation has developed sophisticated gender archaeologies investigating infant agency, life
courses and the human experience (Crawford 2007;Gilchrist2012). It is within this context that the
discovery of a pregnant woman buried with a rich array of grave goods on the margins of a large early
Anglo-Saxon cemetery provided new insights into female fertility, pregnancy and the life course
(Sayer , Mortimer and Simpson 201 1).
World Archaeology Vol. 45(2): 285–297 The Beginnings of Life
ISSN 0043-8243 print/1470-1375 online
http://dx.doi.org/10.1080/00438243.2013.799044
© 2013 The Author(s). Published by Taylor & Francis.
This is an Open Access article. Non-commercial re-use, distribution, and reproduction in any
medium, provided the original work is properly attributed, cited, and is not altered, transformed,
or built upon in any way, is permitted. The moral rights of the named author(s) have been asserted.
Oakington is the site of an early Anglo-Saxon cemetery in Cambridgeshire (AD 450–700).
Excavated in June 2011, grave 57 contained a woman with a descended foetus across her pelvic
cavity, a position unlikely to result from post-mortem extrusion. She was aged between 25 and
30, had congenitally absent teeth and occupational wear on her hands and feet (Buikstra and
Ubelaker 1994). She was buried supine in full dress with a cruciform brooch and two small long
brooches. The foetus lay low and transverse across her pelvis, which was probably the cause of
this double fatality (Fig. 1). Even today transverse lie pregnancy is a dangerous malpresentation
for both mother and foetus, almost always resulting in Caesarean section (Simm 2007). There
are other examples of women with in situ foetuses from Anglo-Saxon cemeteries. However, in
archaeology the dominant interpretation for extruded and partially extruded foetuses is currently
a phenomenon known as coffin birth: the post-mortem extrusion of a foetus into the grave
(Lewis 2007: 35). The recognition that this taphonomic process is in fact improbable under
burial conditions and that death from childbirth was a major cause of female mortality allows
not only an appropriate interpretation of the mortuary context, but also an exploration of female
fertility as a signifi cant and embedded phase in the adult life course.
Calvin Wells was certain that the only way to identify death in childbirth was by direct
association, where the foetus is found in the pelvic canal (Chadwick Hawkes and Wells 1975;
Wells 1978). However, maternal mortality in the Middle Ages may have been the cause of up to
50 per cent of young female fatalities (Högberg et al. 1987) and is the cause of 30–40 per cent of
deaths in the modern developing world, particularly where emphasis is placed on adolescent and
early adult fertility (Marai Bhat 2002; Wilmot and Gemmill 2012). Building on this position, we
will argue that examples of pelvic sit uated and extruded foetuses from Anglo-Saxon cemeteries
were likely to have been caused by death in childbirth and also that neonates found in double
graves may have been the result of maternal mortality because death does not have to result
from mechanical means : infection, haemorrhage, sepsis and eclamp sia can cause infant and
female fatality up to forty-two days post-partum.
Figure 1 Skeleton 57 from Oakington; note the descended, transverse lie foetus in her pelvis. The white
dotted line shows some of the in situ foetus.
286 Duncan Sayer and Sam D. Dickinson
Archaeology and maternal morta lity
Post-mortem extrusion, it is speculated, takes place forty-eight to seventy-two hours after death because
the formation of decomposition gases creates an increase in intra-abdominal pressure, causing the
uterus to prolapse, resulting in post-mortem delivery (Smith 1955: 25). Coffin births have been
described in modern forensic cases but not as the result of decomposition (Schulz, Püschel and
Tsokos 2005). For example, in one fire-related death a foetus was found outside the mother’s body,
reportedly caused by the initial heating and subsequent shrinking of the uterine wall (Vennemann et al.
2008). Another case of coffin birth involved foetal expulsion after heroin overdose; labour had onset so
the foetus was head down (Schulz, Püschel and Tsokos 2005; Vennemann et al. 2008). In this case the
heroin may have induced the early stages of labour. The key diagnosis is the dilation of the cervical
canal and for foetal extrusion to take place unaided a significant degree of dilation prompted by ante-
mortem contractions is required. Plausibly uterine contractions could be ‘caused by the onset of rigor
mortis’ (Schulz, Püschel and Tsokos 2005: 275); however , this is in fact an inhibiting factor because of
the restriction of tissue. Relying on the decomposition process to create forward momentum also
presents a problem. In an earthen grave the cadaver is surrounded by soil, around and on top of the
stomach, pelvis and between the legs, a situation which would certainly prevent the extrusion of an
intact, fully articulated foetus. As a result, the unusual taphonomic situation required for coffin birth
mayberestrictedtocoffin-like cavities. Other taphonomic processes are caused in the coffin environ-
ment because of the absence of soil. When neck ligaments are no longer robust a skull may move,
nudged by water or gravity (Emory and Wooldridge 2011: 22). However , putrefaction takes longer than
forty-eight to seventy-two hours and extrusion would have to overcome an un-dilated, un-plastic,
cervical canal, while the foetus was itself decomposing. As a result, coffin birth would be extremely
unlikely to occur within an archaeological burial even inside a coffin-like cavity.
Calvin Wells’ conservative approach to maternal mortality derives from the certainty of
identification (Chadwick Hawkes and Wells 1975; Wells 1978). At St Nicholas Shambles, a
medieval site in London, he identified a woman with cephalo-pelvic disproportion; she died
with the foetus lodged within the birth canal where it remained for burial (Wells 1978).
However, female skeletons with a foetus within the pelvic cavity, birth canal or in obstruction
between their legs are rare in the archaeological record (Lewis 2007: 34). But death because of
childbirth was not rare in the past (Högberg et al. 1987). An infant who died singularly may
have been placed inside the grave of a contemporary adult, as seen in post-medi eval Anglican
practice, and sometimes infants were passengers in the coffins of unrelated adults, as in two
examples from St Pancras, London (Emory and Wooldridge 2011: 86; Roberts and Cox 2003:
255). These examples are from urban and early modern contexts; populations in pre-industrial,
rural, family-based societies, like Anglo-Saxon England, were small and dispersed so deaths
were less frequent and less likely to coincide: a situation which significantly increases the
probability that a young infant and adult woman found in the same grave were associ ated.
Double obstetric calamity in early Anglo-Saxon England
At
a superficial glance grave 57 at Oakington fits a recognized pattern of infant and woman
double burial seen at other large early Anglo-Saxon cemeteries (Crawford 2007; Lee 2008). Lee
identified a series of burials from Beckford, Barrington and Apple Down where women with
Obstetric death and female fertility in Anglo-Saxon England 287
