Having really enjoyed the Television series, Call the Midwife I was very interested to read the book it is based upon. It was a fascinating look into family life in 1950’s London.
Respect for Women
The first thing that struck me about the stories in this book is the deep respect for women and children. The author frequently mentions that she and her fellow midwives can safely travel in the roughest neighbourhoods, even in the middle of the night without any fear of suffering violence. To me this speaks of a deep seated reverence for the women who cared for the mothers of the area. I suspect this stemmed from a simple and straightforward respect for one’s mother, something which seems to be lacking in today’s society.
Today mother’s are treated as lesser citizens. We are considered to be neglecting our families if we pursue careers or lazy if we stay home to raise our children. A mother is called selfish if she looks after her appearance but slovenly if she doesn’t. No matter what choices we make in life we will be judged to be wrong by what always seems to be an overwhelming majority of society.
A woman’s place in the 1950’s was more clearly defined. Because every women was expected to stay home and raise her children, every woman who did so was respected for it by wider society. She was also respected in her role by her family.
There is actually one story in the book which features a father profusely apologising to medical personnel for making a decision relating to childcare without first consulting his wife. He explained that this was exclusively her domain, not just in terms of her being responsible for doing the work but that she had complete autonomy to make all of the decisions. I cannot imagine a 1950’s father disagreeing with his wife on issues such as disciplining children.
I’m not for single second suggesting that a return to the rigid roles of the 1950’s would be a good idea.
Whilst reading the book I often found myself wondering about the women who would have preferred not to stay home, or have children at all, how trapped they must have felt unable to pursue their dreams and use their talents.
However I am saying that it would be nice to have some of the respect and autonomy afforded to the women of the time.
I doubt anyone in the 1950’s considered the women’s work to be easy. Every boy grew up watching his mother sweat and strain to keep him clean and fed. By respecting her contribution he will have grown up to respect his wife’s contribution to the household.
Hardships and Squalor
Oh the squalor and degradation these people experienced! I knew the BBC would have dramatized the book, of course they would, books don’t always make good TV. But oh my word they have certainly sugar coated the stories detailed in the book.
I’m fascinated by the potential of the human spirit to overcome enormous catastrophe and not only endure but triumph over it.
I was particularly struck by the story of Mrs Jenkins, the local crazy lady who obsesses over the welfare of each new baby born in the area. Her harrowing story of entering the workhouse knowing she would be separated from her children, brought me to tears. The very idea of being separated from my own children, to say nothing of watching one of them die, it brings literal tears to my eyes and makes me want nothing more than to wake them from their sleep and hold them. What that amazing woman must have gone through, working all hours to support her family, selling everything she could and still it not being enough. Watching her children waste away and die before her eyes. Having nowhere to turn but the workhouse, knowing that could mean never seeing them again. And then slowly over years of misery, literally cut off from light and joy, hearing of their deaths from neglect, one by one. Of course she lost her mind, I would.
Perception of Historical Maternal Mortality Rates
Like many books that cover obstetric healthcare throughout history the author frequently refers to the appalling quality of healthcare availible to previous generation. On several different occasions she references the appallingly high maternal mortality rate, saying that mothers of previous generations were risking their lives to have children. Her contempt for “untrained and unregistered” midwives is abundantly clear.
Now the thing is, it’s simply not true.
Please allow me to prove my point. It is widely accepted that in previous centuries large families were the norm. My grandmother had 9 children, larger families even than this were commonplace. We all know this.
If the maternal mortality rate was actually as high as perception would have us believe, then these large families would be very much the exception, not the norm. Simply because the mother’s chance of dying would be appallingly high within a few children, she would never live long enough to have a large number of children.
For example if the mortality rate was as high as 50% as I have often heard referenced in literature, then a mother would have a 50% chance of having one child and surviving. Her chance of surviving two births would be 25% and of three just 12.5%. Families of four children would be just 6.25% of families. A little over 3% for families of five children with a living mother. And so on.
It would simply be impossible for large families to be commonplace if the maternal mortality rate was as high as literature would have us believe.
In reality the pre 1900 maternal mortality rate ranged from 0.6 to 0.3%. Source – https://ourworldindata.org/maternal-mortality.
I’m very familiar with this misconception, what interests me is when and how it came about. I have heard the opinion that the maternal mortality rate rocketed when women started giving birth in hospitals where the risk of infection was considerably higher than at home. And also that the ignorant interventions of early obstetricians caused further problems. Therefore those early obstetricians, being the recorders of the death rates and the writers of medical text books assumed that maternal death rates must be much higher for unassisted births. I have always assumed that it is their mistaken perception that has lead to a now widely accepted misconception.
Incidentally it is absolutely fascinating how many times this has happened throughout history and indeed during the present. If you will indulge me a quick tangent two examples spring to mind.
The first being the risks of wearing a corset. Only a minority of ladies would excessively tighten their corsets, it was not the norm. A properly fitted corset does not restrict movement or growth. And yet there are many, many examples in literature and even from reputable historians that reference the damagers of corset wearing.
The second example that occurs to me right now is a modern medical misconception. Ankylosing Spondylitis is a spinal condition. Even modern medical students are taught that this does not often affect women and when it does it is less severe than in men. However MRI scans have clearly confirmed that women are just as likely to suffer form the condition as men and in fact they are more likely to be more severely affected by the condition. The result is that most women with the condition can expect to be left undiagnosed for 10 years and in some cases even as much as 20 years.
Anyway, back on topic.
What really struck me about the author’s words was her utter contempt of “untrained and unregistered” midwives.
Whilst I am absolutely certain that there were ladies who were more interested in profit than their patient’s health, that there were ladies who delivered babies whilst drunk or didn’t have any thought of cleaning anything. But I am also certain that these would be in the minority.
The author herself mentions that “untrained and unregistered” midwives were taught by their mothers, that the role was passed down through the generations. It was normal for a youngster to assist their parent in their work from a young age. So of course these girls would have received hands on training more like an apprenticeship than academic training. In fact in the book Jenny Worth mentions that in her opinion it takes 7 years of hands on experience to make a good midwife, on top of the academic training she received. The “untrained and unregistered” midwives she mentions will typically have had far more experience than this before attending a birth alone.
Whilst it is well known that the risks of infection were not common knowledge before the early 20th century, what professional, reliant on their trade for survival would do anything other than their best to achieve the best outcome. Can you imagine the consequences if a midwife were to be in attendance when a mother passed away? If this were a frequent occurrence her clientele would quickly loose trust in her abilities. There is no faster form of communication, so they say, than women’s gossip!
So I find myself tentatively concluding a theory I have heard previously, that the widespread defamation of the characters of “untrained and unregistered” midwives is entirely due to the arrogance of male obstetricians.
I thoroughly enjoyed reading Call the Midwife and bought the next book in the series as soon as it was finished.
It’s a fascinating insight into family life in 1950’s London. I was riveted to every single story.
I’ll let you know if I enjoy the second book as much . . .
A Little Bit About Me . . .
Thank you so much for stopping by my corner little of the interweb. I’m Bridie, mum to two small humans, full time homemaker and full time craftaholic – which totally explains why I’m always short on time!
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