Bringing about the death of a woman with preeclampisia (China, 1913)

Status
Not open for further replies.

ThunderBoots

Back with new name, no dachshunds
Super Member
Registered
Joined
Nov 9, 2010
Messages
112
Reaction score
4
Location
A warm rock (O'ahu, Hawaii)
Aloha! It 1913 and my character is a pregnant maid in a Shanghai brothel. I note the date and city to make clear that I'm not looking for information relating to N. American women with preeclampsia today. What I need is a way for my self-centered, manipulative antagonist (courtesan) to bring about the death of her preeclampsic maid without direct violence. Would forcing the maid to lift a heavy weight do anything? Slipping the maid some sort of snack which the maid loves but was warned against eating, such as ...? Making the maid do an early 1900s chore that preeclampsic women should avoid because of fumes? chemicals? Anyone have any ideas?
 

frimble3

Heckuva good sport
Super Member
Registered
Joined
Oct 7, 2006
Messages
11,574
Reaction score
6,396
Location
west coast, canada
Not sure. Isn't pre-eclampsia, and indeed, eclampsia, a blood-pressure related thing? And, frequently a long-term thing, only exacerbated by the pregnancy? Maybe herbs to increase blood pressure,salty snacks or extra and heavy work?

But not, I think a sure way to kill, or an easy thing to diagnose. Also, I believe at the time it was called 'toxemia'.

If your self-centered, manipulative antagonist wants her dead, why not just poison her food. I can't imagine that anyone (in a position to do anything) would care that much about a dead brothel servant.
 

Tocotin

deceives
Super Member
Registered
Joined
Aug 3, 2008
Messages
2,250
Reaction score
1,895
Location
Tokyo, waiting for typhoons
Hello,

I'm a bit surprised that your characters are aware of the maid's condition at all - could she afford to see a doctor? - but there are probably reasons for that. I don't think that there is one surefire thing to cause death of a woman with eclampsia or pre-eclampsia. It would have to be a combination of factors, probably: bad food, a lot of stress, a lot of work, not enough sleep, irregular hours. All of which would apply to your unfortunate maid character. The antagonist could simply work her to death, make her get up when she's been resting or eating and ran around on some foolish errand, rinse repeat. Add to that a few traditional punishments, like kneeling on gravel or on chains with a stone on her head, and it won't end well for the maid.

If the antagonist is pressed for time, maybe poisoning or pushing the maid down the stairs?

Also, I second frimble's words about a death of a brothel maid being of practically no consequence and very easily covered up. Actually, my own main character is a servant in a Tokyo brothel in the 1880s, and he's well aware that any misstep on his part might be fatal, because no one cares if he lives or dies. The brothel owners have the police AND the local gangs on their side or simply in their pocket. I would imagine it is the same for your time and setting, even more so, given that it was a politically unstable time for China - the Qing dynasty had just come to an end, the Kuomintang and the government of Yuan Shikai were at daggers drawn if not outright fighting (depending on the time of the year), and a lot was going on specifically in Shanghai.
 

ThunderBoots

Back with new name, no dachshunds
Super Member
Registered
Joined
Nov 9, 2010
Messages
112
Reaction score
4
Location
A warm rock (O'ahu, Hawaii)
Permit me to clarify (I)

Hello,

I'm a bit surprised that your characters are aware of the maid's condition at all - could she afford to see a doctor? - but there are probably reasons for that. I don't think that there is one surefire thing to cause death of a woman with eclampsia or pre-eclampsia. It would have to be a combination of factors, probably: bad food, a lot of stress, a lot of work, not enough sleep, irregular hours. All of which would apply to your unfortunate maid character. The antagonist could simply work her to death, make her get up when she's been resting or eating and ran around on some foolish errand, rinse repeat. Add to that a few traditional punishments, like kneeling on gravel or on chains with a stone on her head, and it won't end well for the maid.

If the antagonist is pressed for time, maybe poisoning or pushing the maid down the stairs?

Also, I second frimble's words about a death of a brothel maid being of practically no consequence and very easily covered up. Actually, my own main character is a servant in a Tokyo brothel in the 1880s, and he's well aware that any misstep on his part might be fatal, because no one cares if he lives or dies. The brothel owners have the police AND the local gangs on their side or simply in their pocket. I would imagine it is the same for your time and setting, even more so, given that it was a politically unstable time for China - the Qing dynasty had just come to an end, the Kuomintang and the government of Yuan Shikai were at daggers drawn if not outright fighting (depending on the time of the year), and a lot was going on specifically in Shanghai.
Sorry! I guess I need to clarify the situation so folks don’t read between the lines. The courtesan does not intentionally cause the maid’s death, let alone outright murder her. Therefore, no violence should be involved (poisoning, pushing down stairs). She causes the maid’s death through selfishness/self-centeredness and/or thoughtlessness. The maid is clearly pregnant and ill (although, naturally there has been no consultation with a doctor or diagnosis).
I do need the courtesan to bring about the maid’s death — the straw that broke the camel’s back, healthwise. One demand or action that plausibly and quickly leads to premature birth and maternal death.
As for no one caring about the death of a brothel maid — I suppose you mean that no one in a position of power would care? In any case, she isn’t murdered, so I think that’s a moot point.

Thank you for talking time to help me with this point!
 
Last edited:

benbenberi

practical experience, FTW
Super Member
Registered
Joined
Jul 7, 2012
Messages
2,800
Reaction score
843
Location
Connecticut
I believe that pre-eclampsia is a condition that, when identified today, frequently leads to the woman being ordered to complete bed rest for the remainder of the pregnancy. I don't think it was commonly diagnosed in anyone in 1913, let alone a brothel servant. Your selfish courtesan could simply order the maid to continue her normal physically strenuous tasks throughout her pregnancy without allowing any reduction or modification, & so provoke an unfortunate medical crisis & death.
 

Snitchcat

Dragon-kitty.
Super Member
Registered
Joined
Jul 2, 2006
Messages
6,344
Reaction score
975
Location
o,0
Maybe the easy solution would suffice here?

The selfish character is in a rush to go somewhere, runs into the maid, knocks the maid out of the way, the maid hits something and there goes the pregnancy?
 

Snitchcat

Dragon-kitty.
Super Member
Registered
Joined
Jul 2, 2006
Messages
6,344
Reaction score
975
Location
o,0
Or simply: selfish character burns incense or some fragrant herb that affects the maid's blood pressure? Or the selfish character continues to make unreasonable demands on the maid, etc. Doesn't take much to up stress and blood pressure?
 

frimble3

Heckuva good sport
Super Member
Registered
Joined
Oct 7, 2006
Messages
11,574
Reaction score
6,396
Location
west coast, canada
Thanks for the clarification! Yes, when I read your first post, I got the impression that the courtesan wanted a way to kill the maid, and didn't want it traced back to her.
If it's just something the courtesan did, and then the maid died, I can't think of any one action, short of inadvertent food poisoning ("Oh, that's been sitting there for ages, I don't want it, you can eat it!")
But working the maid into eclampsia or premature birth, or just death by exhaustion, doesn't seem unlikely.
In the same way that I previously assumed the courtesan was getting rid of a rival, now I'm assuming a skinny, undernourished young woman being run ragged by an uncaring woman.
And, unless you want her dead early in the story, you can trickle in hints - every scene with the courtesan involves her sending the maid somewhere or wanting something carried, lifted or done, immediately.
 

lonestarlibrarian

senior bean supervisor
Super Member
Registered
Joined
Aug 30, 2009
Messages
756
Reaction score
169
I was reading a 19th c slave memoir. I might have the details a little off, but the gist was--- At one plantation they both served at, the author knew a slave woman who had been the personal servant of the mistress of the plantation, and it was her job to sleep in her doorway, in case she got thirsty and needed water or something. (Because, obviously, pitchers and water glasses hadn't been invented in the 1840's or whatever.) Fast-forward, and both women were pregnant at the same time. But the slave was expected to keep on doing her job, and sleeping on the floor. Because the mistress of the plantation wasn't going to go through the night thirsty, you know, especially while she was pregnant!

The slave woman's baby didn't make it.

So, just complete indifference to a pregnant woman's condition can easily cause the death of the baby, whether or not anyone is aware of any underlying conditions or not.

As a side note, I can't remember which of the women died first--- but the mistress of the plantation wanted, when she died, to have that particular woman buried at her feet, so she could "sleep" at her feet throughout eternity. She was eventually talked out of it, either because (a) no other slaves were buried in the family plot, or (b) she had her own family who had opinions about where she ought to be buried. But she was very sad, because in her own mind, she was very fond of the woman and thought she'd be lonely without her... even though her myopic selfishness had led to the death of the child.
 

Tocotin

deceives
Super Member
Registered
Joined
Aug 3, 2008
Messages
2,250
Reaction score
1,895
Location
Tokyo, waiting for typhoons
Sorry! I guess I need to clarify the situation so folks don’t read between the lines. The courtesan does not intentionally cause the maid’s death, let alone outright murder her. Therefore, no violence should be involved (poisoning, pushing down stairs). She causes the maid’s death through selfishness/self-centeredness and/or thoughtlessness. The maid is clearly pregnant and ill (although, naturally there has been no consultation with a doctor or diagnosis).
I do need the courtesan to bring about the maid’s death — the straw that broke the camel’s back, healthwise. One demand or action that plausibly and quickly leads to premature birth and maternal death.
As for no one caring about the death of a brothel maid — I suppose you mean that no one in a position of power would care? In any case, she isn’t murdered, so I think that’s a moot point.

Thank you for talking time to help me with this point!

Oh, I see! I'm sorry! I thought you were going to have the courtesan deliberately murder the maid.

In this case, I'm afraid there's no one specific action which might unmistakably and surely cause her death. It's not a painful condition, although it might happen that you experience strong cramp-like pain in the upper part of your stomach (or below the breastbone, or around your ribs). You need to lie down, preferably in a dark room, and not move. If this happens to the maid and the courtesan still orders her to keep working, that might kill her.

My good friend was diagnosed with preeclampsia by a doctor who was a well-known expert and also very strict. When my friend told her that her working hours were from late afternoon till night, the doctor said: "You must stop working from tomorrow. If you don't, you will die and your baby will die also."
 

guppie1813

Super Member
Registered
Joined
Nov 25, 2019
Messages
134
Reaction score
65
OB/Gyn Physician here...some thoughts...
Pre-eclampsia is characterized by an increase in blood pressure, fluid retention, and if it progresses to severe then an increase in the break down of red blood cells, an increase in liver enzymes, and a decrease in platelets. A woman with untreated severe pre-eclampsia may die from several different mechanisms. Options include seizure (which would be eclampsia), stroke, pulmonary edema (too much fluid in the lungs), or hemorrhage from a placental abruption (when the placenta separates from the uterus before birth), and rupture of the liver capsule to name some that come to mind immediately. In your setting, you have multiple options to exacerbate the symptoms of pre-eclampsia to the point of death. I would probably opt for some fairly physically demanding activity that leads to any one of those fatal complications. If you are looking for something dramatic it would definitely be the abruption (that involves a lot of bleeding, she might deliver a stillborn first and the hemorrhage and die herself shortly after) and if you want something quick it would be the stroke. I would be happy to provide you with more details about how any of those would play out of you are interested.

Dr. Suzanne :)

My good friend was diagnosed with preeclampsia by a doctor who was a well-known expert and also very strict. When my friend told her that her working hours were from late afternoon till night, the doctor said: "You must stop working from tomorrow. If you don't, you will die and your baby will die also."

Just as a point of clarification and to stave off any (more) internet induced panic in pregnant women (Pre-eclampsia is fairly common) this is definitely an exaggeration of the risks. If you are diagnosed with high blood pressure or pre-eclamsia follow your doctor's recommendations, take your medicine as prescribed, and there is a very good chance that everything will turn out just fine!
 
Last edited:

neandermagnon

Nolite timere, consilium callidum habeo!
Super Member
Registered
Joined
Oct 25, 2014
Messages
7,271
Reaction score
9,333
Location
Dorset, UK
Did they know about preeclampsia then? Eclampsia has been known about for a long time, so named because it's Greek or Latin for lightning strike, because it caused pregnant women to suddenly become extremely ill (see the previous post, seizures etc) then die. Until doctors discovered the warning signs that eclampsia, there was no such thing as preeclampsia. I was hospitalised with preeclampsia at the end of my first pregnancy and had no noticeable symptoms besides a headache (which went away) and swollen feet and ankles. It was the midwife (NHS specialist nurse) who found the preeclampsia signs in a routine test - high blood pressure and protein in urine. Basically, it's symptomless until your life is in danger which is why it's so important for pregnant women to attend all antenatal appointments. Not all pregnant women who get headaches and swollen feet/ankles have preeclampsia.
 

neandermagnon

Nolite timere, consilium callidum habeo!
Super Member
Registered
Joined
Oct 25, 2014
Messages
7,271
Reaction score
9,333
Location
Dorset, UK
Did they know about preeclampsia then? Eclampsia has been known about for a long time, so named because it's Greek or Latin for lightning strike, because it caused pregnant women to suddenly become extremely ill (see the previous post, seizures etc) then die. Until doctors discovered the warning signs that eclampsia, there was no such thing as preeclampsia. I was hospitalised with preeclampsia at the end of my first pregnancy and had no noticeable symptoms besides a headache (which went away) and swollen feet and ankles. It was the midwife (NHS specialist nurse) who found the preeclampsia signs in a routine test - high blood pressure and protein in urine. Basically, it's symptomless until your life is in danger which is why it's so important for pregnant women to attend all antenatal appointments. Not all pregnant women who get headaches and swollen feet/ankles have preeclampsia. Without measuring blood pressure and testing urine, you're not going to spot it. And that seems a bit anachronistic for your setting.
 

neandermagnon

Nolite timere, consilium callidum habeo!
Super Member
Registered
Joined
Oct 25, 2014
Messages
7,271
Reaction score
9,333
Location
Dorset, UK
Maybe the easy solution would suffice here?

The selfish character is in a rush to go somewhere, runs into the maid, knocks the maid out of the way, the maid hits something and there goes the pregnancy?

Pregnant women and unborn babies are way too tough for this to put an otherwise healthy pregnancy in danger. Placental mammals would not have evolved if it weren't so (all placental mammals have basically the same system -lots of variation but all variations on the same theme).
 
Last edited:

guppie1813

Super Member
Registered
Joined
Nov 25, 2019
Messages
134
Reaction score
65
Pregnant women and unborn babies are way too tough for this to put an otherwise healthy pregnancy in danger. Placental mammals would not have evolved if it weren't so (all placental mammals have basically the same system -lots of variation but all variations on the same theme).

True and not True. Healthy pregnancies and babies can tolerate a lot, but significant abdominal trauma can cause a placenta abruption and preterm labor/stillbirth/maternal hemorrhage. A direct fall on a pregnant belly over 20-22 weeks could result in the loss of the pregnancy.
 

neandermagnon

Nolite timere, consilium callidum habeo!
Super Member
Registered
Joined
Oct 25, 2014
Messages
7,271
Reaction score
9,333
Location
Dorset, UK
True and not True. Healthy pregnancies and babies can tolerate a lot, but significant abdominal trauma can cause a placenta abruption and preterm labor/stillbirth/maternal hemorrhage. A direct fall on a pregnant belly over 20-22 weeks could result in the loss of the pregnancy.

How likely is that from Snitchcat's scenario though? Granted a severe enough trauma will cause problems but Snitchcat's scenario was simply that the maid is knocked out of the way and bumps into something.
 

Tocotin

deceives
Super Member
Registered
Joined
Aug 3, 2008
Messages
2,250
Reaction score
1,895
Location
Tokyo, waiting for typhoons
Just as a point of clarification and to stave off any (more) internet induced panic in pregnant women (Pre-eclampsia is fairly common) this is definitely an exaggeration of the risks. If you are diagnosed with high blood pressure or pre-eclamsia follow your doctor's recommendations, take your medicine as prescribed, and there is a very good chance that everything will turn out just fine!

Why do you think my post would have induced any kind of panic? I wasn't giving any advice. I offered one anecdotal case as an example for the OP to play with if they choose. Maybe I should have clarified that it was a Japanese hospital, and the way the doctor treated my friend was a bit different from what we knew to be common practice in our own country (there were no supplements prescribed and no medicine, she was allowed to gain weight only minimally, etc.). Everything did turn out fine at the end, yes, but the baby was born prematurely and there were indeed delivery complications.
 
Last edited:

guppie1813

Super Member
Registered
Joined
Nov 25, 2019
Messages
134
Reaction score
65
I'm sorry, maybe my wording was too strong and I didn't mean to sound like I was targeting you for sharing your story. I just like to help people keep things in perspective. I care for pregnant women and I spend a lot of time providing reassurance and educating them to counteract information that they have picked up or personal stories that other people have related to them. "You will die and your baby will die" is scary sounding and, since many pregnant women will be diagnosed with pre-eclapmsia I just wanted to provide reassurance to mitigate the already stressful situation of being pregnant and dealing with a complication.
 

ThunderBoots

Back with new name, no dachshunds
Super Member
Registered
Joined
Nov 9, 2010
Messages
112
Reaction score
4
Location
A warm rock (O'ahu, Hawaii)
Aloha, and thank you all for your help!
I'm having computer or Internet trouble today -- I have tried to thank you all individually, but my posts are taking forever and not showing when I refresh.

I'm going to go with the strenuous task. The maid is heavily pregnant, but the courtesan insists she lift a heavy object and place it someplace high. The maid has to stand on a stool, gets a bit dizzy and falls. I'm not going to have her land on her belly, though, because I need the baby to survive.

Thanks again!
 
Last edited:

guppie1813

Super Member
Registered
Joined
Nov 25, 2019
Messages
134
Reaction score
65
How likely is that from Snitchcat's scenario though? Granted a severe enough trauma will cause problems but Snitchcat's scenario was simply that the maid is knocked out of the way and bumps into something.

Yes, I would agree. In the knocked and bumped scenario an injury to mother or baby are unlikely. A push and fall scenario could be a different story.
 
Status
Not open for further replies.