Nursing Notes & Midwives’ Chronicle, January 1900: The Evolution of a Profession

We welcome the New Year with some extracts from the January 1900 Nursing Notes: A Practical Journal for Nurses and some thoughts on the subject of transition and change. This blog post also contains a selection of photographs of early 20th century midwives from the heritage collections of the Royal College of Midwives.

An extract from the title page of the January 1900 issue of Nursing Notes. The text reads: CONTROVERSY still, we believe, rages fiercely over the ques¬tion as to when the much-talked-of
An extract from the title page of the January 1900 issue of Nursing Notes. The text reads: “CONTROVERSY still, we believe, rages fiercely over the question as to when the much-talked-of “new century” really begins, the argument being one of such general interest that the merest mention of the subject has proved sufficient to transform the dullest dinner-party from gloom to anima¬tion. For our purposes, and indeed for most people, the first day of 1900 will continue to mark the beginning of a fresh stage in the world’s history. Looking back, then, on the past hundred years, how vast is the change which has come over that department of life with which we are now chiefly concerned the care of the sick, in all its many aspects. How different is now the position of those whose business it is to tend the sick. The trained nurse has made for herself an important place in the world, and those who have watched her evolution with keen interest can only hope that the attention which she has attracted, and the prominence given to her work by the great spread of humanitarianism, will not ultimately spoil her, or render her in the future an unworthy follower of that greatest nurse of the nineteenth century, Florence Nightingale.”

The turn of the 20th century was a pivotal time for nurses and midwives in England and Wales. One of the major events affecting their work was the Second Boer War in South Africa which had been raging since the previous year and would continue for the next two and a half years. This issue makes reference to the hospital ships, the Princess of Wales and the Maine. The former was a Geneva Red Cross vessel tasked with transporting wounded soldiers from South Africa to the United Kingdom. Special mention is made of the ship’s (relative) comforts: spring mattresses, ‘excellent back rests’ and soft down pillows for each bed. The ship also featured an operating room complete with surgical appliances including a ‘Röntgen ray apparatus’, the work of Wilhelm Conrad Röntgen and now more commonly known as an x-ray machine.

The Maine hospital ship was supplied and staffed by the Society of American Women in London with funds raised through social occasions and ‘entertainments’. The Maine’s medical staff were received by the Queen at Windsor in December 1899 before setting sail for South Africa. Post war the Maine was donated to the British Government as a Navy vessel and became part of the Royal Fleet Auxiliary in 1905. Sadly the ship eventually ran aground and was lost near the Isle of Mull in Scotland in 1914.

Photograph of midwife Ethel Strachan (archive reference RCMS/86)
Photograph of midwife Ethel Strachan (archive reference RCMS/86)
Photograph of midwife E. Wilkinson in 1901 (archive reference RCMS/86)
Photograph of midwife E. Wilkinson in 1901 (archive reference RCMS/86)

Other important news centred on the 1899 Midwives’ Bill. The bill was a profession-defining act introduced to improve the national standing of midwives and to raise its status as a career for educated women. This issue notes that finding time in Parliament to gain consent for the legislation was one particular difficulty they faced when trying to get the bill passed. By this point the bill had managed to gain the attention of the Royal College of Surgeons and the Royal College of Physicians alongside many other prominent medical bodies.

The Midwives Act itself would eventually come into force in England in 1903. The act regulated the profession and made it illegal for any midwife to practice without certification. The Act also established the Central Midwives Board to issue certificates and to maintain and publish a roll of midwives working in England and Wales. The approved period of training for a midwife was three months and all midwives were encouraged to keep a case book of deliveries and pre and post-natal examinations they attended. The archives of the Royal College of Midwives holds several of these historic casebooks from British midwives donated by their relatives.

Next we have a Retrospective on the development of nursing and midwifery as professions at the start of the 20th century. It describes them as ‘inexperienced’ and passing through transitional periods: ‘…professions, like individuals, must buy their own experience, and until the experience is bought, it is not grown up.’ It compares professions to children who journey through stages of reckless eagerness (uncalculated and reckless with its spending) into the role of the pupil (where systematic teaching and training begins, providing structure and places to learn). But the issue reminds its readers to not ignore the ‘value of any nursing that could not be set out on a chart, or paged into a case-book’ and to respect the insight of midwives who worked prior to the introduction of regulations and formalised training.

Image from a postcard featuring a group of midwives in uniform (archive reference RCMS/86)
Image from a postcard featuring a group of midwives in uniform (archive reference RCMS/86)

The Retrospective ends with a poignant look to the future: ‘It may be that those who write 2000 [as a date] will be in a position to chronicle the passage from youth to the matured and experience grown-up period of the nursing profession.’

We can only speculate what nurses and midwives of the period would think of 21st century practice and the challenges, new and old, being faced by British medical practitioners today.

Further into the issue we have a warning about ‘Objectionable Advertisements’, where a writer to the Lancet brought attention to an advertisement on the subject of Midwives’ Registration which appeared sporadically during the period in local and London papers. The advertisement encouraged support of the Midwives’ Registration Bill in order to end the practice of ‘man-midwifery’. Nursing Notes agrees with their correspondent’s complaint calling the advertisement ‘silly and offensive’ but had no idea of the advert’s origins.

Photograph of midwife Mrs Messenger, the famous Head Midwife of the London Lying-In Hospital between 1881 and 1900 (archive reference RCMS/86)
Photograph of midwife Mrs Messenger, the famous Head Midwife of the London Lying-In Hospital between 1881 and 1900 (archive reference RCMS/86)

The issue ends with advertisements approved by the Midwives’ Institute in a new page promoting services and work by women from various professions including cake makers, dress makers, rare book dealers, and masseuses. Also featured are job vacancies for trained nurses and offers of classes including, most interestingly, lessons in the ‘Swedish Movements’ style of massage from an experienced medical gymnast!

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