The Poor at Birth: Infant Auxology and Mortality at Philadelphia's Almshouse Hospital, 1848-1873

Abstract

This paper presents an analysis of birth weights and infant mortality in mid-nineteenth century Philadelphia using obstetrics records of Philadelphia's Almshouse hospital, an institution for the poor and their offspring. Children of the poor weighed between 2,900 and 3,200 grams on average at birth, or about the 10th to 25th percentile of modern birth weight standards. 3rthweights declined during the Civil War decade, consistent with the poor state of the economy in the l80s, because birth weights were lower than modern standards the urban poor suffered from higher rates of infant mortality than today. But infant mortality was far worse than that expected from a modern schedule of mortality by birth weight, and a major determinant of excess mortality appears to be the poor quality of nineteenth century obstetrics.