Who Do You Think You Are?
MY ANCESTOR WAS A... MIDWIFE
Today, midwifery is a popular subject for reality TV and drama, but it took centuries for the profession to be officially recognised, says Dr Sara Read
Trace your midwife ancestors and discover their working lives with Dr Sara Read
Women have supported each other during childbirth throughout history, and the title ‘midwife’ is apt as it comes from the phrase ‘with women’. In previous centuries, childbirth was an all-female affair, with the labouring mother surrounded by a group of close friends and relatives known as ‘gossips’.
Until the 20th century, the most common way for a midwife to learn her trade was by means of an apprenticeship. Often daughters followed their mothers into the role. In 1737, Sarah Stone published a short book, A Complete Practice of Midwifery, in which she revealed that she was both the daughter of and the mother of a midwife. No formal qualifications were necessary for the role, but by the early 16th century midwives needed a licence from the church to practice. Licences were hard to obtain, as applicants needed good character references and testimonials from prominent people such as members of the clergy or local doctors. Six women also had to vouch for the midwife’s competence. The convention for ecclesiastical licensing eventually died out in the mid-18th century.
For centuries, many women gave birth with the help of a ‘ handwoman’, also known as a ‘ handywoman’, a local woman who had some experience in assisting with deliveries. Doctors or surgeons were only called
in when things went very wrong. Until 1919, it was the responsibility of the midwife who sent for the doctor to pay his bill, and she would then have to make sure the family reimbursed her. It must have been a relief for midwives when regulations changed in 1919, making the local authority initially responsible for paying a doctor’s bill.
Into the 1940s, most midwives provided care and delivered babies in the mother’s own home. The majority of trained midwives worked as private practitioners, employed directly by the family. This tradition reversed after the creation of the NHS. By 1975, under five per cent of women were opting for home-births, so more and more midwives became hospital-based.
Home-birth conditions varied enormously. A midwife could find herself working in crowded, noisy and unsanitary conditions, especially within industrial city slums, where people were packed several to a room. The popular BBC drama Call the Midwife, based on the memoirs of Jennifer Worth, brings to life some of the domestic settings midwives encountered in the 1950s. Jennifer worked for a scheme run by an Anglican nunnery in Poplar, East London. The Community of St John the Divine was set up in 1848 to help some of the poorest women in the area. Prior to 1918, many religious or charitable organisations provided maternity care and continued to do so after local authorities were required to offer this service.
In the 1990s, Nicky Leap and Billie Hunter collected accounts by midwives in the pre-NHS era and published them in The Midwife’s Tale. This book gives a real insight into the pay and working conditions experienced by midwives in the early 20th century. Recalling her practice in the 1930s, Mary W explained that she had to work as an independent midwife because married women were discouraged from working in hospitals. Midwives at that time were expected to live in the attached nurses’ accommodation. Mary described being constantly on duty, delivering an average of 80 babies a year.
Pay was low, and in the 1920s a midwife employed by a nursing association was paid just £ 84 a year. In the 1930s, independent midwife Mary W charged 30 shillings per delivery, but during the Depression era she was often paid by families in instalments.
In 1881, the Matron’s Aid or Trained Midwives Registration Society, later renamed the Midwives Institute, was formed by London midwife Zepherina Veitch. The group campaigned to
A midwife could find herself working in crowded, noisy and unsanitary conditions
achieve government recognition for the status of trained midwives. It established an insurance scheme in 1901, which ensured that midwives received an income if they had to go into quarantine after attending a woman with puerperal fever (post-partum infection). They also paid legal expenses if a midwife was required to attend an inquest.
A year later, as a result of their lobbying, the 1902 Midwives Act for England and Wales entered the statute books. The Act regulated the training of midwives and also outlawed untrained women practising as midwives. At first, to register, a midwife needed to have practised for a year and to provide a written testimonial to substantiate her good character. For a few years, handwomen could get around this act and continue to work as long as they did not call themselves midwives, but this loophole was closed in 1910.
By the 1930s, midwifery required a two-year training course or a year’s additional training for qualified nurses. While there were lectures and much learning-by-rote, most of the training was on-the-job, resembling the apprenticeships of previous centuries. A completed casebook took the place of the testimonials. Former midwife Christine Fillingham recalls that much of her training, which began in 1957, was practical. As formal qualifications were not a prerequisite, Christine was one of only three in her intake of 20 to possess O-levels. During her training, she realised that most of her instructors were the widows of World War Two veterans.
The Midwives Institute was renamed once more in 1941 as the College of Midwives, before gaining its modern identity as the Royal College of Midwives in 1947. Thirty years later, the RCM became a union, with a trust set up to continue the professional educational side of its work.
From the late 17th century into the 19th century, men began to specialise in midwifery. Known as man-midwives, or later accoucheurs, they caused a lot of bad feeling amongst midwives, who felt their traditional role was being encroached upon. The term ‘man-midwife’ appeared in print from the early 17th century. Man-midwives were often medically trained or practising in other areas, such as surgeons.
Midwives were legally registered professionals from 1902, but the legislation that brought this in did not mention men, so technically men could have also registered. However, the 1951 Midwives Act, designed to bring all the various laws surrounding midwifery together, formally excluded men from the profession. An exemption from the 1970s Sex Discrimination Act later upheld this rule.
The same concerns that Sarah Stone raised in the 18th century about men taking over women’s jobs were repeated in the 1950s. In 1958, trainee midwife Christine Fillingham’s superintendent tutor cautioned her pupils not to join in the national agitation taking place for pay rises for nurses, warning them that male midwives wouldn’t “take time out for babies”. Men only won the right to train as midwives in 1983. In 2014, just over 100 men were employed in this capacity in the NHS.
Today, there are over 30,000 midwives working in the NHS, while many others practice as independent midwives or work in the private sector.