Central Midwives Board (CMB) The regulatory body created under the 1902 Midwives Act to: designate and approve training institutions and teachers; set the syllabus and examinations for the CMB certificate; issue the certificate upon successful completion of training; formulate and codify rules by which the midwife’s practice would be defined and supervised; and, in the event of suspected malpractice, carry out investigations and disciplinary procedures.
Certified midwife A midwife who held a certificate from the CMB entitling her to practise.
Cervix Neck of the uterus.
Cervical dilatation The opening of the cervix in the first stage of labour, caused by uterine contractions. When an internal examination is carried out through the vagina, the diameter of the opening is assessed. These days, it is recorded in centimetres.
Deep vein thrombosis (DVT) A blood clot in the veins of the legs, often caused by keeping women in bed too long after childbirth. The DVT can move through the bloodstream and block vital organs, such as the lungs, causing death.
Direct-entry training Midwifery training for those who do not have a nursing qualification.
Domiciliary In the first half of this century, community or district midwives were often referred to as domiciliary midwives since they attended women in childbirth in their homes.
Ergometrine An oxytocic drug given to prevent or control haemorrhage in the third stage of labour by causing strong uterine contractions.
Grand multipara or ‘grand multip’ A woman who has given birth to several children, usually at least four.
Handywoman Usually a working-class woman who attended women in childbirth but did not register as an official midwife. Known often as ‘the woman you called for’, or the ‘midwife’, most handywomen also laid out the dead. After 1910, handywomen could only practise under the direct supervision of a doctor, and after 1936, they were no longer allowed to practise at all. Some continued to work alongside the trained midwives, offering domestic duties in the postnatal period such as washing, cleaning, cooking and childcare.
Inspector of Midwives People appointed by the Local Supervising Authority to supervise and inspect midwives practising within their jurisdiction. They were also referred to as Supervisor of Midwives, the modern equivalent.
Local Supervising Authority (LSA) County borough governments charged with ensuring that midwives were registered under the Midwives Act and that their practices conformed to the rules of the CMB.
Medical Officer of Health Public health physician appointed by the LSA to supervise and inspect midwives in their area.
Midwives Institute The organisation that sought to make midwifery into a profession for well-educated women. Founded in 1881, it became the Royal College of Midwives in 1947.
Morbidity Damage, both mental and physical, in this case following childbirth.
Mortality rates
Maternal: The number of maternal deaths (due to pregnancy and childbearing) per 1,000 registered births.
Infant: The number of deaths of infants under one year per 1,000 registered live births.
Neonatal: Infant deaths during the first four weeks of life per 1,000 registered live births.
Perinatal: The number of stillbirths and neonatal deaths occurring during the first weeks of life per 1,000 total births.
Multiparous women or ‘multips’ Women who have given birth to at least one viable baby.
Os The opening formed within the cervix.
Perineum The area around and between the vagina and the anus.
Placenta The afterbirth.
Placenta praevia A condition in which the placenta has implanted abnormally over the internal entrance to the cervix, blocking the way out for the baby and often causing severe haemorrhage.
Post-partum After giving birth.
Primipara or ‘primip’ A woman having her first baby, or having given birth to one viable baby.
Puerperal fever/sepsis A condition associated with systemic bacterial infection and septicaemia that occurs following childbirth. It can be introduced by non-sterile hands or instruments inserted into the vagina and was once a major cause of maternal deaths.
Puerperium The six- to eight-week period following childbirth when the woman’s uterus and other organs return to their pre-pregnant state (apart from her breasts if she is lactating).
Registered midwife Any midwife who was registered under the Midwives Act.
Stages of labour
First: The period from the onset of labour to complete dilatation of the cervix.
Second: The expulsive stage of labour, from full dilatation of the cervix to the complete birth of the baby.
Third: The period from the birth of the baby to the complete expulsion of the placenta and membranes.
Sulphonamides A group of drugs used to combat bacterial infections.
Trained midwife A midwife who had undergone formal training leading to a recognised examination, enabling her to register as a midwife.
Reference List
New Introduction
1. Worth J. (2010) The Midwife Trilogy: Call the Midwife, Shadows of the Workshouse, Farewell to the East End. London: Orion Publishing Group.
2. McIntosh T. (2012) A Social History of Maternity and Childbirth: Key Themes in Maternity Care. Oxford: Routledge.
3. Reid L. (2011) Midwifery in Scotland: A History. Erskine, Renfrewshire: The Scottish History Press.
4. Reid L. (2008) Scottish Midwives: Twentieth Century Voice. Dunfirmline: Black Devon Books.
5. Fisher K. (2008) Birth Control, Sex and Marriage in Britain 1918–1960. Oxford: Oxford University Press.
6. Davis A. (2012) Modern motherhood: women and family in England c.1945–2000. Manchester: Manchester University Press.
7. Borsay A., Hunter B. (Eds) (2012) Nursing and Midwifery in Britain since 1700. Basingstoke: Palgrave Macmillan.
8. Department of Health. (1993). Changing Childbirth. London: Department of Health HMSO.
9. Hunter B. (2012) ‘The Reshaping of Midwifery, 1920–2000’, in Borsay and Hunter [Eds], Nursing and Midwifery in Britain since 1700. Basingstoke: Palgrave Macmillan: pp.151–176.
10. Smith A. & Dixon A. (2008) Health care professionals’ views about safety in the maternity services. London: The Kings Fund.
11. Cheyne H., Bick D., McNeill J., Hunter B. (2011) ‘United but divided? The need to consider the potential consequences of devolved UK government on midwifery education and practice’. Midwifery 27(6) pp. 770–774.
12. Davis-Floyd R. (2001). ‘The technocratic, humanistic and holistic paradigms of childbirth.’ International Journal of Gynaecology & Obstetrics 75 S5-S23.
13. Hunter B. (2011) The heart of the job: emotion work in midwifery. Essentially MIDIRS. February 2011. 2(2) pp. 17–21.
14. Leap N. (2009) ‘Woman centred care or women centred care: does it matter?’ British Journal of Midwifery. 17(1) pp. 12–16.
15. Kirkham M. (1997) ‘Stories and Childbirth’. In: Reflections on Midwifery. M. J. Kirkham and E. R. Perkins [Eds]. London: Bailliere Tindall: pp.183–204.
Chapter 1: From Handywoman to Midwife: the development of a profession
1. Thompson, F. (1978) Lark Rise to Candleford. Harmondsworth: Penguin: pp.135–136.
2. Gregory, A. (ed.) (1923) The Midwife: Her Book. London: Frowde & Hodder & Stoughton: p. 12.
3. Ibid., p. 15.
4. Llewelyn Davies, M. (ed.) (1977) Life as We Have Known it-by Cooperative Working Women. London: Virago: pp. 43–46, (Copyright 1931 Quentin Bell and Angelica Garnett).
5. Nursing Notes, (March 1905), pp. 38–39.
6. Nursing Notes, (March 1907), pp. 42–44.
7. Heagerty, B. (1990) Class, Gender and Professionalization: the Struggle for British Midwifery, 1900–1936: unpublished dissertation: Royal College of Midwives’ Library.
8. Gregory, A. (ed.), op. cit, p. 137.
9. Dickens, C. (1844) Martin Chuzzlewit. London: Chapman & Hall.
10. Campbell, J. (June 1923) Report on Public H
ealth and Medical Subjects – No. 21 The Training of Midwives. London: Whitehall.
11. Nursing Notes, (January 1928).
12. Letter to the authors from a retired midwife following an appeal in the midwifery press for information about handywomen.
13. Richardson, R. (July 1982) ‘Laying Out and Lying In’. Association of Radical Midwives Newsletter: p. 4.
14. Gregory, A. (ed.), op. cit, p. 135.
15. Roberts, Dr H. (14 May 1934) ‘The Price of Motherhood’. The News Chronicle.
16. Maternal Mortality-Report of Meeting Held at Central Hall, Westminster, on February 28th 1928. London: The Maternal Mortality Committee.
17. Departmental Committee on Maternal Mortality and Morbidity, 1930: pp. 24–25, 39.
18. Quoted in ‘Maternal Mortality’ Memorandum 156/MCW. Nursing Notes (January 1931): p. 4.
Chapter 2: Handywomen: ‘the woman you called for’
1. Little, B. (1983) Go Seek Mrs. Dawson. She’ll know what to do – The Demise of the Working-Class Nurse/Midwife in the Early Twentieth Century. University of Essex: unpublished thesis.
2. Campbell, J. (1923) Report on Public Health and Medical Subjects – The Training of Midwives. London: HMSO: p. 24.
Chapter 3: Midwives in Pre-NHS Britain
1. Thomson, M. Storks Nest, unpublished autobiography. We would like to thank Mary Thomson’s son for allowing us to publish quotations from her book.
2. Towler, J. & Bramall, J. (1986) Midwives in History and Society. London: Croom Helm: p. 214.
3. Nursing Notes (November 1920): p. 118.
4. Donnison, J. (1977) Midwives and Medical Men. New York: Schocken Books.
5. Gregory, A. (ed.) (1923) The Midwife: Her Book. London: Frowde & Hodder & Stoughton: p. 11.
Chapter 4: Women’s Knowledge about ‘the Facts of Life’
1. Jordan/Terry, (1988) Agony Columns. London: MacDonald Optima: Chapter 5.
2. ibid., pp. 100–101.
3. Arbuthnot Lane, Sir W. (ed.) (c.1930s, undated) The Modern Woman’s Home Doctor. London: Odhams Press Ltd: pp. 120–145
4. Stopes, M. (1918) Married Love. London: G.P. Putnam & Sons.
5. Ibid., p. 63.
6. Ibid., p. 28.
7. Lewis, J. (1984) Women in England 1870–1950. Sussex: Wheatsheaf Books.
8. Roberts, E. (1984) A Woman’s Place – An Oral History of Working-class Women: 1890–1940. Oxford: Basil Blackwell.
Chapter 5: Birth Control
1. Holdsworth, A. (1988) Out of the Dolls House. London: BBC Books: p. 96.
2. Cited in Hall, R, (ed.) (1978) Dear Dr. Stopes – Sex in the 1920s. London: Penguin: p. 81.
3. Arbuthnot Lane, Sir W. (ed.) (1930s, undated) The Married Woman’s Home Doctor. London: Odhams Press Ltd.: p. 94.
4. Hall, R. (ed.), (1978) Dear Dr. Stopes – Sex in the 1920s. London: Penguin: p.12.
5. McCrystal, C. (23 August, 1992) ‘The Monster and the Master Race’. The Independent on Sunday.
6. Kenner, C. (1985) No Time For Women: Exploring Women’s Health in the 1930s and Today. London: Pandora Press: p. 42.
7. Woman’s Own (7 July 1934).
8. Beddoe, D. (1983) Discovering Women’s History. London: Pandora Press: p. 182.
9. Ibid., p. 180.
10. Gittins, D. ‘Married Life and Birth Control between the Wars’. Oral History – The Journal of the Oral History.
11. Fairbairn, J. S. (1924) A Textbook for Midwives. Fourth edition. Oxford: Oxford University Press: p. 48.
12. Robertson, W. H. (1990) An Illustrated History of Contraception. Carnforth, Lanes: The Parthenon Publishing Group: p. 118.
13. Nursing Notes (May 1934) p. 69.
Chapter 6: Abortion: ‘There was no other way’
1. Nursing Notes (January 1928).
2. Cited in Kenner, C. (1985) No Time For Women. London: Pandora Press: p. 42.
3. Cited in Oakley, A. (1984) The Captured Womb. Oxford: Basil Blackwell: p.91.
4. Little, B. (1983) Go Seek Mrs. Dawson – She’ll Know What to Do. University of Sussex: unpublished thesis.
5. Chamberlain, M. (1981) Old Wives’ Tales. London: Virago Press.
6. Cited in ibid, p. 120.
7. Untaped conversation with Elsie and Arthur Hunter, 1983.
8. Chamberlain, M. (Spring 1983) ‘Life and Death’, Oral History-the Journal of the Oral History Society: vol. 11 no. 1.
Chapter 7: Unmarried Mothers
1. Cited in Lewis, J. (1984) Women in England 1870–1950. Sussex: Wheatsheaf Books: p. 5.
2. Roberts, E. (1984) A Woman’s Place – an Oral History of Working-class Women: 1890–1940. Oxford: Basil Blackwell: p. 76.
3. Lewis, J. (1984) Women in England 1870–1950, Sussex: Wheatsheaf Books: p. 65.
4. Ibid., p. 64.
5. Humphries, S. (6 April 1991) ‘Sex in a Cold Climate’, The Independent on Sunday: p. 27.
Chapter 8: Wartime Midwifery: ‘Everybody was for everybody else’
[No references]
Chapter 9: Working Lives: the effect on childbearing women
1. Cited in Kenner, C. (1985) No Time For Women. London: Pandora Press.
2. Woman’s Own, First issue, (15 October 1932).
3. Weldon’s Dressmaker (1932).
4. Woman’s Own (15 October 1932).
5. Lewis, J. (1980) The Politics of Motherhood. London: Croom Helm.
6. Thunhurst, C. (1982) It Makes You Sick – The Politics of the NHS. London: Pluto Press: pp. 32–33.
Chapter 10: The Experience of Birth: women and midwives tell their stories
1. Towler, J. & Bramall, J. (1986) Midwives in History and Society. Beckenham: Croom Helm: Chapter 8.
2. Campbell, R. & Macfarlane, A. (1987) Where to be Born - The Debate and the Evidence. Oxford: National Perinatal Epidemiology Unit: p. 12.
3. Towler, J. & Bramall, J. op. cit: p. 222.
4. House of Commons Health Committee (1992) Report on Maternity Services. London: HMSO.
5. Oakley, A. (1984) The Captured Womb. Oxford: Basil Blackwell: p. 91.
6. Ibid. p. 87.
7. Ibid. p. 68.
Chapter 11: Midwifery Practice in pre-NHS days: ‘the tricks of the trade’
1. Campbell, R. and Macfarlane, A. (1987) Where to be Born – The Debate and the Evidence. Oxford: National Perinatal Epidemiology Unit: p. 12.
2. Central Midwives Board Rules 1934.
3. Gregory, A. (ed.) (1923) The Midwife: Her Book. London: Frowde & Hodder & Stoughton: p. 25.
4. Ibid. pp. 22–24.
5. Odent, M. (1984) Birth Reborn. London: Souvenir Press.
6. Balaskas, J. (1989) New Active Birth. London: Thorsons.
7. Gregory, A. (ed.), op. cit, pp.20–21.
8. Op. cit, p. 39.
9. Nursing Notes (November 1920).
Methodology: using oral history in midwifery research
1. O’Neill, G. (1990) Pull No More Bines, London: The Women’s Press: p. 145.
Author Biographies
Nicky Leap was born in 1948 and grew up in the West Country, England. She became a National Childbirth Trust (NCT) teacher in the 1970s and was a youth and community worker in London before training to be a midwife. For more than 30 years Nicky has worked in a variety of roles in midwifery practice, education and research. She is an Adjunct Professor of Midwifery at the University of Technology, Sydney. Nicky divides her time between living in Bristol (UK) and Sydney (Australia).
Billie Hunter was born in 1953 in South London. After training as a midwife in 1979, Billie worked in a rural GP unit in Wales, as an independent midwife in London and as a health visitor in the Outer Hebrides, covering remote islands. Since 1992, Billie has lived in Wales and has been engaged in midwifery teaching and research, gaining her PhD in 2002. She was appointed as Professor of Midwifery at Swansea University in 2006 and as Royal College of Midwives Professor of Midwifery at Cardiff University in 2012.
sp; Billie Hunter, The Midwife's Tale
The Midwife's Tale Page 27