Medieval skeletons have been in the news of late, or rather the results have of osteological research into medieval populations. While the BBC announced the findings of a major project looking at the genetics behind the “Black Death”, I had a rather more staid evening, but still on the topic of medieval health, population and causes of death. I attended a talk at a local archaeological society, given this week by Dr Heidi Dawson of Bristol university’s department of archaeology and anthropology. The topic was health, status and burial practices as reflected in medieval cemetery populations, based on an excavation at the priory of SS Peter and Paul, Taunton, Somerset. The cemetery was used by both the clergy and the lay population between possibly as early as the 1150s and no later than 1539, as the Dissolution wiped out burial practice at this site. The archaeologists only excavated the lay cemetery, which was situated to the west of the priory church, as the area east of the church (presumably containing the clerics) lies underneath a cluster of Victorian housing. So much for the general context. Three questions aroused my curiosity, and brought me back to thinking of my early academic pursuits, when I did some studies on disability in medieval palaeopathology of the literature-review type.

One: a lot ot the females buried in the lay cemetery appeared to be aged between 20 and 35 years of age, i.e. in their prime childbearing years. Was this mortality pattern, as several people, both the speaker and in the audience suggested, due to death in childbirth? That’s always the standard answer that tends to be given when confronted with young females dying in the past. Our stereotypical view, from the comfortable position of belief in the superiority in all aspects of our own times, is that medieval standards of hygiene and medical care were generally abysmal, so we simply take it as a given that large numbers of women died in childbirth. Where is the evidence? From my (albeit limited) knowledge of osteology and palaeopathology it transpires that there are ways of ascertaining whether a female skeleton is that of a woman who has given birth (or tried to give birth) to a child, in that every birth results in scarring of the pubic bones, particularly of the pelvis. If one were to examine the pelvises of the skeletons of those females who died in the 20 to 35 age range one might be able to figure out which of these women had given birth or tried to. These individuals might likely (but still not definitely) be the ones who could have died in childbirth. Those individuals with no evidence of scarring to the pelvis are then the ones that definitely died from causes other than childbirth. I raise these questions because in my simple mind, when it comes to statistics, I cannot fathom how most of us alive today would actually have got here if our putative ancestral mothers had all died in childbirth. To the argument that we are the descendants of those (few) women who survived childbirth I would counter that such a limited line of descent would contradict the genetic diversity we see today.

Two: Still related to female mortality was the observation made by the excavating archaeologists that many of the females in the 20 to 35 age range had lost teeth, and of those teeth still intact in the jaw bones of their skeletal remains quite a number had caries. Now there is some research that supports the old wives’ tale of “gain a child, lose a tooth”, meaning that for every baby a woman has she loses a tooth. Not for nothing do pregnant women nowadays, even in the cash-strapped and threatened NHS, get free dental treatment for the duration of their pregnancy and for the first year afterwards. Nourishing a fetus and lactating diverts nutrient resources that would otherwise go into the production/preservation of the soft tissue (gums) holding teeth in place, and possibly also affects tooth enamel.

So one could quite simply do a study on this specific Taunton burial population that tries to correlate incidence of female pelvis scarring with incidence of female tooth loss and tooth decay. If my hypothesis is correct, those female skeletons with signs of pelvic scarring should be more likely to also present evidence of ante-mortem tooth loss. Conversely, since teeth can also be lost for loads of other reasons besides pregnancy and lactation, I would expect to find a number of female skeletons that show tooth loss/decay but no pelvic scarring. If you then were to look at the age range of the former group (the ones with both pelvic scarring and ante-mortem tooth loss), then you might be getting closer to finding a group of women who might perhaps have died in childbirth. That is, in other words, if the group affected by pelvic scarring and tooth loss were found to have perished in their 20s and 30s, then perhaps they may have died in childbirth. If, however, you find that women from the group affected by pelvic changes and lost teeth lived beyond their 30s, you are dealing with women who had at least one pregnancy (primae gravidae, for those who like jargon) and quite happily survived the apparent mortal peril of childbirth.

Three: A further interesting question raised by this presentation on the medieval Taunton cemetery population was: where are all the older women? It seems that once women reach menopausal age or even get past the menopause, the physiology of their skulls becomes similar to those of males. An archaeological paper on ‘Sexism in Sexing‘ (p. 36) highlighted the mis-readings and mis-interpretations reached by relying on cranial features alone. Hence there is a problem for osteologists in establishing the sex of more mature skeletons if they are either only relying on the cranium to ‘sex’ the individual, or the other bones, i.e. the pelvis, have not survived in the ground. Skeletal remains of older women have tended to be subsumed by the interpretative group of ‘mature males’. So a recent textbook notes: “An emphasis on the skull [as a means of sexing skeletal remains] probably contributed to an overabundance of males in earlier osteological reports” (Mary Anne Katzenberg & Shelley Rae Saunders, Biological Anthropology of the Human Skeleton, John Wiley & Sons, 2008, p. 576). Better sexing methods of mature skeletal remains might remove the paradigm of female mortality in childbirth in past populations, for if it turns out that far more women were becoming ‘old’ than previously assumed, far more women were living past their childbearing years and hence surviving childbirth.