In Knife of Dreams the Wise Ones ensured that Elayne finally consulted a midwife. She had already had a thorough medical examination via Caressing the Child in Crossroads of Twilight.
In our world medical care during pregnancy and birth during the 17th century was given by female midwives. It was not until after a surgeon attended a mistress of Louis XIV in 1663 that male midwives, “accoucheurs”, were accepted. In the Wheel of Time series, midwives are female (possibly even in Amadicia, where herbalists are male):
"Pity he can't learn my craft, but no one would buy herbs from a man. Or have a man midwife." Melfane laughed uproariously at that ridiculous notion.It is the rise of skilled male Healers such as Flinn, which may change attitudes.
- Knife of Dreams, The Importance of Dyelin
Elayne’s midwife examines Elayne’s urine daily, even tasting it. One obvious disease that would show in the urine is diabetes of pregnancy, which would result in sweet-tasting urine. Liver disease results in orange or brown urine, kidney disease, foamy or red urine, and white urine can signify infection. Examination of urine (uroscopy) for color, consistency, smell, and sometimes taste, has been used regularly since ancient times and was still performed during the 18th century, as was examination of faeces.
Examination of Elayne’s eyelids would indicate whether she was anaemic (this is still done). Elayne’s heart is checked with an early stethoscope, as will be the babies’ hearts after the quickening, the first movements of the baby able to be felt, has occurred, usually around weeks 16-20 for a first pregnancy. The Wise Ones also use simple stethoscopes (Lord of Chaos, An Embassy) and do not rely on Healing for medical care, but practise preventative medicine with diet, herbs and exercise:
"No midwife?" Nadere said incredulously. "Who tells you what to eat and drink? Who gives you the proper herbs? Stop looking daggers at me, woman. Melaine's temper is worse than yours could ever be, but she has sense enough to let Monaelle govern her in these things."Elayne’s midwife has (correctly) forbidden alcohol, which certainly would not have happened in the 17th and 18th centuries, since plain water was often unsafe to drink and alcoholic drinks were consequently very popular. (Coffee and tea also became popular in Europe in the 17th and 18th centuries respectively). Other ‘modern’ advice given to Elayne is to read to, and have music played to, her babies. Elayne is also weighed daily, which would have been atypical (Knife of Dreams, The Importance of Dyelin).
- Knife of Dreams, A Different Skill
Birth was usually at home in the 17th and 18th centuries, which was a good thing, since hospitals were dangerous hotbeds of infection due to the lack of infection control. Limited pain killers or intervention were used, just as in the Wheel of Time world:
“Since you ask questions, what would you do to ease birthing?” [asked Nynaeve].Not exactly true.
Mother Guenna snorted. “Apply warm towels, child, and perhaps give her a little whitefennel if it was an especially hard birth. A woman needs no more than that, and a soothing hand.”
- The Dragon Reborn, Following the Craft
Childbirth was dangerous to women in the 17th and 18th centuries and it remained so, despite several advances, until well into the 20th century, with both deaths and injuries occurring. Maternal death affected all social classes, and in Europe one in 200 pregnancies (0.5%) ended in the death of the mother. In developing countries, maternal mortality is still a major problem and can be as high as 1% in areas with poor health care. The causes are sepsis, obstructed labour, haemorrhage and hypertensive disease. (In the series, a long-lasting effect of the Shadow-induced famine and poor nutrition will be pelvic deformities caused by rickets leading to a higher rate of difficult and fatal births.)
However dangerous for the mother, childbirth was, and is, well over 20 times more dangerous for the baby. Infant mortality rates were as high as 20-30% prior to the 20th century and were still 7% in the UK in 1935:
In the late 16th/early 17th centuries over 12% of all children born would die within their first year…Approximately 2 per cent of babies born in the Elizabethan period died before the end of their first day of life. Death claimed a cumulative total of 5 per cent within the week, 8 or 9 per cent within a month, and 12 or 13 per cent within a year, with a slightly higher rate of infant mortality in the later seventeenth century."Elayne tells us that there is a high infant mortality rate in the Wheel of Time world:
- Carolyn Freeman Travers, Dead at Forty
"My babes and I are safe." Elayne laughed, hugging back. "Min's viewing?" Her babes were safe, at least. Until they were born. So many babies died in their first year. Min had said nothing beyond them being born healthy.Twins are especially at risk. To have both born healthy and strong was not at all common.
- Knife of Dreams, A Different Skill
It’s interesting that the only “on-screen” pregnancies are both of twins. Readers have hypothesised that Elayne’s twins are/will be the Heroes of the Horn, Calian and Shivan:
and Shivan the Hunter behind his black mask. He was said to herald the end of Ages, the destruction of what had been and the birth of what was to be, he and his sister Calian, called the Chooser, who rode red-masked at his side.They are not described as twins, just as brother and sister, and it is Shivan who marks the end of the Age. Since the Age is to end soon, he must have been conceived at the very least, if not actually already born. Of course, this time they might be twins.
- The Great Hunt, The Grave Is No Bar To My Call
Pregnancy interferes with the ability to channel. It is harder to touch the Source or weave the flows. The mood swings of pregnancy and the resulting loss of calm may be part of the reason why. This difficulty often grows worse as the pregnancy progresses and the mother will be unable to channel at all while in labour or giving birth. That will make Elayne vulnerable; however Aviendha left the Shadow-shielding dagger ter’angreal with her (see Ter’angreal article). The difficulty with channelling ceases after the child is born (Crossroads of Twilight, What Wise Ones Know).
Women channellers are unaffected by morning sickness, but it is not known if they are immune to post-natal blues or depression. The thought of Elayne the drama queen with the baby blues is not a pretty one.
It has been 6 WOT weeks, 8 to 9 of ours, since the twins were conceived. Normally she would be considered to be 2 of our weeks further along, being since her last period. Elayne complains of breast tenderness, and frequency of urination, and her fatigue is also due in part to her pregnancy.
The earliest she could feel the babies move would be at 12 of our weeks since conception, about 9 WOT weeks, far more likely would be 2 to 3 of our weeks after that.
With nearly 30 of our weeks of her pregnancy to go, there's a fair bit of time left before the Last Battle if she is to give birth during its climax.
Elayne doesn't know the twins are a boy and a girl, just that they will be born healthy. Aviendha and Birgitte got so drunk after Min told them this that they don't remember her viewing properly. Min is the only one who can give either future parent the full information.
Rand has not yet been informed of Elayne’s pregnancy, the reason being the women think he has enough to worry about already. And his sanity has not been too crash hot either. When he does eventually find out, no doubt he will stress out (and be annoyed at not being told sooner). He’ll want to rush to Elayne’s side. If Rand thought Elayne was placing herself in danger, pregnant or not, he would try to prevent it.
There is a Dragon who pursues a pregnant woman in Revelation – in fact Revelation has quite a few parallels with Wheel of Time end times. The important difference is that in Revelation the Dragon is named as Satan. Early in the series quite a few of the Two Rivers folk, like many people in the Third Age, equated the Dragon with the Dark One due to his insane deeds. There is also the possibility that Taim or one of the male Forsaken may be set up as a dark Dragon to do evil in Rand’s name. Joiya Byir claimed this was a plot of the Black Ajah in The Shadow Rising. So it is uncertain if the real Dragon or a false Dragon chases after Elayne. It could, or course, be both.
In Revelation the Dragon and his angels fight Michael [a parallel of the M’Hael] and his angels (Rev 12:7). The dragon loses and is hurled to earth and his angels with him. He pursues a pregnant woman, and then continues to fight on Earth and amasses great power. The Dragon champions two beasts, the second of which is the false prophet [Masema was one who played this role]. The first is probably the antichrist [the Naeblis, and or Shaidar Haran or the Forsaken in general]. The Dragon, false prophet and beast gather great forces for Armageddon. After the battle, the Dragon, Satan, is thrown into the abyss by the rider called Faithful and True and is bound for a thousand years. (Rev 20:2-9).
Which ever side pursues her, the passage suggests that Elayne’s pregnancy is important to the Last Battle.