The Midwife: A Memoir of Birth, Joy, and Hard Times

 

Praise for
The Midwife

“Worth is indeed a natural storyteller—in the best sense of the term, with apparent artlessness in fact concealing high art—and her detailed account of being a midwife in London’s East End is gripping, moving, and convincing from beginning to end. . . . [
The Midwife
] is also a powerful evocation of a long-gone world . . . and in Worth it has surely found one of its best chroniclers.”

—David Kynaston,
Literary Review

“A chilling insight into life for the average mother [in the 1950s].”

—
Sunday Express

“Worth is a stylish and dramatic writer.”

—Matthew Parris,
Spectator

“This delightful memoir brings to vivid life London’s East End . . . full of humor . . . Worth’s talent shines from every page.”

—
Sainsbury’s Magazine

“In her marvelous new book . . . there are desperately sad stories here, but tales of great hope too. Of ordinary people living, giving birth and building their families despite enormous hardship and poor sanitation. And of midwives delivering superb care in the toughest conditions.”

—
East End Life

“Nobody who reads [
The Midwife
] will ever forget it.”

—
The Woman Writer

“The Docklands in London’s East End in the 1950s seems more like the nineteenth century than fifty years ago.”

—
Good Book Guide

“Sheer magic.”

—
The Lady

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80 Strand, London WC2R 0RL, England

First published in Great Britain by Merton Books 2002
Published by Phoenix, an imprint of Orion Books Ltd. 2008
This edition published in Penguin Books 2009

 

Copyright © Jennifer Worth, 2002

All rights reserved

 

This is a work of nonfiction, and the events it recounts are true. However, certain
names and identifying characteristics of some of the people who appear in its pages
have been changed. The views expressed in this book are the author’s.

 

LIBRARY OF CONGRESS CATALOGING IN PUBLICATION DATA
Worth, Jennifer, 1935-
The midwife : a memoir of birth, joy, and
hard times / Jennifer Worth ; clinical editor, Terri Coates.
p. cm.
Rev. ed. of: Call the midwife / by Jennifer Worth. Twickenham : Merton, 2002.
Includes bibliographical references.

eISBN : 978-1-101-10577-1

1. Worth, Jennifer, 1935- 2. Midwives—England—London—Biography.
I. Coates, Terri. II. Worth, Jennifer, 1935- Call the midwife. III. Title.
[DNLM: 1. Worth, Jennifer, 1935- 2. Nurse Midwives—London—Personal Narratives.
3. Home Childbirth—history—London. 4. Poverty Areas—London. WZ 100 W932m 2009]
RG950.W675 2009
618.2—dc22 2008054663

 

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without the permission of the publisher is illegal and punishable by law. Please purchase only
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of copyrighted materials. Your support of the author’s rights is appreciated.

This book is dedicated to Philip, my dear husband

The history of ‘Mary’ is also dedicated to the memory of Father Joseph Williamson and Daphne Jones

ACKNOWLEDGEMENTS

All nurses and midwives, many long since dead, with whom I worked half a century ago

Terri Coates, who fired my memories
Canon Tony Williamson, President of The Wellclose Trust
Elizabeth Fairbairn for her encouragement
Pat Schooling, who had courage to go for original publication
Naomi Stevens, for all her help with the Cockney dialect
Suzannah Hart, Jenny Whitefield, Dolores Cook, Peggy Sayer,
Betty Howney, Rita Perry
All who typed, read and advised
Tower Hamlets Local History Library and Archives
The Curator, Island History Trust, E14
The Archivist, The Museum in Dockland, E14
The Librarian, Simmons Aerofilms

PREFACE

In January 1998, the
Midwives Journal
published an article by Terri Coates entitled “Impressions of a Midwife in Literature”. After careful research right across European and English-language writing, Terri was forced to conclude that midwives are virtually non-existent in literature.

Why, in heaven’s name? Fictional doctors grace the pages of books in droves, scattering pearls of wisdom as they pass. Nurses, good and bad, are by no means absent. But midwives? Whoever heard of a midwife as a literary heroine? Yet midwifery is the very stuff of drama. Every child is conceived either in love or lust, is born in pain, followed by joy or sometimes remorse. A midwife is in the thick of it, she sees it all. Why then does she remain a shadowy figure, hidden behind the delivery room door?

Terri Coates finished her article with a lament for the neglect of such an important profession. I read her words, accepted the challenge, and took up my pen.

INTRODUCTION

Nonnatus House was situated in the heart of the London Docklands. The practice covered Stepney, Limehouse, Millwall, the Isle of Dogs, Cubitt Town, Poplar, Bow, Mile End and Whitechapel. The area was densely populated and most families had lived there for generations, often not moving more than a street or two away from their birthplace. Family life was lived at close quarters and children were brought up by a widely extended family of aunts, grandparents, cousins and older siblings, all living within a few houses, or at the most, streets of each other. Children would run in and out of each other’s homes all the time and when I lived and worked there, I cannot remember a door ever being locked, except at night.

Children were everywhere, and the streets were their playgrounds. In the 1950s there were no cars in the back streets, because no one had a car, so it was perfectly safe to play there. There was heavy industrial traffic on the main roads, particularly those leading to and from the docks, but the little streets were traffic-free.

The bomb sites were the adventure playgrounds. They were numerous, a terrible reminder of the war and the intense bombing of the Docklands only ten years before. Great chunks had been cut out of the terraces, each encompassing perhaps two or three streets. The area would be roughly boarded off, partly hiding a wasteland of rubble with bits of building half standing, half fallen. Perhaps a notice stating DANGER - KEEP OUT would be nailed up somewhere, but this was like a red rag to a bull to any lively lad over the age of about six or seven, and every bomb site had secret entries where the boarding was carefully removed, allowing a small body to squeeze through. Officially no one was allowed in, but everyone, including the police, seemed to turn a blind eye.

It was undoubtedly a rough area. Knifings were common. Street fights were common. Pub fights and brawls were an everyday event. In the small, overcrowded houses, domestic violence was expected. But I never heard of gratuitous violence children or towards the elderly; there was a certain respect for the weak. This was the time of the Kray brothers, gang warfare, vendettas, organised crime and intense rivalry. The police were everywhere, and never walked the beat alone. Yet I never heard of an old lady being knocked down and having her pension stolen, or of a child being abducted and murdered.

The vast majority of the men living in the area worked in the docks.

Employment was high, but wages were low and the hours were long. The men holding the skilled jobs had relatively high pay and regular hours, and their jobs were fiercely guarded. Their skills were usually kept in the family, passed from father to sons or nephews. But for the casual labourers, life must have been hell. There would be no work when there were no boats to unload, and the men would hang around the gates all day, smoking and quarrelling. But when there was a boat to unload, it would mean fourteen, perhaps eighteen hours of relentless manual labour. They would start at five in the morning and end around ten at night. No wonder they fell into the pubs and drank themselves silly at the end of it. Boys started in the docks at the age of fifteen, and they were expected to work as hard as any man. All the men had to be union members and the unions strove to ensure fair rates of pay and fair hours, but they were bedevilled by the closed shop system, which seemed to cause as much trouble and ill feeling between workers as the benefits it accrued. However, without the unions, there is no doubt that the exploitation of workers would have been as bad in 1950 as it had been in 1850.

Early marriage was the norm. There was a high sense of sexual morality, even prudery, amongst the respectable people of the East End. Unmarried partners were virtually unknown, and no girl would ever live with her boyfriend. If she attempted to, there would be hell to pay from her family. What went on in the bomb sites, or behind the dustbin sheds, was not spoken of. If a young girl did become pregnant, the pressure on the young man to marry her was so great that few resisted. Families were large, often very large, and divorce was rare. Intense and violent family rows were common, but husband and wife usually stuck together.

Few women went out to work. The young girls did, of course, but as soon as a young woman settled down it would have been frowned upon. Once the babies started coming, it was impossible: an endless life of child-rearing, cleaning, washing, shopping and cooking would be her lot. I often wondered how these women managed, with a family of up to thirteen or fourteen children in a small house, containing only two or three bedrooms. Some families of that size lived in the tenements, which often consisted of only two rooms and a tiny kitchen.

Contraception, if practised at all, was unreliable. It was left to the women, who had endless discussions about safe periods, slippery elm, gin and ginger, hot water douches and so on, but few attended any birth control clinic and, from what I heard, most men, absolutely refused to wear a sheath.

Washing, drying and ironing took up the biggest part of a woman’s working day. Washing machines were virtually unknown and tumble driers had not been invented. The drying yards were always festooned with clothes, and we midwives often had to pick our way through a forest of flapping linen to get to our patients. Once in the house or flat, there would be more washing to duck and weave through, in the hall, the stairways, the kitchen, the living room and the bedroom. Launderettes were not introduced until the 1960s, so all washing had to be done by hand at home.

By the 1950s, most houses had running cold water and a flushing lavatory in the yard outside. Some even had a bathroom. The tenements, however, did not, and the public wash-houses were still very much in use. Grumbling boys were taken there once a week to have a bath by determined mothers. The men, probably under female orders, carried out the same weekly ablution. You would see them going to the bath-house on a Saturday afternoon with a small towel, a piece of soap, and a dour expression, which spoke of a weekly tussle once again waged and lost.

Most houses had a wireless, but I did not see a single TV set during my time in the East End, which may well have contributed to the size of the families. The pubs, the men’s clubs, dances, cinemas, the music halls and dog racing were the main forms of relaxation. For the young people, surprisingly, the church was often the centre of social life, and every church had a series of youth clubs and activities going on every night of the week. All Saints Church in the East India Dock Road, a huge Victorian church, had many hundreds of youngsters in its youth club run by the Rector and no less than seven energetic young curates. They needed all their youth and energy to cope, night after night, with activities for five or six hundred young people.

The thousands of seamen of all nationalities that came into the docks did not seem to impinge much upon the lives of the people who lived there. “We keeps ourselves to ourselves,” the locals said, which meant no contact. Daughters were carefully protected: there were plenty of brothels to cater for the needs of the seamen. In my work I had to visit two or three of them, and I found them very creepy places to be in.

I saw prostitutes soliciting in the main roads, but none at all in the little streets, even on the Isle of Dogs, which was the first landing place for the seamen. The experienced professional would never waste her time in such an unpromising area, and if any enthusiastic amateur had been rash enough to attempt it, she would soon have been driven out, probably with violence, by the outraged local residents, men as well as women. The brothels were well known, and always busy. I daresay they were illegal, and raided from time to time by the police, but that did not seem to affect business. Their existence certainly kept the streets clean.

Life has changed irrevocably in the last fifty years. My memories of the Docklands bear no resemblance to what is known today. Family and social life has completely broken down, and three things occurring together, within a decade, ended centuries of tradition - the closure of the docks, slum clearance, and the Pill.

Slum clearance started in the late 1950s, while I was still working in the area. No doubt the houses were a bit grotty, but they were people’s homes and much loved. I remember many, many people, old and young, men and women, holding a piece of paper from the Council, informing them that their houses or flats were to be demolished, and that they were to be rehoused. Most were sobbing. They knew no other world, and a move of four miles seemed like going to the ends of the earth. The moves shattered the extended family, and children suffered as a result. The transition also literally killed many old people who could not adapt. What is the point of a spanking new flat with central heating and a bathroom, if you never see your grandchildren, have no one to talk to, and your local, which sold the best beer in London, is now four miles away?

The Pill was introduced in the early 1960s and modern woman was born. Women were no longer going to be tied to the cycle of endless babies; they were going to be themselves. With the Pill came what we now call the sexual revolution. Women could, for the first time in history, be like men, and enjoy sex for its own sake. In the late 1950s we had eighty to a hundred deliveries a month on our books. In 1963 the number had dropped to four or five a month. Now that is some social change!

The closure of the docks occurred gradually over about fifteen years, but by about 1980 the merchant ships came and went no more. The men clung to their jobs, the unions tried to defend them, and there were numerous dockers’ strikes during the 1970s, but the writing was on the wall. In fact the strikes, far from protecting jobs, merely accelerated the closures. For the men of the area, the docks were more than a job, even more than a way of life - they were, in fact, life itself - and for these men, the world fell apart. The ports, which for centuries had been the main arteries of England, were no longer needed. And therefore the men were no longer needed. This was the end of the Docklands as I knew them.

 

In the Victorian era, social reform had swept through the country. For the first time authors wrote about iniquities that had never before been exposed, and the public conscience was stirred. Among these reforms, the need for good nursing care in hospitals gained the attention of many farsighted and educated women. Nursing and midwifery were in a deplorable state. It was not considered a respectable occupation for any educated woman, and so the illiterate filled the gap. The caricature figures of Sairey Gamp and Betsy Prig - ignorant, filthy, gin-swilling women - created by Charles Dickens, may seem hilarious as we read about them, but would not have been funny if you had been obliged, through poverty, to place your life in their hands.

Florence Nightingale is our most famous nurse, and her dynamic organisational skills changed the face of nursing for ever. But she was not alone, and the history of nursing records many groups of dedicated women who devoted their lives to raising the standards of nursing. One such group was the Midwives of St Raymund Nonnatus,
¹
They were a religious order of Anglican nuns, devoted to bringing safer childbirth to the poor. They opened houses in the East End of London, and in many of the slum areas of the great industrial cities of Great Britain.

In the nineteenth century (and earlier, of course) no poor woman could afford to pay the fee required by a doctor for the delivery of her baby. So she was forced to rely on the services of an untrained, self-taught midwife, or “handywoman” as they were often called. Some may have been quite effective practitioners, but others boasted a frightening mortality rate. In the mid-nineteenth century, maternal mortality amongst the poorest classes stood at around 35-40 per cent, and infant mortality was around 60 per cent. Anything like eclampsia, haemorrhage, or mal-presentation, would mean the inevitable death of the mother. Sometimes these handywomen would abandon a patient to agony and death if any abnormality developed during labour. There is no doubt that their working practices were insanitary, to say the least, and thereby spread infection, disease and often death.

Not only was there no training, but there was also no control over the numbers and practice of these handywomen. The Midwives of St Raymund saw that the answer to this social evil lay in the proper training of midwives and control of their work by legislation.

It was in the struggle for legislation that these feisty nuns and their supporters encountered the fiercest opposition. From about 1870 the battle raged; they were called “an absurdity”, “time wasters”, “a curiosity”, and “an objectionable body of busy-bodies”. They were accused of everything from perversion to greed for unlimited financial gain. But the Nonnatus Nuns would not be put down.

For thirty years the battle continued, but in 1902 the first Midwives Act was passed and the Royal College of Midwives was born.

The work of the Midwives of St Raymund Nonnatus was based upon a foundation of religious discipline. I have no doubt that this was necessary at the time, because the working conditions were so disgusting, and the work so relentless, that only those with a calling from God would wish to undertake it. Florence Nightingale records that when she was in her early twenties she saw a vision of Christ, telling her that her life was required for this work.

The St Raymund midwives worked in the slums of the London Docklands amongst the poorest of the poor and for about half of the nineteenth century they were the only reliable midwives working there. They laboured tirelessly through epidemics of cholera, typhoid, polio, and tuberculosis. In the early twentieth century, they worked through two world wars. In the 1940s, they remained in London and endured the Blitz with its intensive bombing of the docks. They delivered babies in air-raid shelters, dugouts, church crypts and underground stations. This was the tireless, selfless work to which they had pledged their lives, and they were known, respected and admired throughout the Docklands by the people who lived there. Everyone spoke of them with sincere love.