As a mother, historic attitudes towards pregnancy and childbirth have always fascinated me. Recently, I came across the term “monthly nurses” while researching a client’s ancestor.
I was familiar with midwives and wet nurses, but “monthly nurse” was new to me. Of course, I had to investigate! What did these nurses do?
I quickly discovered these women were employed for just a short time to assist a mother with her new-born baby. Often, care would start once a woman entered ‘confinement’.
It would continue for the first couple of weeks after a child was born. At times a monthly nurse assisted with the birth itself, so the line between midwives and monthly nurses were sometimes blurred.
The Desirable Characteristics of Monthly Nurses
A good moral and religious character was preferable. Abstinence from alcohol was strongly desirable. Experience of raising children ideal. Married or widowed middle-aged ladies were perfect candidates.
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, (Source: Google Books) gives an interesting insight into attitudes towards monthly nurses, albeit from the perspective of male medical practitioners.
Chavasse provides a long list of qualities that should be sought from a monthly nurse. He sensibly advises against employing gossips or those that create discord among the other servants and nurses.
Amongst these sensible suggestions, however, Chavasse has some rather peculiar demands:
This long list of essential qualities would have been hard to fulfil, especially since most monthly nurses were from working class backgrounds with little formal education.
Employment Terms
In return for their efforts, monthly nurses faced a life of precarious employment. Court cases recorded in newspapers show that it was not necessarily uncommon for monthly nurses to find themselves being refused pay.
They sometimes had to resort to legal action in order to enforce employers to cough up the moneys owed. These same monthly nurses were highly reliant on good references from previous employers.
A failure to pay would have robbed them not only of the moneys owed from their latest job, but potentially from the possibility of obtaining further work.
Formal qualifications were rare. A few ‘lying in’ hospitals might provide basic training, and doctors that had worked alongside these women might also vouch for their skills. Otherwise, monthly nurses were dependent on selling their experience along with a good reputation.
To find work 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 not qualifications.
Risks When Employing Monthly Nurses
For the women employing a monthly nurse there were risks. The nurse might turn out to be incompetent, for isntance, which could have deadly results for both mother and baby. Understandably, this was a real fear for Victorian families.
Dishonest monthly nurses could fake references, as there was no central registration with any governing body. In the poorer areas of the cities, wet nurses might even have links to ‘baby-farming’ – perhaps recommending to mothers the name of a woman willing to adopt illegitimate babies for a small fee.
It wasn’t until 1872 that an act called the Infant Life Protection Bill was passed. 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.
The bill 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).
Childbirth and Breast-Feeding
For most women in the mid 19th century, childbirth and childcare remained an exclusively female domain. Most women gave birth at home, assisted by a midwife.
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. He places blame for high death rates with nurses and their supposedly out-dated practices.
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 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.
Additionally, he advocates against the wet nurse and encourages women to breast feed their own children. The risks of an excitable wet nurse were great indeed:
“Fretfulness, agitation, and violent emotions of the mind, invariably do injury to a suckling 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 highly idealistic – perhaps even romanticised. He claims:
“…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
Despite lofty claims, Conquest provides no empirical data to evidence his claims and his motives are questionable.
Was the promise of a milder temper really appealing to female readers and would encourage them to breastfeed? Or was this text really appealing to husbands – encouraging them to persuade their wives to breastfeed?
Monthly Nurses Today
By the 1890s attitudes towards the importance of training those that attended births had started to change. Untrained Monthly Nurses were recognised as dangerous. By 1891 “The Nursing Record” had reported 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.’” (Source: Elizabeth Walne Blog)
In 1902 an act was passed requiring midwives to undertake formal training. In 1910 this was formalised further, and all women attending to childbirth needed certification.
For more information on childbirth practices themselves I recommend searching the Internet Archive which has a wealth of digitalised historical texts from medical professionals.
Further Reading:
https://elizabethwalne.co.uk/blog/2011/2/22/the-rise-of-the-monthly-nurse.html
www.janeausten.co.uk/developements-in-childbirth-in-regency-and-victorian-england/
http://reframingthevictorians.blogspot.co.uk/2014/12/victorian-pregnancy-and-childbirth.html
http://www.victorianweb.org/gender/wojtczak/pregnancy.html
http://mentalfloss.com/article/50513/historical-horror-childbirth
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1633559
https://www.rcm.org.uk/news-views-and-analysis/analysis/the-midwives-act-1902-an-historical-landmark
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