"Where's The Midwife?"

Many of us have watched, and are still watching, the television series “Call The Midwife”, which was originally based on the memoirs of Jennifer Worth. She worked with the community of St. John the Divine at their convent in the East End of London. The order was founded as a nursing order in 1849. The series extended beyond the memoirs to include new, historically sourced material and information. The series has also tackled subjects such as adoption, miscarriage, abortion as well as prostitution, incest and birth defects. It is so interesting to see how these things were looked at and dealt with in the 1950’s and 1960’s, compared to how we view them (and deal with them) today.

The history of midwifery is so very interesting to those of us who love this subject. Today, every midwife is trained to the highest standard with all of the modern equipment, to ensure that mother and baby come through childbirth as healthy as possible. We take it for granted today that an ambulance can be called (if necessary) and the child will be born in a clean and sterile hospital, which is especially adapted to childbirth, with all of the equipment needed to keep mother and baby alive and healthy.

Midwifery only became legally recognized in Britain in 1902. Before the First World War, for example, working-class women were attended during childbirth by a local woman (probably because they could not afford a professional person). However, there have always been midwives all through history and they were usually women with first hand experience rather than medically trained nurses.

In ancient Egypt, this was a female occupation. Five columns of the Ebers Papyrus (1700 BCE) deal with obstetrics and gynecology, and the Westcar Papyrus (1900 to 1500 BCE) has instructions for calculating the expected date of the confinement and it also describes the different types of birthing chairs.

In Greco-Roman times, a wide range of women covered midwifery, including older women who used ‘folk medical traditions’ in Roman Villages. Trained midwives collected their knowledge from a variety of sources, and the highly trained women were looked at as physicians. The physician Soranus of Ephesus (2nd Century) described certain “characteristics” for midwives: “ a suitable person will be literate, with her wits about her, possessed of a good memory, loving work, respectable and generally not unduly handicapped as regards her senses, sound of limb, robust, endowed with long slim fingers and short nails at her fingertips”. He also said that the midwife should eb of a sympathetic disposition and that she should keep her hands soft for the comfort of mother and baby (although she need not have had a child herself). There seemed to be three “grades” of midwives then: 1/ technically proficient, 2/ had read some texts on obstetrics and gynecology, and 3/ highly trained and considered a specialist.

From the 18th Century, there was a conflict between the surgeons and the midwives. The medical men started to say that their modern scientific methods were better and midwives believed in the folk medicine which had been used for hundreds of years. Midwifery was now seriously regulated, especially in the U.S.A and Canada. In Northern Europe and Russia, a midwifery school was established from 1811 until the First World War. The training lasted for seven months and, at the end of the training, a certificate of practice was issued to the female students. Whilst some accused these women of being poorly trained, it was the badly trained surgeons who were the threat to the mothers and babies.

In 1846, it was observed that more women died in maternity wards which were staffed by male surgeons than by the female midwives. This was traced to the fact that the male students did not wash their hands properly, going from dissecting a dead body to delivering a baby without washing properly. This carried on until the early 1900’s when the study of bacteriology started and hospital hygiene greatly improved. Women started to feel safer when going into hospital to have their babies. “Physicians trained in the new Century found a great contrast between their hospital and obstetrics practice in women’s homes where they could not maintain sterile conditions or have trained help”, (Wikipedia). Midwives possessed knowledge and skills of assisting at the birth, contraception and abortion, and they were ‘persecuted’ by public authorities for this.

It is interesting to note that the World Health Organization (“WHO”) recommends a natural, normal and humanized birth.

Today, in the year 2022, midwifery ‘encompasses’ a range of primary health care for women from adolescence to beyond menopause. Their services include: gynecologic and family planning services / preconception care / care during pregnancy / childbirth and the postpartum period and care of the newborn. We are well looked after and in good hands ladies!

It seems only appropriate here to mention (a little) about the series “Call The Midwife”. The television series follows newly qualified midwife Jenny Lee, plus the work of the other midwives and nuns of Nonnatus House (which is a nursing convent and is part of an Anglican religious order). The series is very interesting as it shows how these ladies cope with the medical problems within the “poor” Poplar district of London’s East End in the 1950’s. The actual program is based on the very true story “Call The Midwife: A True Story of the East End in the 1950’s”, which are the memoirs of Jennifer Worth. It is the first of a trilogy of books which describe Jennifer’s work as a district nurse and midwife. She wrote the books after retiring and the first publication was published in July 2002. By the time of Jennifer’s death in June 2011, the book had sold almost a million copies. The television series brought further interest in the books, which are (again) at the ‘top of the charts’.

Jennifer started to write the books in response to an article in the Royal College of Midwives Journal by Terri Coates. Terri felt that midwives had been under-represented in literature and asked for “a midwife somewhere to do for midwifery what James Herriot did for vets”, (Wikipedia). Jennifer wrote the first volume of her memoirs by hand and sent them to Terri to read. Terri then served as an advisor on the books and the television series.

The Jennifer Lee in the series is actually Jennifer Worth’s maiden name but most of the other names are written under pseudonyms (written under different names), which even includes Nonnatus House.

“Worth’s powers of description, authenticity of detail and richness of characterization evoke from the start an unforgettable milieu — Poplar and the London docklands of the mid to late 1950s — to which I and clearly many thousands of other readers willingly and completely surrendered”. David Kynaston in The Guardian.

“Worth tells it like it is; and her brisk frankness about birth, copulation and death can make Irvine Welsh read like Barbara Cartland. If you don’t care for the details of terrified teens at full term, or botched abortions, look away now. Her compassion and anger drive the shock and gore”. Boyd Tonkin in The Independent.

So, instead of asking “where’s the midwife?” us ladies should be saying “thank God for the midwife!”

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