If you have a heart, the story of the life of Queen Anne of England (ruled 1702 – 1717) will break it. Anne wanted children – badly – both for normal maternal instinct and reasons of state. Anne’s husband, Prince George of Denmark, helped Anne get pregnant 17 times.
Anne died childless at the age of 49.
Seven of Anne’s pregnancies resulted in miscarriages. Five pregnancies came to term, but the babies were stillborn. Five children were born alive. Four – three daughters and a son – died before their second birthday. The fifth, Prince William, died at the age of 11.
When a child predeceases their parent, it produces a special kind of grief. Losing a son or daughter hurts more than losing a parent, a sibling or a friend. Everyone I know who has experienced this tragedy seems to have a sadness of the soul that never goes away. I think it is because such a death goes against the natural sequence of life. We are supposed to bury our parents, not our children.
The amount of grief that Queen Anne experienced in her life is almost unfathomable. But she was not alone. Anne – whether as Princess Anne or Queen Anne – lived an incredibly comfortable life. She had the best of food, the best of lodging, and the most attentive and skilled medical care available at the time. But still, all her children died. The grief that she experienced was shared by almost all women of her time and place. Researchers from Cambridge University and the University of Newcastle have examined birth and burial records from several English communities. They conclude that 35 to 40 percent of babies born died before their first birthday. Less than half of all children got to blow out five candles on a birthday cake.
Improvement was slow. A researcher from Statista.com estimates that in 1800, one third of all children born in Britain died before their fifth birthday. Better than in Queen Anne’s time, but not by that much. By 1900, “only” 28 percent of British children died before turning five. By 2000, this death rate was down to 0.7 percent. In 2020, this dropped to 0.4 percent.
That’s a lot better than in the good old days.
I’ve started with England/Britain because reasonably reliable data goes back much further than in what is now Canada. We don’t know with precision what the infant and child mortality rates were amongst indigenous people here, but when smallpox and tuberculosis were superimposed on “normal” mortality rates of the time, the death rates for children must have exceeded 80 or 90 percent amongst indigenous people. Every mother had as much grief as Queen Anne. Assuming she lived until the ripe old age of 49.
By 1905, Canada had fairly reliable vital statistics. An agency to count births and deaths was one of the first functions taken on by provincial governments upon becoming a province. In 1921, the federal government started adding up provincial numbers. Let’s start looking at trends in infant and child deaths in Canada after Alberta and Saskatchewan became provinces. These numbers were compiled by Statista.com.
Percentage of children dying before their first birthday
1905: 13.7 percent
1915: 16.6 percent
1925: 9.9 percent
1955: 3.5 percent
1995: 0.6 percent
2005: 0.5 percent
For those keeping score, that’s a 96.4 percent cut in the infant mortality rate in a hundred years. There has been no real change in the rate since 2005.
Percentage of children dying before their fifth birthday:
1905: 21.1 percent
1915: 26.9 percent
1925: 13.5 percent
1955: 4.4 percent
1995: 0.7 percent
2005: 0.6 percent
The first year of life is always the riskiest (until one gets really old). After that, risk of children dying declines. But in 1905, 7.4 percent of children died between their first and fifth birthday. A hundred years later, this was down to 0.1 percent. For those keeping score, that’s a 98.6 percent drop.
Something better than in the good old days: fewer children dying and fewer parents grieving.
Why do fewer children die today?
The evidence is pretty clear. Things are better than in the good old days. Fewer infants and children die? What’s the reason?
I cannot answer this question. There is no such thing as THE reason. This is not a dodge, or an appeal to the virtue of ignorance. The question is unanswerable as asked because in the good old days small numbers of children died for large numbers of reasons. The numbers added up.
Let’s go back 100 years. Let’s look at children under the age of one dying in the month of April 1924. In that month, in Canada, 1,110 babies died. That’s a lot of dead babies for one month, at least by today’s standards. In the good old days, it was a normal month. The babies died for a lot of reasons. According to the Dominion Bureau of Statistics, causes of death included:
187 from pneumonia or bronchitis,
55 from injuries sustained in the process of being born,
42 from convulsions,
32 from influenza,
31 from whooping cough,
17 from measles, and
9 from tuberculosis.
Remember, this is one month from one year. It was normal. No big epidemic, famine, or natural disaster.
How much are things better?
The numbers above were for one month for children less than year old. Because of data availability issues, I’m going to give figures for an entire year – for children up to their fifth birthday. Even expanding these reference points so dramatically, in 2022 (according to Statistics Canada):
12 died from pneumonia, bronchitis or influenza. In April of 1924 – one month – 219 children under the age of one died from these diseases. What caused this dramatic decrease? Better heating in houses, better diet, and anti-biotics.
Today, Statistics Canada does not even have a category for injuries suffered during the delivery process. They do report on things like complications for pregnancy, but don’t even have a category to record traumatic injuries arising from trying to get the little gaffers out. Remember, a century ago, 55 babies died from this IN ONE MONTH.
There is no category for death from convulsions. I assume diagnostic criteria for causes of fatal convulsions are better. For example, in 2022, 1 child under the age of 5 died from meningitis. That’s a far cry from 42 babies in one month. Since we don’t know what caused the convulsions a century ago, we cannot speak to why the numbers decreased.
In 2022, no child under the age of five died from whooping cough – compared to 31 under the age of 1 IN ONE MONTH a century earlier. The main reason for the dramatic improvement – vaccinations.
In 2022, no child under the age of five died from measles – compared to 17 under the age of one IN ONE MONTH a century earlier. The main reason – vaccinations.
In 2022, no child under the age of five died from tuberculosis – compared to 9 under the age of one IN ONE MONTH a century earlier. The main reasons – vaccinations, anti-biotics, better ventilation in homes and pasteurized milk.
Let’s take some other causes of children dying.
My wife’s immediate observation to this column idea was that fewer children die in car accidents than in the good old days. Seat belts. Car seats. Safer cars. Better roads. Indeed, as I outlined in one of my first columns, fewer people die in car accidents than four or five decades ago. The decline in deaths overall has been dramatic, so there is no reason to believe that this does not include children even though I cannot readily find age adjusted data. However, if we change our definition of the good old days to a century or two in the past, more children die in motor vehicle accidents today. Balanced against this is the probability that fewer die falling off horses or getting crushed beneath hoofs.
Let’s look at kids dying in fires, either from burn wounds or smoke inhalation. Accurate counts since the good old days – however defined – are devilishly hard to come by but we do know one thing. Fewer kids are dying in fires. I cannot put precise numbers to this but trust me. It is a fact. Why?
Different types of heating systems in home. Burning wood is dangerous.
Smoke detectors warn people of a fire.
Flame retardant fabrics and upholstery.
More people living in cities where there are fire departments closer at hand.
Fewer smokers.
Different cigarette paper – stuff that does not keep a cigarette smoldering.
Better electrical wiring.
Automatic sprinkler systems.
More fast-food restaurants leading to fewer kitchen fires.
Artificial Christmas trees.
And other reasons that I cannot think of.
The example of “fewer children dying in fires” points to the futility of looking for mono-causal explanations for the decline in infant and child mortality.
Better than the good old days
In countries such as Canada, fewer children die before their parents than at any other time or place in the history of humanity. The change is not just quantitative. It is qualitative. Our children are so safe that we cannot even realistically imagine harm coming to them.
So, being human, we imagine imaginary harms. Therein lies the potential to return – at least partially - to the good old days. You know, the days when lots of kids died.
Scroll up and look at the common causes of infant death a century ago. Today, no child dies from many of these causes. Look at the reasons for the decline. How many times do you see the word vaccination?
So what do many of us do?
We decide it is too dangerous to get our children vaccinated. Vaccination rates for these diseases are falling. Parents are channeling their inner Nancy Reagan to “just say no.”
There is a reason for this bizarre turn of affairs. The vaccination programs for diseases that used to kill lots of children have been so successful that we take their benefits for granted. We have lost our fear of diseases such as whooping cough, measles, and tuberculosis. Instead, we begin to fear the rare or imaginary dangers of the vaccines. This is understandable, but pathologically stupid. We are risking returning to the good old days. You know. The ones with lots of small coffin funerals.
But there is more.
Because I teach at a community college, I spend a lot of time in the presence of 18- and 19-year-olds. They are good kids, but they kind of freak me out. They are extremely timid and risk averse. Many have told me they are AFRAID to ask a question in class. They are not afraid of me. They are not afraid of the other students. They are afraid of asking a question or making a comment. They have been taught to be afraid of everything.
It is unnerving for me.
Being young used to be a time to be bold – indeed, for being reckless. Now it has become a time for being timid and afraid. Us old fogies have done this to these young people. In a time of great safety, we have convinced them to be afraid of everything up to and including their own shadow. This is something that is not better than in the good old days. Our youth are fearful. It is not supposed to be this way.
So – let us celebrate how much safer Canada has become for infants, children, and youth. Fewer of them die before their parents. This is a great accomplishment that has causes too numerous to even identify. Let us celebrate the real safety that our children enjoy rather than teach them they should be afraid of everything and everybody.
I think of a guy named John Boyd. He was a fighter pilot in the U.S. Air Force who went on to design the F-18 that was the mainstay of the American Air Force in the last part of the 20th century and is still used by Canada’s armed forces.
The story is this:
Boyd was talking to the General in charge of training fighter pilots. The General was bragging about the safety record of the training program under his command. There had been no accidents for two years. Boyd was appalled. He said this was proof of a bad training program. If pilots had no accidents, they were not being trained to push the limits. In a time of war, they would be unprepared. Some accidents – even a few deaths – in peacetime were necessary for both success and survival in times of war. A perfect safety record in a fighter pilot training program was a sign of failure to properly prepare.
Boyd’s view was controversial. Let’s be honest. A lot of people thought he was insane. But he was on to something. Sometimes an excessive preoccupation with safety can make things more unsafe.
Let’s look at vaccinations. A good vaccine saves lives. A lot of lives. But there is sometimes a real or imagined risk of side effects. If we just look to the side effects – if we protect our children from those risks by not getting them vaccinated - we might return to the good old days of dead children.
Take “stranger danger”. We teach our children to be afraid of every stranger. This might prevent a child or two from being kidnapped and brutally murdered. However, one side effect is to erode the ties that make us a community. Another is to make every young person live in fear. This can be a greater danger.
I am stumbling around a bit, but here is what I am trying to say. Our children are much safer than they were in the good old days. By an order of magnitude. Let us acknowledge this fact and celebrate it rather than undo our accomplishment by fearing the means that made it possible.