Transcribing and editing
The transcripts were written exactly as the women spoke, but we only included phonetic renderings of speech if these were relevant to an accurate conveyance of meaning. All ‘umms’ and ‘ers’ were originally retained in the transcripts. Later, they were mostly edited out, as were any repetitions, unless they were significant, for example, if they portrayed someone’s embarrassment or sorrow.
Editing the transcripts presented us with dilemmas. How could we edit such lively, diverse reminiscences? So much of the material was riveting. There was a temptation to select humorous or shocking stories at the expense of those that were more mundane, but possibly more representative. And what were we to do with remarks that we found distasteful – for instance, racist statements? We were shocked to find some of these warm-hearted, older women holding racist prejudices. However, we realised that the prejudices themselves are all part and parcel of women’s experiences, and that it is not for us to select out only the parts that were ‘ideologically sound’.
Reflections on issues in oral history
At the beginning of this project, as we started looking for women to interview, there was a sense of urgency. It felt vital to record the reminiscences of an older generation of midwives before it was too late to hear their stories. With a good deal of enthusiasm, we set off armed with tape recorders and notebooks (and Billie’s three-month-old baby) to record the forgotten voices of the past and to rewrite history using the words of women themselves.
Several interviews later, we stopped, feeling confused and anxious. We were going into people’s homes, and by probing and asking questions, we were stirring up buried memories and evoking feelings that had often been put aside. Sometimes we were the only people the women had confided in, and much of the material was of a very intimate nature – a potential difficulty for women from a less ‘explicit’ generation. After the interview, we would walk out of their lives, possibly leaving them feeling exposed and vulnerable.
As we questioned what we were doing, oral history did not seem to be the egalitarian process that we had originally envisaged. We realised that, as interviewers, we had considerable power and that we could control the information we were given. We could encourage certain memories and block others merely by the tone of our voices or our body language.
We began to question our own role and motivation in the situation. What were we getting out of it all? We needed to accept the amount of power we had as interviewers and editors of the material, instead of naively pretending that we were just listening ears and the means by which the stories were put down on paper. Were we just taking and not giving back? How much could we realistically expect to offer in terms of friendship or support to these women, many of whom appeared lonely? There are no easy answers to these questions, but we feel that it is important that anyone undertaking research of this nature develops an awareness of the issues involved and a sensitivity to the dynamics of the interviewing situation.
We learned that it was important to see oral history as a reflection of the woman’s personal history, affected by her class, religion, culture and politics. Rarely were memories told against a larger political backdrop. As so often happens today, local people or organisation were blamed when it was actually government policies that were creating the problem. Occasionally however, there were glimpses of a wider historical context, as in this quote from midwife, Nellie H.:
‘When there was the General Strike in 1926, I was training in Plaistow. The policeman used to come and look after us and escort us along the road. The policeman came because people went absolutely mad. I don’t think anybody realises what it was like unless they were alive then. They were throwing eggs, tomatoes and all sorts of things all over the place. There used to be big vans, full of men, all gone crazy. Throwing things at you. So the police had to guard us to get us safely to the mothers’ homes.’
As we did more interviews, we became more aware of the particular difficulties presented in the women’s language itself, especially when women spoke with strong regional accents. How often were we missing some vital clue or nuance in what was said? In Chapter 6, for instance, we describe the process of discovering that many women referred to abortions as ‘miscarriages’, and how initially this confused our analysis of what they were telling us about women’s control of their fertility.
One of the problems of interpreting oral evidence is that people’s memories are selective. The ‘truth’ for them may not tally with the historical ‘facts’. The women we interviewed rarely complained about how bad things had been for them. They tended to recall only happy times and would dismiss the bad memories with sweeping generalisations. For instance, Josephine M., a midwife working in the East End in the 1930s, says:
‘When you’d go to a family they’d just have one room and one little bed. They might have a sheet or two – they were very, very poor but grateful. They might have a rug or two on the bed and no blanket. And if they’d got a drunken bum of a husband, which was very often the case, as long as he got money for a drink that’s all he cared. Life was really hard. Coal fires and a gas lamp. But they were very happy.’
References to the ‘happy poor’ cropped up time and time again and are hard to untangle. We wondered whether memories of bad times had been repressed because they were too painful. It also seemed that women had an investment in holding onto the good things there had been, so that they could talk about their lives with pride and dignity. Most of the women we talked with combined memories of poverty and hardship with those of happiness. There were only a few who admitted that they had felt overwhelmingly oppressed by their lives. Edie M. is one of these:
‘Looking back, it was a horrible life. At that time, I used to accept it because we knew no other. You never knew carpets or fridges or heating … This old memory don’t shut much out either. It goes over all the worst parts. Sometimes I have to block it out and think, “Well, let’s think of some nice things”. When I go to bed I have to. I think, “Now, stop it Edie. Stop it Edie”. You’ve either got to take a second sleeping tablet, or you’ve got to block it out … You can’t live with some things you’ve done.’
Understandably, women’s memories of the same situation varied, even on factual points (e.g. the amount of dole money paid out in the 1920s). Some midwives had difficulty remembering when things happened and would describe situations that could only have occurred in a later period than the one with which we were concerned.
It also seemed that women sometimes told us what they thought we would like to hear – things that they thought would please us. This particularly happened when we interviewed the midwives. They often answered questions as though they were being ‘tested’ on their midwifery knowledge – hence the recitation of whole chunks of midwifery textbook (referred to above).
It is possible that embarrassment on the part of the interviewees may well have been a factor when we were researching the chapter on women’s knowledge about ‘the facts of life’. Some women may have felt too inhibited to discuss their sexuality frankly, although we were often surprised and moved by the intimate nature of some of the testimony.
So, how reliable is oral reminiscence? As discussed above, memories can be distorted because of poor or selective recall, a desire to please the interviewer or inhibition. At the end of the day, we have to settle for the fact that, in the words of oral historian Gilda O’Neill:
‘Each version of a story has its own truth. And our myths, whether of the universal, numinous kind, or of the more prosaic family variety, are used by us to tell and retell truths in ways that mean we can make sense of our world.’1
While acknowledging some of the limitations of oral history, we consider it to have radical potential. Without it, the memories of the women in this book would never have been passed on to more than a few relatives and friends. It is our hope that some of the testimonies that we have collected will inspire and educate readers as they have done for us.
Milest
ones in British Midwifery 1902–1948
1902
The First Midwives Act (England and Wales)
The Central Midwives Board (CMB) is set up for England and Wales with responsibility for: regulating, supervising and limiting practice; admission to and removal from the Roll; training; examinations; issuing and cancelling certificates; Penal Board.
Local Supervising Authorities (LSAs) are also set up with responsibility for: supervising midwives; investigating malpractice; suspending midwives from practice in order to prevent the spread of infection; reporting malpractice and legal offences to the CMB; keeping a local list of midwives who notify their intention to practise annually; monitoring changes of address or deaths; ensuring midwives know about the regulations and role of the CMB.
Admission to the Roll is granted to the following:
1. Those who already have a recognised midwifery qualification from the London Obstetrical Society (LOS) or certain lying-in hospitals;
2. Women who can prove they are of good character who have already been in practice for at least one year – to be known as bona fide midwives;
3. Those who can pass the CMB examination of competence following a three-month period of training.
1905
Publication of the First Roll of Midwives
Of 22,308 names on the Roll: 9,787 had undertaken a course of midwifery training and 12,521 were bona fide midwives.
From now on nobody can assume the title ‘midwife’ unless they have a certificate from the CMB. The LOS examination is replaced by the CMB examination.
1909
The first antenatal clinic is opened at Queen Charlotte’s Hospital.
1910
Women who are not certified midwives are forbidden to attend women in childbirth ‘habitually and for gain’, except under the direction of a medical practitioner.
1911
The National Insurance Act
Workers have to make a weekly compulsory payment entitling them to the services of a ‘panel doctor’ and to sickness and maternity benefits.
1915
Notification of birth after the twenty-eighth week is now compulsory.
1915
The Midwives (Scotland) Act
This act receives Royal Assent and the Central Midwives Board for Scotland is constituted.
1916
The midwifery training period is increased to six months (four months for those with a nursing qualification).
1917
In a government report by Dr Janet Campbell – The Physical Welfare of Mothers and Children in England and Wales’ – the important role of the midwife is highlighted; also her long hours and poor remuneration.
1918
The Second Midwives Act
Local Supervising Authorities (LSAs) are to be responsible for paying the doctors’ fees in the first instance, but these fees are still to be recovered from the patient if possible.
The CMB is given power to suspend midwives from practice. [Previously, they could only remove names from the Roll.] Midwives are to be compensated for loss of earnings if suspended from practice.
All forms and books that the midwife is required to complete will now be provided free, as well as postage for statutory notification forms.
The Maternal and Child Welfare Act
Local authorities are encouraged to set up maternal and child welfare centres to include provision for antenatal clinics.
1919
A grant of £20 is made available from the Treasury, payable to each pupil midwife who guarantees to practise on qualification.
1923
A Government report on ‘The Training of Midwives’ by Dr Janet Campbell highlights the need for more trained midwives to reduce maternal mortality [static at four per 1,000 births between 1907 and 1922].
1926
The Third Midwives Act
Uncertified women attending births are to satisfy a court that ‘the attention was given in a case of sudden or urgent necessity’. They are liable to a fine of up to £10.
Maternity homes now have to be legally required to register with the local LSA and be open for inspection.
Courses and examination for the Midwife Teachers Certificate are set up by the Midwives Institute for qualified midwives.
1927
The CMB issues a directive on advertising: ‘All advertising is to be deprecated and midwives ought to be satisfied with a plate on their doors and cards’.
The General Register Office’s first tabulation of live births in England and Wales by place of delivery identifies 85 per cent of births taking place at home, 15 per cent in institutions.
1929
A Government report on the working of the Midwives Act 1902–1926 identifies the midwife as remaining the key provider of maternity care and highlights areas of concern.
1930
The Ministry of Health authorises payment of fees to GPs for the routine examination of pregnant women who have engaged a midwife and who are not insured under the National Health Insurance Act.
1932
In 1932, 76 per cent of births occur at home, 24 per cent in institutions.
1935
It is estimated that 80 per cent of all pregnant women have some antenatal care.
1936
The 1936 Midwives Act
LSAs in England and Wales are charged with providing an adequate salaried midwifery service. This service is to be subsidised by the government. Compensation is to be given to midwives who are rejected by the LSAs or who surrender their certificates due to not wishing to become salaried. Midwives can choose to continue to work independently.
Parturient women have to pay the LSA for midwifery services, the fees to be collected by the midwives.
The CMB is to grant a Midwife Teacher’s Diploma after examination. Residential Refresher Courses of seven days’ duration at five-yearly intervals will now be compulsory for all practising midwives. Midwives returning to practice will have to undertake a course of instruction, the duration of which will be decided by the CMB.
Qualifications and requirements are laid down for Supervisors of Midwives.
1937
The Maternity Services (Scotland) Act
This act heralds similar reorganisation of maternity services in Scotland to that of the 1936 Midwives Act but all women having home births in Scotland will be entitled to the services of a medical practitioner.
Nearly 35 per cent of all births in England and Wales now take place in institutions.
Statutory midwifery responsibility for postnatal care is extended to 14 days.
1938
Midwifery training is lengthened and divided into two parts, with an exam after each part: one year for State Registered Nurses, two years for non-nurses.
1939
Maternal mortality rates start to drop due to: better distribution of wealth and benefits in the Second World War, improved housing and sanitation and overall rise in the standard of living; the introduction of sulphonamides, Ergometrine, blood transfusions and emergency obstetric units also play a part. [By 1943, maternal mortality was half the 1935 rate, at 2.30 per 1,000 registered births: the stillbirth rate: 30 per 1,000.]
The Emergency Powers (Defence) Act authorises LSAs to allow women whose names have been removed from the Roll to act as midwives in situations where there is a shortage of midwives. Midwifery is designated as a form of National Service.
1941
The Rushcliffe Committee is set up to consider salaries and conditions of service for midwives.
1943
The Ministry of Labour and National Service highlights the shortage of midwives and mounts a publicity campaign to attract more midwives.
The Employment of Women (Control of Engagement) Order requires newly qualified midwives to practise for at least one year.
The Rushcliffe Report identifies midwifery as a ‘distinct profession with its own traditions’ and provides mechanisms for negotiations between midwives and their
employing authorities. [The Rushcliffe Committee was succeeded by the Whitley Council in 1948.]
1944
In this year, 55 per cent of babies are born at home.
1946 NHS Act
The Beveridge Committee begins to formulate proposals for social legislation and restructuring health services in order to deal with social and economic inequalities in Britain. The shortage of midwives is critical as the birth rate reaches its post-war peak. Midwifery training courses for State Enrolled Nurses are instigated.
1947
The CMB produces a new-style Rule Book incorporating a Code of Practice.
1948 The National Health Service comes into being
A comprehensive health service is launched, free at the point of service, paid partly by contributions of those in employment, partly by local rates and partly from the General Exchequer funds.
The main source for this section is Towler, J. and Bramall, J., Midwives in History and Society, (Croom Helm Ltd, Beckenham, Kent, 1986).
Glossary
Bona fide midwife The 1902 Midwives Act allowed midwives who had been in practice for at least one year and who could produce written testimony of their good character to register and thereby practise midwifery legally. This was a stop-gap measure to cope with the shortage of trained midwives. The system of registering as a bona fide midwife was discontinued after 1905.
Breech Emergence of the baby’s feet, knees or buttocks before the head in childbirth. A breech birth is recognised as being potentially more complicated for the baby.
Caul The amnion, or membrane enveloping the foetus and enclosing the liquor or ‘waters’. Occasionally, it does not rupture and the baby is said to be born ‘in the caul’. This is considered lucky in some folklore where the caul is endowed with properties for preventing drowning at sea.
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