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This paper takes, as its starting point, Preston and Haines' observation in Fatal Years that social class was the most important influence on infant and child mortality in England and Wales in the early twentieth century. A subsequent study suggested that this could in part be due to the spatial distribution of the different classes across different types of place, and that some of the mortality differences by social class might actually reflect the contextual effects of healthy and unhealthy places. Although this line of argument has received a considerable amount of attention in health geography literature, it has rarely been examined for a specific historic period, and then only within particular urban areas. In this paper, we apply multi-level models to a complete count individual-level dataset of the 1911 census of England and Wales, comparing influences on infant and child mortality at the level of the individual couple and for two spatial levels. We find that although most variation in infant and child mortality operates at the individual level, there is also important variation at the two spatial levels and part of the mortality differences between social classes is better explained by the areas in which people lived rather than by their social class. A consideration of independent variables at all three levels suggests that different spatial scales capture different sorts of influences on early age mortality. [ABSTRACT FROM AUTHOR]

We use individual-level census data for England and Wales for the period 1851-1911 to investigate the interplay between social class and geographical context determining patterns of childbearing during the fertility transition. We also consider the effect of spatial mobility or lifetime migration on individual fertility behavior in the early phases of demographic modernization. Prior research on the fertility transition in England and Wales has demonstrated substantial variation in fertility levels and declines by different social groups; however, these findings were generally reported at a broad geographical level, disguising local variation and complicated by residential segregation along social class and occupational lines. Our findings confirm a clear pattern of widening social class differences in recent net fertility, providing strong support for the argument that belonging to a certain social group was an important determinant of early adoption of new reproductive behavior in marriage in England and Wales. However, a relatively constant effect of lower net fertility among long-distance migrants both before the transition and in the early phases of declining fertility indicates that life course migration patterns were most likely factor in explaining the differences in fertility operating through postponement of marriage and childbearing. [ABSTRACT FROM AUTHOR]

The Own Children Method (OCM) is an indirect procedure for deriving age-specific fertility rates and total fertility from children living with their mothers at a census or survey. The method was designed primarily for the calculation of overall fertility, although there are variants that allow the calculation of marital fertility. In this paper we argue that the standard variants for calculating marital fertility can produce misleading results and require strong assumptions, particularly when applied to social or spatial subgroups. We present two new variants of the method for calculating marital fertility: the first of these allows for the presence of non-marital fertility and the second also permits the more robust calculation of rates for social subgroups of the population. We illustrate and test these using full-count census data for England and Wales in 1911. [ABSTRACT FROM AUTHOR]

This paper examines influences on post-neonatal mortality in Derbyshire (England) in the early twentieth century, by applying multivariate hazard analysis to a rare individual-level data set. The data allow detailed patterns of breastfeeding and weaning to be examined. The role of feeding is given special attention as a mediator between mortality and the other environmental, social, and demographic factors considered. Twins and illegitimate children were more likely to have been hand-fed, but this could explain only a small fraction of their increased vulnerability. Artificial feeding was associated with increased risks of death from diarrhoea, respiratory disease, and wasting diseases, lit is suggested that the link with wasting diseases was predominantly the result of the greater likelihood of congenitally weak children being hand-fed. Most of the variation in post-neonatal mortality, particularly from respiratory disease, was explained by environmental influences -- population density, altitude, and the presence of mining. [ABSTRACT FROM AUTHOR]

Neonatal mortality and stillbirths are recognised to be subject to similar influences, but survival alter a successful live birth is usually considered in isolation of foetal wastage. Moreover, individual-level data on age-specific influences and causes of death in a historical context are rare. This paper uses an unusual data set to compare the influences on neonatal mortality and stillbirths in early twentieth century Derbyshire, England. Multivariate hazard and logistic analyses are performed to examine the relative roles of various social, environmental, and demographic factors. The influences on and causal structures of neonatal mortality and stillbirths emerge as broadly similar, with previous reproductive history linked to a considerable amount of variation. The clustering of endogenous deaths was much greater than the clustering of exogenous and post-neonatal deaths, probably reflecting the cause-of-death structure and the relatively healthy social and environmental position of early twentieth century Derbyshire. [ABSTRACT FROM AUTHOR]

After the passing of the 1902 Midwives Act, a growing proportion of women were delivered by trained and supervised midwives. Standards of midwifery should therefore have improved over the first three decades of the twentieth century, yet nationally this was not reflected in the main outcome measures (stillbirths, early neonatal mortality and maternal death). This paper shows that there was a difference in the risks associated with delivery by the different attendants, with qualified midwives having the best outcome, then bona-fide (untrained) midwives and lastly doctors, even when account is taken of the fact that doctors were called in cases of medical need and may have been booked where a problematic delivery was expected. The paper argues that the lack of improvement in outcome measures could be consistent with improving standards of care among both trained and bona-fide midwives, because increased attention to the rules stipulating when midwives called for medical help meant that a doctor was called into an increasing number of deliveries (including less complicated ones), raising the chance of unnecessary and dangerous interventions.