Child/infant mortality in low income countries & history

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Child/infant mortality in low income countries & history

Post by discovolante » Sun Nov 22, 2020 2:36 pm

Does anyone know of research and other general publications about the psychological/mental impact of high child and infant mortality in areas/periods of time where this is common? Or demographics within nations/regions...basically any situation where there is a statistically high likelihood of it happening to a group of people in a society.

So far I have just found this: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3124431/ but my science research skills are non-existent so any help would be appreciated. There is a shitload of stuff on income, educational disparities and all that but not seen much at all on the actual psychological effects.

Asking this kind of because of the assumption/belief/argument that 'back then' people were less affected and more accepting of their kids dying, because it was so common, but not sure that it really needs to be limited to a particular period of time. Although of course any historical enquiries of literature/letters/diaries/asylum records/whatever people use to find out this sort of stuff from the past would be good too.

Also it doesn't have to be focused on the effects on women of course, but it would be interesting to compare.

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Re: Child/infant mortality in low income countries & history

Post by sTeamTraen » Sun Nov 22, 2020 4:52 pm

Typically you would start with access to a database like PubMed and a keyword search for something like "Perinatal death". To get ideas for keyword searches, start with papers you have already found and see if the keywords in them look interesting. Sadly (perhaps), keywords are basically free text, so "Perinatal death" and "Perinatal mortality" will deliver different results.

Another good place to look is in the references that are cited in the opening paragraphs (the literature review) of each article.

I'd be happy to help with the database access that I have.
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Re: Child/infant mortality in low income countries & history

Post by discovolante » Sun Nov 22, 2020 4:56 pm

Ah sh.t I didn't even notice that! Fixed now.

Thanks, will try again later. I guess it is just basic keyword stuff, but in a different database to what I would use day to day, but I just assume there is some kind of science magic to it that I'm not privy to.
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Re: Child/infant mortality in low income countries & history

Post by sTeamTraen » Sun Nov 22, 2020 6:10 pm

One of the things to think about is what the nature and source are of the variance you are attempting to explain. For example, the paper you cited seems to conclude principally that women who had recently lost a baby had worse mental health than those who had not, which seems to me to be quite close to what the psychologist Jan Smedslund would call a pseudo-empirical question, in that we would consider it absurd if we found the opposite. We know that having a child die is one of the most awful things that can happen to someone and we know that it will have a substantial negative impact on them. It's perhaps interesting to attempt to quantify that, but it's very much Day 1 research.

If (as I think may be the case from reading the OP) it's something along the lines of "the extent to which the impact on the bereaved of their personal experience of loss of a child varies with the prevalence of perinatal mortality in their society", that's going to be very hard to do with Western samples because infant mortality has been pretty low more or less since we started measuring depressive symptoms (etc) with any degree of reliability. So you're unlikely to find very much from the pre-polio vaccine period, especially since psychology wasn't all that interested in the well-being of women from statistically poorer populations back then (not that it's doing an excessively fabulous job on that today either).

On the other hand, if you tried to compare a Western sample with one from a much poorer country, there would be a ton of cultural confounds to deal with. For example, maybe there is something looking at the experiences of Bangladeshi-descent women in Western countries. (Normally I would want to write "I hope there's been lots of studies of this", but of course for the studies to happen requires that some tragedies have occurred. :()

Given that the trends are mostly positive worldwide, it might be an interesting longitudinal project to see what happens with this over time within a country that still has a lot of room for improvement in its perinatal mortality figures, but now we're talking about a major funded research undertaking that would go way beyond even a PhD project.

Of course, this is all about quantitative research. This feels to me like an area where qualitative methods may have something to offer.
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Re: Child/infant mortality in low income countries & history

Post by discovolante » Sun Nov 22, 2020 7:30 pm

What triggered the question was a discussion about the sort of casual assumption a lot of people make about people in the 'olden days' (heh) being somehow emotionally tougher and able to cope with death and particularly the death of their children. I instinctively find this quite hard to accept; perhaps people had different coping mechanisms and ways of dealing with it but I've heard anecdotal historical evidence of people, women in particular, being profoundly affected. And the interest in women is partly the physical aspect of it - the idea of pregnancy after pregnancy ending in death while the child is still physically dependant on you (and you yourself might be injured/ill) seems like it would take an almost unbearable psychological toll on me including a lot of guilt. Perhaps it's the case that where death is more common, it's accepted as a fact of life rather than a failing, but on the other hand without the medical knowledge we have now it seems like it would also be easier to assume some fault on the part of the mother. I don't know.

But yeah, it seemed unlikely there would be much in the way of 'scientific' evidence of this occurring in history, so the next best thing seemed to be to look at areas of high infant mortality that exist now, and why I also suggested diaries and other historical sources. On the other hand contemporary studies would be much more useful too because these people are still alive and experiencing it, and the thought that their emotional and psychological needs may not be considered in any serious way seemed quite galling - but again I don't know, I was only struck by the very quick initial search I did.

Obviously if the original aim is to go back and look at how people in 'history' (also a pretty broad subject...) reacted to infant mortality, looking at women in rural Bangladesh now is going to be very very imperfect. So yes some sort of comparison with low-mortality countries would be a better start.

I'm not hoping to find a 'perfect', rigorous answer to this - if anyone else goes to that trouble I'd be delighted - but just enough to address the general assumption, or confirm it if I'm wrong.
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Re: Child/infant mortality in low income countries & history

Post by jimbob » Sun Nov 22, 2020 7:34 pm

discovolante wrote:
Sun Nov 22, 2020 7:30 pm
What triggered the question was a discussion about the sort of casual assumption a lot of people make about people in the 'olden days' (heh) being somehow emotionally tougher and able to cope with death and particularly the death of their children. I instinctively find this quite hard to accept; perhaps people had different coping mechanisms and ways of dealing with it but I've heard anecdotal historical evidence of people, women in particular, being profoundly affected. And the interest in women is partly the physical aspect of it - the idea of pregnancy after pregnancy ending in death while the child is still physically dependant on you (and you yourself might be injured/ill) seems like it would take an almost unbearable psychological toll on me including a lot of guilt. Perhaps it's the case that where death is more common, it's accepted as a fact of life rather than a failing, but on the other hand without the medical knowledge we have now it seems like it would also be easier to assume some fault on the part of the mother. I don't know.

But yeah, it seemed unlikely there would be much in the way of 'scientific' evidence of this occurring in history, so the next best thing seemed to be to look at areas of high infant mortality that exist now, and why I also suggested diaries and other historical sources. On the other hand contemporary studies would be much more useful too because these people are still alive and experiencing it, and the thought that their emotional and psychological needs may not be considered in any serious way seemed quite galling - but again I don't know, I was only struck by the very quick initial search I did.

Obviously if the original aim is to go back and look at how people in 'history' (also a pretty broad subject...) reacted to infant mortality, looking at women in rural Bangladesh now is going to be very very imperfect. So yes some sort of comparison with low-mortality countries would be a better start.

I'm not hoping to find a 'perfect', rigorous answer to this - if anyone else goes to that trouble I'd be delighted - but just enough to address the general assumption, or confirm it if I'm wrong.
I've seen heartrending writings by bereft parents from the sixteenth Century (I can't recall where). Or even the fact that we have infant and child burials from archaeology suggests that it might have happened to most parents, but it still was hard.
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Re: Child/infant mortality in low income countries & history

Post by sTeamTraen » Sun Nov 22, 2020 11:04 pm

discovolante wrote:
Sun Nov 22, 2020 7:30 pm
What triggered the question was a discussion about the sort of casual assumption a lot of people make about people in the 'olden days' (heh) being somehow emotionally tougher and able to cope with death and particularly the death of their children.
I think we tend to romanticise the old days on this and other topics. I suspect that PTSD and related conditions were just as prevalent then as they are now (per 100 incidents of whatever tragedy); it's just that large numbers of people were walking round with PTSD and so that became "normal". Psychology hadn't yet separated from philosophy, which itself (depending how far back you went) hadn't separated from religion.

There is a tendency to conflate lack of data with lack of a problem. A bit like people who say "Eee, in my day we didn't have allergies" - well, yes, you did, but either they were bad and people died from them, or you just put up with it because there were no antihistamines and other ailments like TB or leprosy had an even higher priority.

To some extent looking at rural Bangladesh today probably takes you back some of the way there, in that people's thought processes about any adverse event will likely still be dominated by religious explanations for bad things, as would have been the case in most of Europe only a century ago.
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Re: Child/infant mortality in low income countries & history

Post by Millennie Al » Mon Nov 23, 2020 4:39 am

I remember hearing quite a long time ago that it was common to avoid naming a child until a short while after birth in an attempt to avoid getting too emotionally attached until the chance of early mortality had lessened. I don't know how true it is, and can't find any reference to it now. Though I did find this: Infant Mortality and Child-Naming: A Genealogical Exploration of American Trends. It does show that babies were frequently not named until a while after being born, though I'm not very impressed by the bit where it says:
The more striking finding, though, is that unnamed
infants usually lived only a very short time after birth.
as it seems perfectly obvious that it's a side effect of when naming occurred - for example, if babies were all named at seven days, then all deaths of unnamed babies must have been at or before seven days.

That might provide you with inspiration for more keywords.
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Re: Child/infant mortality in low income countries & history

Post by mediocrity511 » Mon Nov 23, 2020 7:07 pm

jimbob wrote:
Sun Nov 22, 2020 7:34 pm
discovolante wrote:
Sun Nov 22, 2020 7:30 pm
What triggered the question was a discussion about the sort of casual assumption a lot of people make about people in the 'olden days' (heh) being somehow emotionally tougher and able to cope with death and particularly the death of their children. I instinctively find this quite hard to accept; perhaps people had different coping mechanisms and ways of dealing with it but I've heard anecdotal historical evidence of people, women in particular, being profoundly affected. And the interest in women is partly the physical aspect of it - the idea of pregnancy after pregnancy ending in death while the child is still physically dependant on you (and you yourself might be injured/ill) seems like it would take an almost unbearable psychological toll on me including a lot of guilt. Perhaps it's the case that where death is more common, it's accepted as a fact of life rather than a failing, but on the other hand without the medical knowledge we have now it seems like it would also be easier to assume some fault on the part of the mother. I don't know.

But yeah, it seemed unlikely there would be much in the way of 'scientific' evidence of this occurring in history, so the next best thing seemed to be to look at areas of high infant mortality that exist now, and why I also suggested diaries and other historical sources. On the other hand contemporary studies would be much more useful too because these people are still alive and experiencing it, and the thought that their emotional and psychological needs may not be considered in any serious way seemed quite galling - but again I don't know, I was only struck by the very quick initial search I did.

Obviously if the original aim is to go back and look at how people in 'history' (also a pretty broad subject...) reacted to infant mortality, looking at women in rural Bangladesh now is going to be very very imperfect. So yes some sort of comparison with low-mortality countries would be a better start.

I'm not hoping to find a 'perfect', rigorous answer to this - if anyone else goes to that trouble I'd be delighted - but just enough to address the general assumption, or confirm it if I'm wrong.
I've seen heartrending writings by bereft parents from the sixteenth Century (I can't recall where). Or even the fact that we have infant and child burials from archaeology suggests that it might have happened to most parents, but it still was hard.
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Re: Child/infant mortality in low income countries & history

Post by discovolante » Mon Nov 23, 2020 7:16 pm

Thanks for the replies so far folks. I've got myself tied up in a few other little things so not got round to doing any actual searching yet but appreciate the input/ideas/suggestions.
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Re: Child/infant mortality in low income countries & history

Post by Stephanie » Tue Nov 24, 2020 2:42 pm

This book apparently looks at the case notes of Richard Napier. https://www.amazon.co.uk/Mystical-Bedla ... 052127382X. There's a review here from the 80s https://www.ncbi.nlm.nih.gov/pmc/articl ... 64/?page=1, which contains the following:
and that seventeenth-century parents distanced themselves emotionally from their children. Richard Napier's parents did not: many of them came with what a modern psychiatrist would undoubtedly call a reactive depression, caused by the death of a spouse or child
Medical history might be a good thing to look at.
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Re: Child/infant mortality in low income countries & history

Post by discovolante » Tue Nov 24, 2020 2:47 pm

That book looks awesome! £24 though eek, and more from bookshop.org. Pretty tempted though.
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Re: Child/infant mortality in low income countries & history

Post by Stephanie » Tue Nov 24, 2020 2:58 pm

Sara Coleridge, in 1840 writing to a friend:
Our loss indeed has been a great disappointment, and even a sorrow; for, strange as it may seem, these little speechless creatures, with their wandering, unspeaking eyes, do twine themselves around a parent's heart from the hour of their birth. Henry suffered more than I could have imagined, and I was sorry to see him watch the poor babe so closely, when it was plain that the little darling was not for this world, and that all our visions of a " dark-eyed Bertha," a third joy and comfort of the remainder of our own pilgrimage, must be exchanged for better hopes, and thoughts more entirely accordant with such a religious frame of mind as it is our best interest to attain.
from here https://archive.org/stream/memoirletter ... t_djvu.txt
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Re: Child/infant mortality in low income countries & history

Post by Stephanie » Tue Nov 24, 2020 3:05 pm

And haveing had three houers' sleepe, his face when he awaked was full of red round spotts like the smale pox, being of the compasse of a halfpeny, and all whealed white over, these contineuing in his face till night, and being in a slumber in my arms on my knee he would sweetly lift up his eyes to heaven and smile, as if the old saying was true in this sweet infant, that he saw angells in heaven. But then, wheather through cold uppon his dressing then, or what else was the cause, the Lord knoweth, the spotts struck in, and grew very sicke all night, and about nine a'clocke on Satterday morning he sweetely departed this life, to the great discomfort of his weake mother, whoes only comfort is that the Lord, I hope, has receaved him to that place of rest in heaven where litle children beholds the face of theire heavenly Father, to his God and my God. [...] My son William Thornton was buried at Easby in the same grave with his eldest sister, which died before baptized, by Mr. Kirton, he beeing scarce fourteen daies old, near my Lady Wharton's grave at Easby, Aprill 29th, 1660 : his father beeing much troubled at his losse, whom the child was exceding like in person, and allso his eldest sister.
From the autobiography of Mrs Alice Thornton https://archive.org/details/autobiograp ... 4/mode/2up
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Re: Child/infant mortality in low income countries & history

Post by Stephanie » Tue Nov 24, 2020 3:11 pm

"I got a flu virus named after me 'cause I kissed a bat on a dare."

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Re: Child/infant mortality in low income countries & history

Post by discovolante » Tue Nov 24, 2020 4:41 pm

Thank you again :)
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Re: Child/infant mortality in low income countries & history

Post by Sciolus » Tue Nov 24, 2020 7:09 pm

Nothing sciency I'm afraid, just a few random thoughts:

Charles Darwin is said to have lost his faith largely due to the death of his daughter Annie. Not exactly a low-income family but perhaps 1851 is within your scope.

I've been trying to think of examples in literature. There's Tess, but Hardy throws so much sh.t at her that one more tragedy is hardly noticeable; and Jude is just weird. There must be some in Dickens, but I haven't read him much. There Macduff of course; there's an element of losing one's heir but Macb IV 3 has real grief as well (the original "one fell swoop" -- it seems distasteful to use that phrase for such trivial things as it is these days).

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Re: Child/infant mortality in low income countries & history

Post by Allo V Psycho » Sun Nov 29, 2020 1:57 pm

Sciolus wrote:
Tue Nov 24, 2020 7:09 pm
Nothing sciency I'm afraid, just a few random thoughts:

Charles Darwin is said to have lost his faith largely due to the death of his daughter Annie. Not exactly a low-income family but perhaps 1851 is within your scope.

I've been trying to think of examples in literature. There's Tess, but Hardy throws so much sh.t at her that one more tragedy is hardly noticeable; and Jude is just weird. There must be some in Dickens, but I haven't read him much. There Macduff of course; there's an element of losing one's heir but Macb IV 3 has real grief as well (the original "one fell swoop" -- it seems distasteful to use that phrase for such trivial things as it is these days).
Dombey and Son is pretty touching, and Dombey Snr has a long journey to go after the loss of little Paul. Hastily passing over Little Nell (even G.K. Chesterton said that it was not so much her death as her life he objected to), the death of Johnny, Betty Higden's ?great-grandson in Our Mutual Friend, is expressed unusually simply and I think is quite touching.

Dickens and Catherine lost baby Dora in infancy. She was their ninth child. From Wiki:
Dickens did not break down until he returned home, when, his daughter Mary later recalled, "I remember what a change seemed to have come over my dear father's face when we saw him again... how pale and sad it looked.".[4][5] All that night he sat keeping watch over his daughter's body, supported by his friend Mark Lemon. The next day Dickens wrote to his wife Catherine, who was recuperating at Malvern in Worcestershire. Anxious that the news might cause a further breakdown in her health, Dickens wrote "I think her very ill", even though Dora was already dead.[5] Forster delivered the letter to her at Malvern himself, and eventually told her the truth.

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