Entries in Health (1)

Tuesday
Feb222011

The rise of the 'monthly nurse'

Every time I come to write a blog I try and think of something that has interested me, and might interest others.

Last weekend I was doing some research looking into a lady in Chatteris. In 1861, she was listed as a pauper, head of the household and sharing with her grown up son and daughter, an ag lab and a seamstress. Ten years later, she appears in 1871 as a ‘monthly nurse’ living with a local family, the Graingers. I was intrigued by the concept of the monthly nurse, as in as little as three generations, the term has pretty much fallen out of use. Those that I have spoken to have not had a clue about the duties of these women, perhaps surprising as only a century ago there were over 5000 monthly nurses in London alone. The figures suggest that many of us will find such a lady somewhere in our family tree.

Given I am something of a Norfolk and Suffolk focussed researcher, I decided to look into the history of the profession in this part of the world. What follows are some of my conclusions, thoughts and ideas.

Firstly, I must answer the question: What is a monthly nurse? As long ago as 1700BC the Egyptions recognised female midwives, who would have both tended a woman during her lying in, during the birth and provided care afterwards while the baby was young. However, by the early 1800s, those who could afford it paid a surgeon to be present at the birth. This left families with less after care, and many families could not afford a surgeon at all. Enter the monthly nurse, to provide support to the family. While the term originates in the idea that these nurses would help out for ‘about a month’ this is a little misleading and the actual employment could last as little as a few visits or as long as several months. Many working class women could not afford to ‘lie in’ as long as their more wealthy counterparts so some nurses would have visited several mothers on a part time basis at around the same time.

The 1851 census shows approximately 4175 monthly nurses across England and Wales. Norfolk and Suffolk had relatively few, 40 and 36 respectively, based on an occupation key word search (and therefore open to some errors). The average age for a woman in this profession was just over 40 in Norfolk and 53 in Suffolk. Requirements for the job were informal, and most women providing the service were experienced mothers themselves. They tended to be older women, often widows, who would likely have been present at numerous births of relatives and neighbours, and very likely given birth themselves several times.

In 1851 the youngest nurse across the two counties appears to be Elizabeth Plantin of Bramford near Ipswich, aged 27 on the census. The eldest in Norfolk was 72 year old Mary Ann Woolsey, living with a family in Great Yarmouth and their young family. She may have been living with them for some time, or perhaps a member of the household was expecting another child. The eldest in Suffolk was 77, May Glass, of Street Farm, Assington near Sudbury.

By 1861, the total number of women recorded on the census as a monthly nurses was half as large again as ten years earlier – around 6425. Numbers in Norfolk (74) and Suffolk (49) had also risen. This time, the youngest seems to have been Mary Barnard, of Heigham, Norwich, who was just 19. In this case Mary was the youngest sister of the wife in the household. Baby Elizabeth was a month old at the time of the census. Norfolk also shows the eldest monthly nurse I found during my research – an 88 year old woman living in Norwich workhouse, listed only as ‘M L’. There is probably no way of knowing whether she was still actively helping women. The average age of the women provided this time was 54 in Norfolk and 57 in Suffolk, slightly older than ten years earlier.

1871 saw another increase in total numbers – 7125 were recorded. Norfolk had 75 and Suffolk 82, not massively different from a decade before. Average ages were almost identical, 56 in Norfolk and 55 in Suffolk. Another ten years, and the total number rose to around 8225 with a significant increase in our Counties of interest (Norfolk, 108, Suffolk, 158) although average ages remained very similar. 1891 saw the first and only decrease, with 7525 recorded monthly nurses. Perhaps due to transciption anomalies, the numbers in Norfolk and Suffolk had almost switched (152 and 93 respectively).

Finally, I looked at numbers in 1901. A staggering 22,300 were recorded as monthly nurses on the schedule this time around, 463 in Norfolk and 371 in Suffolk, with the average age remaining around 50 in both cases. Only a year later, changes to the status of midwifery began the process of transforming the care of women and babies which eventually saw the occupation drop off the radar and the arrival of our modern care processes.

It seems clear that, given skills were generally passed from generation to generation, those with most experience were often considered the best people to have around during a birth and therefore elder women were most likely to act as monthly nurses. However, few of the women had the same level of knowledge and training as midwives of the time. While some worked in lying in hospitals for a limited time, many did this purely in order to open their own, often substandard, establishments and make a living. 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’.

This is not to say that no monthly nurses had skills, and some described them as ‘motherly’ nurses to reflect their value – I am sure there are many women today who would have liked the help of another woman for a month rather than having a few hours in hospital and then heading home. For many widows, passing on their experience enabled them to keep a roof over their heads. They moved from one family to another receiving board and lodging.

Unfortunately some had no interest in being part of a caring profession, had little or no ability and used the title only as a way of earning money, often running dirty establishments. For anyone interested in reading Marian’s article “The Monthly Nurse; her origin, rise and progress” the report, published May 21st 1891, can be found here: http://rcnarchive.rcn.org.uk/data/VOLUME006-1891/page267-volume006-21may1891.pdf. The article is followed by a fantastic ‘special prize competition’ for a sewing machine with a walnut case!

As for the subject of my initial research in Chatteris, ten years later, a Tom Grainger, now a decade old, appears on the census with his parents. Sarah, who probably helped deliver him, had moved on. She was 76 when he was born. Who knows how many children she helped into the world - and how well she did it. Still, it is wonderful anecdote for a family research project to be able to surmise that your ancestor delivered babies, especially when you can identify who some of them were.