Since in the 1890s-1920s there wasn't very good medical care, what about during those 3 decades, anytime a sim in your household gives birth, you have to roll three 6-sided dice. If the sim has a single birth, and if they roll 1-9, they live with no sickness, 10-15, they live, but they can't be out of bed for more then 3 hours at a time, and they shouldn't be outside or overexerting themselves, and getting an in-game sickness will kill them (use your cowplant). Sickness lasts for 3 in-game days. If they roll 16-18 they die (once again, use your cowplant). If your sim has twins, 1-7 is live, 8-14 is live with sickness, 15-18 is die. If your sim has triplets or more, then 1-5 is live, 6-10 is live with sickness, and 11-18 is die. What do you think?