Between 1907 and 1929, Mrs Sarah C. was taken to court on three occasions and brought before the Maternal and Child Welfare Committee of the Belfast Corporation on six occasions for misconduct and mishandling of maternity cases in Belfast. Sarah C. had never been registered as a qualified or bona-fide midwife, and there is no evidence to suggest that she had ever received any sort of professional training. Sarah C. acted as a midwife in Belfast and at least three maternal deaths in this twenty-two year period were a result of her malpractice. Sarah C. appeared undeterred from practicing midwifery, continuing to offer her services in spite of continuous warnings, declaring at one point that, although untrained, she “had as much skill as any doctor.” Sarah C. would have been referred to as a handywoman; a person that had no professional training or qualifications, instead learning through experience and attending women during childbirth.

 In an attempt to regulate midwifery in Belfast and improve maternal and infant mortality rates, two acts were introduced: the Corporation Act (1911) and the Midwives (Ireland) Act, (1918). The 1911 Act was the first piece of legislation, in what would become Northern Ireland, to create a Roll of Midwives. Women who completed training, or had at least three years’ experience acting as a midwife, could be registered as recognised birth attendants in the city. Similar legislation was also put in place across the island of Ireland with the introduction of the Midwives (Ireland) Act, (1918), which, similar to its predecessor in Belfast, limited who could practice as a midwife and attempted to stamp out handywomen, people who were untrained but attended women during labour.

The urge to control and monitor these traditional birth attendants stemmed from assumptions that the unsanitary practices of handywomen and their ignorance when dealing with difficult labours led to excessive maternal and infant mortality rates, with legislation “directed against the handywoman … serving as a controller measure” for the occupation.[1] However, not all handywomen were deterred by these acts. Unqualified women continued to offer their services during childbirth, like Sarah C., and indeed, women continued to seek the care offered by and used the services of these traditional birth attendants.

Though handywomen were allowed to continue their practice for five years following the introduction of the Midwives Act, 1918, and on the grounds that they did not claim to be trained professionals, handywomen continued to offer their services to parturient women well after this. In fact, by 1926, twelve known handywomen were operating within the city of Belfast. This tells us much about maternity provision in Belfast at this time. Many pregnant women in Belfast lacked the financial means to afford qualified birth attendants, such as midwives and doctors. Moreover, hospitals were not used by the majority of mothers in Belfast until the establishment of the National Health Service (NHS). This goes some way to explain why handywomen continued to be used in Belfast and Northern Ireland by working class women during the first half of the twentieth century. They were traditional birth attendants, but further, they were a more affordable option for many working class women who needed assistance during childbirth.

 Finally, it must be noted that while women, such as Sarah C., did not carry out their practice to a high standard and, at times, put women and infants at risk during childbirth, not all handywomen acted in this way. Indeed, the reputation of handywomen was often diminished by ‘officials’ such as medical and government personnel.[2] This also occurred in  contemporary newspapers. For instance, the Belfast News-Letter, in a report on puerperal fever in September 1911, suggested that deaths from puerperal fever were “proof of the baneful effect of allowing unqualified practice to be carried on in the city.”[3] Now, it is a possibility that handywomen were unfamiliar with, and therefore unlikely to, carry out sanitising measures. However, little attention was placed on doctors who also attended women in childbirth and could therefore spread the illness.

While we know little about the handywomen that operated in Belfast during the twentieth century, as they lack a voice in archival records, newspaper articles such as those on Sarah C., as well as more general articles on the practice of these traditional birth attendants, give us some understanding of their existence and activities. It must be remembered that while some may have been connected to dangerous practice, others offered working class mothers affordable birth assistance, and did their best to provide women with good care. Indeed, the existence of handywomen gave mothers the agency to choose who attended them during childbirth.

Bio

Dr Caitlín Smith has recently completed her PhD at Ulster University and is interested in women’s, medical and social history. Her research is focused on maternal and infant welfare in Belfast between 1900 and 1974. The main aim of this research is to determine whether women and infants in Belfast were at a disadvantage in terms of mortality rates and medical care compared to those in other cities across Ireland and Britain.

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[1] “Irish Midwives Bill: Its powers and penalties,” Belfast Weekly Telegraph 16 February 1918, 2.

[2] For more on perception of handywomen, see for example Ciara Breathnach, “Handywomen and birthing in rural Ireland, 1851-1955,” Gender and History 28 no. 1 (2016): 34-56.

[3] “Puerperal Fever,” Belfast News-Letter, 11 September 1911, 10.