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

Who Do You Think You Are? Magazine - - CONTENTS - Dr Sara Read is the author of Maids, Wives, Wid­ows (Pen and Sword, 2015)

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.

Work­ing con­di­tions

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.

Early train­ing

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.

A mid­wife at Queen Char­lotte’s Hospi­tal re­ceives a phonecall re­quest­ing an emer­gency de­liv­ery

In the 1930s, mid­wife train­ing took two years or one year for a trained nurse

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