Midwives and Midwifery in Birmingham and Its Environs, 1794-1881
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DELIVERING MATERNITY CARE: MIDWIVES AND MIDWIFERY IN BIRMINGHAM AND ITS ENVIRONS, 1794-1881 By Frances Jane Badger A thesis submitted to the University of Birmingham For the degree of DOCTOR OF PHILOSOPHY History of Medicine Unit School of Health and Population Sciences College of Medical and Dental Sciences University of Birmingham 25 MARCH 2014 University of Birmingham Research Archive e-theses repository This unpublished thesis/dissertation is copyright of the author and/or third parties. The intellectual property rights of the author or third parties in respect of this work are as defined by The Copyright Designs and Patents Act 1988 or as modified by any successor legislation. Any use made of information contained in this thesis/dissertation must be in accordance with that legislation and must be properly acknowledged. Further distribution or reproduction in any format is prohibited without the permission of the copyright holder. ABSTRACT This thesis examines the working milieu of midwives in the urban west midlands, primarily in Birmingham and Coventry, between 1794 and 1881. Adopting a microhistorical approach, and by integrating sources including a midwife’s register, lying-in charity and poor law records, the thesis argues that developments in midwifery provision over the period mainly arose from local factors and circumstances, however some metropolitan influences can also be discerned. Reasons for the relatively late introduction of midwifery training in the locality, and the minimal interest by local midwives are considered, alongside evidence of midwives’ awareness of the varying reputation of their occupation. This research indicates that midwives worked for a range of clients including charities, the poor law and private clients, and midwifery could be combined with other strands of caring work, or even work unrelated to caring. The analysis illustrates the existence of full-time, sustained midwifery careers and of midwives who achieved a middle-class lifestyle, and a degree of status within their localities. Combined with the evidence of entrepreneurial approaches to midwifery, the thesis argues that these provincial midwives should be integrated into the historiography of businesswomen. Acknowledgements This work was undertaken at a number of archives and libraries across the country. I would like to thank the staff at all these facilities, in particular those at the Wolfson Centre for Archival Research, Library of Birmingham, and Coventry History Centre. Colleagues at the University of Birmingham encouraged me to register and provided encouragement throughout. Thanks must be extended to Collette Clifford, Carol Dealey, Alistair Hewison, Karen Shaw, and Stuart Wildman for their enthusiasm and encouragement. Preliminary analyses have been presented at national and international conferences and the feedback from fellow delegates has been helpful in developing my thoughts and ideas. I am grateful to Bob Arnott for his encouragement to register for the doctorate, and to Barbara Mortimer, for her time and supervision in the early years of my studies. Leonard Schwarz was another valued supervisor in the early stages who gave his time freely. Stuart Wildman has made an important contribution over the last two years and I am grateful for his insights. The bulk of the supervision has been undertaken with characteristic enthusiasm by Jonathan Reinarz. I am very grateful to him his advice, encouragement, and time, and for seeing this project through to completion. Finally my family, and especially my husband David, have been an unfailing source of support and encouragement. CONTENTS CHAPTERS 1. Introduction: Historiography, Sources And Methods 1 Birmingham and its Environs in the late Eighteenth and Nineteenth 3 Centuries Coventry: regional centre and silk ribbon weaving capital 10 Women’s work in the eighteenth and nineteenth century 13 Businesswomen and the business of caring 19 Justification for the study 29 The Historiography of Midwifery 31 Changing practitioners, changing places 40 Whiggish histories 43 Conflict writing 47 The dominance of capitals and their lying-in hospitals 49 Considering provincial midwifery through microhistory 55 Locating maternity care: Study location and chronology 57 Records and methods 60 Content of the thesis 65 2. Midwifery at the General Dispensary, Birmingham, 1794-1845 70 Anne York and her daughters 79 Appointing a midwife from London- Elizabeth Maurice 86 Mrs Thomas, 1835–1838: a brief encounter with the dispensary 101 Elizabeth Hallett - the last chief midwife 103 Reviewing the midwifery department 106 Conclusions 109 3. Smaller lying-in charities in Birmingham and its environs 113 Scope of the lying-in charities 116 Meeting the criteria for relief 126 Coventry’s lying-in charities 135 Lying-in charity subscribers 140 The Union Lying-in Charity 149 Conclusions 156 4. Birmingham Lying-in Charity, 1868-1881: the first trained 158 midwives in the midlands The charity’s early years 159 Closing the hospital 162 Appointing trained midwives 168 Midwives’ practice, management and remuneration 172 Metropolitan influences and connections 182 Competing aims: containing costs, extending charity 187 The status of the charity’s midwives 188 Training midwives 191 Conclusion 197 5. Midwifery and the poor law: childbirth, unmarried and destitute 199 women, 1834-1881 Midwifery in midlands poor law unions 207 Midwifery in Aston Union, 1836-1881 214 Births in Aston workhouse, 1868-1881 225 Giving birth in Wolverhampton workhouse, 1842-1845 233 Midwifery in Birmingham workhouse, 1815-1880 236 Midwifery in Coventry union, 1859-1881 238 Conclusion 240 6. A Coventry midwife’s practice, 1847-1875 243 A sworn midwife 246 The provenance of the register 247 A developing midwifery practice 249 Mary Eaves’s caseload 259 Mary Eaves’s clients 269 Working for lying-in charities and the poor law 277 Deliveries over a midwifery career 280 Conclusion 281 7 Conclusion 284 FIGURES Chapter 2 Figure 2.1: Annual Midwifery Cases, Birmingham General 83 Dispensary, 1794-1868 Chapter 3 Figure 3.1: Lying-in charities in Birmingham and environs 120 Chapter 5 Figure 5.1: Births in Aston Workhouse, 1868-1881 226 Chapter 6 Figure 6.1: Mary Eaves Annual Caseload, 1847-75 261 Figure 6.2: Streets where Mary Eaves conducted 1% or more visits 267 1847-75 TABLES Chapter 1 Table 1.1: Estimates of the average annual institutional deliveries in 42 1880s Table 1.2: Proportions of deliveries attended by ‘medical men and by 54 women’: Midlands and London, 1869 Chapter 2 Table 2.1: Westminster Lying-in Hospital Annual Cases, 1811-1818 89 Chapter 3 Table 3.1: Lying-in charities in Birmingham and environs: Founding 119 and duration of activity, 1788 - 1900. Table 3.2: Lying-in charities in Birmingham and environs: Summary 133 of provision, 1825-1860 Table 3.3: Types of tickets in Mary Eaves’s register, 1850-1867 139 Table 3.4: Ten most frequent lying-in charity subscribers in Mary 143 Eaves's register, 1853-1867 Table 3.5: Register entries - Devonport, 1852–1864 145 Table 3.6: Register entries - Charlotte Shufflebottom, 1854 – 1861 145 Chapter 4 Table 4.1: Births in Birmingham: Lying-in Charity 1869-1881 175 Table 4.2: Midwives of Birmingham Lying-in Charity, 1868-1881 180 Chapter 5 Table 5.1: Midwifery Provision in Eight Midlands Workhouses, 1868 208 Table 5.2: Statistics of Childbirth in Union Workhouses, 1871 to 1880 213 Table 5.3: Aston union- Births in the workhouse as a percentage of all 227 births in Aston District, 1873-1879 Table 5.4: Coventry – admissions due to pregnancy, and outdoor 240 deliveries by a midwife, 1859-1881 Chapter 6 Table 6.1: Mrs Cole, 1851-54 255 Table 6.2: Mrs Rainbow, 1851-68 271 Table 6.3: Mrs Puddynert, 1859-69 271 Table 6.4: Mrs Dowling, 1854-67 272 Table 6.5: Mrs Lucas, 1853-68 272 Table 6.6: Mrs Stirling, 1861-71 274 Table 6.7: Mrs Mander, 1863-75 276 APPENDICES 1. Population of Birmingham, 1801 -1841 297 2. Population of Birmingham and towns in adjacent counties, 1841-1881 298 3. Principal Occupations in Birmingham in 1851 300 4. Coventry Lying-in Charities - Women and Subscribers 301 5. Locations where Mary Eaves made 1% or more visits 302 6. Midwife Rebecca Tongue 303 LIST OF REFERENCES 1. Primary sources: archive material 304 2. Official government publications 306 3. Newspapers, journals and periodicals 307 4. Trade directories 308 5. Theses 309 6. Published books and journals up to 1900 310 7. Published books and journals after 1900 312 CHAPTER 1. INTRODUCTION: HISTORIOGRAPHY, SOURCES AND METHODS On 21 June 1819, an announcement concerning Birmingham General Dispensary appeared in the local paper, Aris’s Gazette . At a special general meeting of the Governors of the Dispensary held this day, the Rev. Edward Burn in the chair, it was resolved. That the governors are much gratified by the report of their committee concerning the appointment of Mrs Elizabeth Maurice to the situation of midwife in the dispensary; it being their opinion that the credit, and usefulness of the Institution are eminently consulted by this measure and they hereby confirm the appointment so made. J M Baynham, Secretary.1 From its opening in 1794, Birmingham’s dispensary had a midwifery department. Elizabeth Maurice’s appointment, however, marked a new approach for the charity. In contrast to previous midwives, Maurice was not a local, and the committee had enlisted the help of London medical-men to identify a suitable candidate. The announcement indicates the governors’ expectations that the dispensary’s standing would be enhanced by this appointment. Birmingham General Dispensary is the earliest setting of midwifery practice considered in this thesis, and forms the starting point of an analysis which considers five separate, though overlapping, contexts of midwifery provision in Birmingham and its environs. 2 Commencing at the end of the eighteenth century, and ending in 1881, in addition to midwifery at the general dispensary, this analysis considers midwifery care provided by three other types of institution: smaller lying-in charities in Birmingham’s satellite towns; Birmingham’s lying-in hospital and charity, and Aston poor law union.