If that would not be enough, any lack of medical care could be another. 10% chance of dying for every birth for the mother. Flu, any tooth ache, appendix inflammation or any more severe cut would be easily deadly for young and old.

Everybody had tons of parasites and smelled horribly including royalty, think working out hard daily and wearing the same cloth, bathing once a year (maybe). Freedom we consider a basic human right was basically unheard of, everybody was a prisoner of some form of somebody else.