As a mother, historic attitudes towards pregnancy and childbirth, have always fascinated me. Recently, I researched a client’s ancestor – a woman who spent a long time working as a “monthly nurse”. I think most people already know what a midwife or a wet nurse is / was, but may be less familiar with monthly nurses. These women were employed for a short term (e.g. a month) to assist a mother with her new-born baby. Often the care would start once a woman entered ‘confinement’ and continue for the first couple of weeks after a child was born. At times monthly nurses assisted with the birth itself, and the line between midwives and monthly nurses was sometimes blurred.
For employment as a monthly nurse (like midwives and wet nurses), a good moral and religious character was preferable. Abstinence from alcohol was strongly desirable, as was experience of raising children. Married or widowed middle-aged ladies were ideal! In 1875, the 11th Edition of Pye Henry Chavasse’s book Advice to a Wife on the Management of Herself; during the periods of menstruation, pregnancy, labour, and suckling with an introductory chapter especially addressed to a young wife was published by J.&A. Churchill. This fascinating text, which can be viewed at here at Google Books, gives an interesting insight into attitudes towards monthly nurses (at least from men in the medical profession).
Chavasse provides a long list of qualities that should be sought, when looking to employ a monthly nurse. He sensibly advises against employing; gossips, those that create discord among the other servants and nurses that insist on giving their ladies odd concoctions or waking them to force them to eat. However, amongst the long list of required attributes are some that are very comical to the modern ear. I particularly like the advice below:
Chavasse, Page 193; Retrieved from Google Books on 19 Feb 2018
At times this long list of essential qualities must have been a tall order to fulfill, especially since these women were likely to be from working class backgrounds with little formal education. In return for their efforts they faced a life of precarious employment – the newspapers of the mid 1800s are full of cases in which monthly nurses were reduced to turning to the law to force their employers to pay up. They were also highly reliant on good references from previous employers, as formal qualifications were rare. A few ‘lying in’ hospitals might provide a bit of basic training, and doctors that had worked alongside these women might also vouch for their skills. Otherwise they were dependent on selling their experience, and good reputation.
To find work these nurses would advertise their services in local papers, or answer ads from potential clients requesting assistance. As the ad below shows, experience and age are mentioned – but nothing about qualifications or training.
The Luton Times and Advertiser for South Beds. & North Herts; 23 April 1859; Page 1; Column 6; Retrieved from www.findmypast.co.uk on 19 Feb 2018
For the woman employing a monthly nurse there were also risks. She might turn out to be unreliable, or worse incompetent. A truly incompetent nurse could have deadly results for both mother and baby. This was a real fear for Victorian families hiring nurses. Even royalty experienced trouble with their wet nurse. The below lithiograph shows a horrified Victoria and Albert entering the nursery just as the wet nurse is about to feed the Prince of Wales (later Edward VII) a drop of alcohol.
A monthly nurse could have fake references, there was no central registration such as we have for childminders today. In the poorer areas of the cities, they might even have links to ‘baby-farming’ – perhaps recommending other women, willing to adopt illegitimate babies, for a small fee.
It wasn’t until 1872, after much campaigning, that an act called the Infant Life Protection Bill was passed through parliament. This bill was a result of concerns that wet nurses were farming off their own children in order to gain employment feeding the children of wealthier families. It enshrined in law that “women who cared for other women’s children for longer than twenty-four hours had to register their establishments, and the babies of wet nurses were less likely to ‘disappear’” (Worsley, Lucy. If Walls Could Talk: An Intimate History of the Home. Faber and Faber, London: 2011, page 35).
Margaret Waters, Disposing of the Bodies, The Illustrated Police News [Public domain] 15 October 1870, via Wikimedia Commons
For most women in the mid 19th Century, childbirth and child care remained an exclusively female domain. The average working-class family could not afford to employ a doctor, and so midwives and nurses were turned to – as they had been for centuries. Most women gave birth at home, although there were some lying-in hospitals.
In 1850 John Tricker Conquest of the Royal College of Physicians of London published a book entitled “Letters to a mother, on the management of herself and her children in health and disease; embracing the subjects of pregnancy, childbirth, nursing, food, exercise, bathing, clothing, etc., etc.; with remarks on chloroform”. Within this text, Conquest laments the lack of doctors [men] willing to investigate causes of individual infant mortality, and in part blames nurses out-dated practices for high death rates. Conquest recommends sending for a doctor as soon as possible during labour, not only to “combat accidental complications, but because the very fact of his being at hand consoles the female and and inspires her with confidence” (p. 41). Conquest relegates a nurses duties to making the bed, preparing the women’s dress, and providing comfort and companionship.
As for wet nurses, Conquest advocates for breast feeding one’s own children when ever possible. An understandable point of view, bearing in mind fears over health and habits of potentially unscrupulous nurses. Conquest even advises that:
“Fretfulness, agitation, and violent emotions of the mind, invariably do injury to a sucking child…Instant death has occurred, in some instances, traceable to no other cause than the changes in the milk induced by the operation of great mental excitement” (Conquest, page 107, retrieved from Internet Archive 20 Feb 2018)
Conquest’s views on breastfeeding are, at least in my personal experience (!), highly idealistic – perhaps even romanticised. If any women reading this blog ever felt even the slightest pressure or anxiety over alternative feeding methods (expressing, bottles etc), than imagine being told this by a medical professional:
“…fewer women die whilst nursing than at any other period of life. It is a very common observation that their spirits are more lively and uniform, their tempers milder and more equable, and their general feelings more healthy and pleasant, than under any other circumstances”. Moreover…at no period is the countenance of the female more attractive, the expression more soft and beautiful, or the colour of the skin more delicate and natural, than during the period of suckling.” (Conquest, page 92, retrieved from Internet Archive 20 Feb 2018)
As with most of Conquest’s other statements no empirical data was provided to back his claims. I’m also intrigued was the promise of a milder temper really appealing to women readers? Encouraging them to breastfeed? Or was this text really appealing to husbands – encouraging them to persuade their wives to breastfeed?
As time progressed more formal training began to be available for midwives and nurses. In 1902 an act came to pass that required midwives to undertake formal training, and possess certification in order to call themselves ‘midwives’. In 1910 this was formalised further, and all women attending to childbirth needed certification.
Even before the acts of the 1900s, attitudes were changing. “By 1891, Marian Humfrey MRBNA, reported in “The Nursing Record” that monthly nurses were ‘one of the most despised members of the nursing profession’ and that they had ‘no place whatever in the hospital nursing hierarchy’” (Elizabeth Walne Blog)
That is not to say that monthly nurses disappeared, but the overlap with midwives was slowly dissipating. Today we might call monthly nurses, mother’s helpers or night nurses.
For more information on childbirth practices themselves I recommend searching the Internet Archive which has a wealth of digitalised historical texts from medical professionals.