The Midwife's Tale

by Billie Hunter

  Despite the opposition, the number of clinics increased from less than 20 in the period 1921–1931 to about 60 in the period 1931–1941. By 1951, there were approximately 140 clinics offering birth control advice. However, these clinics only gave information and advice to married women or those who could prove that they were engaged to be married – a policy still in existence when the authors were teenagers in the 1960s.

  None of the women we interviewed had attended such a clinic, and only one middle-class woman had used ‘precautions’:

  ‘When I’d been married about six months and got used to married life, I said, “Oh we won’t bother any more now with precautions, I’m ready to have a child.” He wasn’t a bit willing really. He was going to be jealous, of course. And then he said to me, “Well, I don’t mind as long as he doesn’t come before me.”’

  This account is in vivid contrast to the testimony of the working-class women, most of whom had a more fatalistic attitude to childbearing and indeed to life. As Edie M. says:

  ‘And that was the time we was having babies all the time. Just get looked at and you got a baby. Well, there were FLs [French letters] about, I suppose, but they was never spoken of. I never used nothing. You just took what come, didn’t ya? Just took a chance, didn’t ya?’

  Molly B., who grew up in South Shields, Tyneside, describes the devastating effect that constant childbearing had on everyone’s lives:

  ‘My mother was one of 21 children. She was 17 when she married in 1914. She had her first baby a year later and in all she had eight of us. Three died in infancy and two were killed in the war. I remember her saying, “I wouldn’t have had the children if I’d known what I know now. No way would it have happened. I didn’t want a lot of children but there was no birth control then.” So many of the children died because of the terrible conditions and I think death and poverty and hunger were just accepted. When a child died it was another mouth you didn’t have to feed. There was no room for being sentimental. But then, as soon as you finished breastfeeding one baby, another would be on its way … and so it went on.’

  While breastfeeding can afford women a certain degree of protection from pregnancy – if they consistently and frequently feed the baby on demand – it has never been a reliable form of contraception. Elsie B., who was a district midwife in rural Devon all her working life, starting in 1929, remembers women trying to control their fertility in this way:

  ‘You’d got an old idea that while the mother was breastfeeding her baby she wouldn’t become pregnant. So some of them used to feed for a long time. You see, there wasn’t much birth control around in those days.’

  Even when women managed to get to a birth control clinic, there could still be problems. Lou N. describes her friend’s experience of going to a clinic in wartime rural England:

  ‘When I was evacuated away, there was a woman there who told me this story. Her husband come on leave – this is true – and she kept on having babies very quick. She didn’t want no more children so she goes to the clinic. Apparently, in those days, they used a thing called a “Rendell” [a spermicide pessary containing quinine]. It looks like a half of a Brazil nut. One of the women at the clinic said, “Oh, I tell you what Bessie, you meet me on Tuesday and I’ll give you something.” See, well, she gave ‘em these Rendells but she didn’t tell her what she was to do with ‘em. You can guess what happened, can’t you? Well, she goes up to bed about five or ten minutes before her husband and she hadn’t been up there five minutes and she’s screaming blue murder. Ugh! Choking! She’d put it in her mouth instead of anywhere else!

  ‘We tried the French letters once, y’ know. My husband’s brother gave him one, and again, with no instructions. And of course me and him, being green, knew nothing about sizes. Oh, he nearly went barmy. Never again! So bang went that idea! It was far too small.’

  Given the evidence about the lack of use of contraception, it is surprising that statistics show a steady decline in average family size since the beginning of the twentieth century. On average, a married couple in mid-Victorian England would have 5.5 to six live births, whereas the statistic for a couple in the period 1925–1929 was 2.2 live births.8

  Family size figures suggest that many couples used some kind of ‘unofficial’ birth control. Deirdre Beddoe suggests that possible methods used were restraint, abstinence and the ‘safe period’.9 We would add abortion and withdrawal to this list. When women referred to their husbands’ ‘taking care’ of them or ‘being careful’, they were often using popular euphemisms for the withdrawal method. In some cases, the phrase ‘taking care of me’ may have implied abstinence and restraint, the idea being that ‘decent’ men control themselves and do not expect ‘it’ too often.

  In her article, ‘Married Life and Birth Control between the Wars’, Diana Gittins questions the theory that the decrease in the birth rate for married couples in the 1920s can be attributed to economic influences or the availability of improved contraception, since these came much later.10 She considers changes in attitude to family size to be crucially important and suggests this is usually connected to the couple’s increased expectations for their standard of living. She also found that use of contraception was related to the woman’s occupation prior to marriage. Those who worked outside of the home were more likely to want to limit their family. They were also more likely to know how to do this. This was borne out by evidence given to us during the interviews.

  Apart from abortions, the only forms of contraception available in the first half of the twentieth century were barrier methods. The Marie Stopes clinics favoured the use of the cervical cap in conjunction with a jelly or pessary. After the 1940s, the diaphragm or ‘Dutch cap’ became increasingly popular. Centuries-old barrier methods, such as sponges soaked in solutions of quinine, oil, lemon juice or vinegar, were in use and may well have had some spermicidal value.

  The use of birth control methods such as the diaphragm, cervical cap or greasy spermicidal pessaries could be problematic in homes where there was no inside toilet or running water, or where family members had to share bedrooms. Perhaps for this reason, the women we interviewed only ever mentioned using condoms, which they referred to as ‘French letters’.

  Sterilization was rare, but one middle-class woman, Vera W., was sterilized for medical reasons:

  ‘Incidentally, they sterilized me at the same time as I had the Caesarean – tied off my tubes – because they said that I shouldn’t have any more children. So they got my husband’s permission and sterilized me. I didn’t mind at all. I’d got one child and actually my husband, he didn’t particularly want children. That was my doing, my wanting.’

  According to the midwives we interviewed, it was not women’s modesty that prevented them from discussing contraceptive methods. Rather, they had a general lack of information. Even midwifery textbooks of the time made no mention of contraception, and midwives generally felt that they had little to offer in terms of helping women to control their fertility. As Edith B. said:

  ‘There wasn’t much family planning available then. I think it came on the man’s side. They never asked me for advice. No, no. It was a forbidden subject. Nothing about anything like that. My mother never told me about a thing. Nothing. I mean, I thought I was dying when … I was about 15 … “Oh ma, I’m dying, bleeding to death!” She’d told me nothing at all. I hope if you ever have a girl you’ll tell her; or even a boy. They should know too.’

  Elizabeth C. was a district midwife in Battersea, south-west London, for many years before and after the NHS was set up in 1948. Known as ‘Aunty Betty’ to her clients, she was unusual in that she felt able to give useful advice about birth control.

  ‘Yes, they did ask me how to prevent having babies. They did have condoms and the cap. They went to the doctor for those, but I knew a certain amount about the “safe period”.’

  Elizabeth C. was the only interviewee who mentioned the ‘safe period’. Possibly she was remembering a later time in
her midwifery career, since it is questionable how much accurate information about the ‘safe period’ was available before the mid-1930s. In the 1920s, midwives were taught that conception was most likely to occur around the time of menstruation. Birth control clinics were giving the same misinformation as midwifery textbooks, such as Fairbairn’s Textbook for Midwives, published in 1924:

  ‘Though it has never been proved, it is probable that ovulation and menstruation occur together, and in any case it is quite certain that there is a very close connection between the two.’11

  In 1930, researchers Ogino in Japan and Knaus in Austria independently determined that ovulation occurred mid-cycle.12 Over the next decade this information filtered through to the midwifery textbooks.

  It was not until the 1960s that midwifery textbooks contained a section on contraception. In the 1920s and 1930s midwives were actively discouraged from giving advice about contraception. A directive in the May 1934 edition of Nursing Notes reflects this:

  ‘Advice on the question of contraceptives does not come within the practice or work of a midwife as such; if for health reasons she thinks there is a risk in her patient again becoming pregnant, she should refer her to her doctor or a clinic for medical examination and advice: as the training she received as a midwife does not give her the necessary knowledge to judge whether or not if for medical reasons it is necessary for her patient to use contraceptives.’

  There was also concern about the conclusions that could be drawn if midwives were involved in distributing contraceptives: ‘There is a danger of them being falsely accused of being abortionists.’13

  Midwives may have been anxious to distance themselves from the issue of abortion, but for many of the women in their care, abortion was the main form of fertility control. Whenever we asked working-class women about birth control, they always mentioned abortion. While almost all of them had never used contraception, they all knew how to procure an abortion. Several described giving themselves abortions. This led us to conclude that for many women, abortion was one of the most common forms of birth control.

  6

  Abortion: ‘There was no other way’

  ‘That was the first thing I knew how to … not prevent, but how to get rid of… There was no other way.’

  Here, Edie M. describes how it felt to be a working-class woman in the 1920s and 30s. Unless a woman wanted and could support a large family, her fertility must have felt like a huge burden. More babies meant more mouths to feed, more work to do and increasing poverty. As soon as one baby was weaned, another was on its way, and in pre-NHS days it was extremely difficult to find out about contraception. There were few birth control clinics and most GPs refused to give advice. So how did women control their fertility? Withdrawal, abstinence and plain avoidance all depended on the man’s co-operation, so for many women abortion was the only viable option.

  Abortion was declared illegal in 1803. In the 1930s and 40s, it became legal only in exceptional circumstances – to save the life of the woman. The situation persisted until the 1967 Abortion Act legalised abortion in England, Wales and Scotland. In the decades before 1967, there were many campaigners – including members of the Women’s Co-operative Guild and the Abortion Law Reform Association – who wanted to legalise abortion. Reform was strongly supported by feminists such as Stella Browne and Dora Russell, who argued that a change in the law was necessary because so many women died each year as a result of illegal abortions. In 1934, for instance, 13 per cent of maternal deaths resulted from abortions. They were mostly deaths of married women, and the majority resulted from infection.

  Before abortions were legalised, the birth control clinics could offer no help to women seeking abortions. Women had to arrange abortions themselves, putting them at risk of death and injury from the various complications that could arise from abortion, including: shock, haemorrhage or infection. Instruments were usually not sterile; the uterus could be perforated; the pregnancy might not be wholly removed. Women could also suffer from resulting sterility, pelvic inflammation or miscarriage in subsequent pregnancies.

  As well as using instruments, women also took pills and various herbal concoctions in an attempt to abort pregnancies. It is impossible to quantify the long-term effects on their health. Concoctions containing poisonous substances such as lead would, at the very least, have had a debilitating effect. In the worst cases, they would have proved fatal.

  It should be remembered that the women we interviewed usually talked as though contraception and abortion were the same thing. Women did not define abortion in the way we do now. It was seen as a form of birth control. This was discussed in the midwifery journal, Nursing Notes, in January 1928:

  ‘There is one matter that some midwives and nurses may not have realised and which adds a complication when dealing with uneducated persons viz. the difficulty in making them understand the very great difference between contraception and procuring abortion. Midwives know very well how common the latter has become since the economic and housing difficulty has been so acute, and should not forget how the two questions are often confused.’1

  Several of the women we interviewed had given themselves abortions, often more than once. Nearly all of them knew how to ‘get rid of a baby’ should the need arise. As Edie M. says:

  ‘My sister was a very boyish type of girl, very … well, never talked about sex or men or nothing. She was … how can I say it … very down to earth. Me and my sister never talked sex. But one day she was telling me she found out how to get rid of babies. When she told me, it was the first time we’d ever talked sex in our lives; grew up together, worked together, lived together, but never really talked until then when she told me how to do it.

  ‘Soap and water injection – you used to make the solution of soapy water, best yellow soap, you have to have a pure soap, not any old soap; it had to be a pure baby soap. You’d get the syringe and put it inside you. She said, “You can feel your womb inside, don’t press inside, just put the nozzle to your womb and get the soapy water to it”. I put myself in hospital twice with bad haemorrhages after doing that.’

  The method Edie described would have been in common usage in the 1920s and 1930s and would have been more effective in causing an abortion than most of the concoctions taken orally. Molly B. and her sister Lily N. remember:

  Lily: ‘Oh yes, there was back street goings on. Because, don’t forget, South Shields is a port and a lot of seamen came in and there was a lot of prostitutes down by the docks, thousands of ‘em. And there was a chemist down there where all these “awful women” – as my mum referred to them – went to get pills and potions to make them abort. I don’t know what they used. Someone told me they used cotton wool dipped in some strong disinfectant to put up inside them, but they also used knitting needles and crochet hooks as well.’

  Molly: ‘Oh no, it wasn’t just the prostitutes. I think married women did something too. Hardly anyone had any work for a start. Awful wasn’t it, Lil? And they just couldn’t afford to have anymore. I think women got quite desperate about all the children. I quite think that women hated sex up there, the majority of them, because they were frightened to have another baby.’

  Since it was impossible to quantify an illegal practice that people were at pains to deny, the abortion statistics of the time may well have been a gross underestimation of a common practice. Nevertheless, they make sobering reading. In 1938, a government committee on abortion estimated that at least 90,000 illegal abortions were performed every year,2 and the 1937 Report on an Investigation into Maternity Mortality observed that the rate of criminal abortion nearly doubled between the years 1911–1920 and 1930–1933.3

  Although none of the women we interviewed had been to an abortionist, most knew of their existence. Lou N. told us:

  ‘When I was a child I ear-wagged and apparently a woman across the road – Mrs Thackery – apparently she used to do jobs with a crochet hook – it sounded terrible to me but I do remember that.’ />
  The decision to abort usually seemed to be made by the woman. In fact, abortion was one of the few controls that women had over their bodies. Ruby C., however, was given abortion-inducing tablets by her mother and later by her husband, without her full knowledge or consent.

  ‘My mother gave me these tablets. As a matter of fact, I never even knew what they were. Mother says, “You have to take these to help you.” I thought they were just to – you know, boost you up like a kind of tonic or something! I didn’t know I was losing the baby. I got up and oh, I was flooding all over, on my dress, on the chair and my mother hurried my friend out, and then my mother said, “Oh, that’s good.” That was all I knew about it. I just felt lightheaded and all, like that.’

  Ruby also recalled another occasion that made her suspicious:

  ‘There was another time when my husband brought me some tablets. I had an idea what they were. I was out at the pictures and he had given me these – “sweets” he called them. We were coming home down an alleyway and I said “Oh, I don’t know what’s wrong, whether I want to go to the toilet”, and I had a miscarriage down an alleyway. Oh God. I thought nothing of it, ‘cause I didn’t know anything and it just didn’t worry me ‘cause when you don’t know … it’s silly.’

  Abortions were very often described as miscarriages. When we started interviewing, we probably missed several accounts of abortion because we assumed that ‘miscarriage’ meant an accidental rather than conscious termination of the pregnancy. For example, Edie M. initially talked about her miscarriages, but later redefined them as abortions. The women’s stories show that abortion was seen as a normal event – one more hazard of being a woman. Significantly, Edie continued: