Preston’s first qualified midwife/nurse - Elizabeth Phillips
This article has been in the in-tray for several months - reserved because despite
considerable research and an e-mail correspondence, I didn’t know the full identity
of this lady. I knew her last name (Phillips) and that she served the village community
from January 1911 until the end of 1915. There was also a photograph of her in Mrs
Maybrick’s Scrapbook (shown above) but that was the sum total of what was known.
Then, in September 2016, the web-site, Ancestry.co.uk, released details of British
historical midwives and many of the blanks about Nurse Phillips’ life could be filled
in - although her origins are still a mystery......
Before the eighteenth century, women in labour were traditionally attended by other
women. These included friends and relatives with experience or women who made it
their profession. Women became midwives through an ‘apprenticeship’ by attending
labours, particularly in the company of another midwife.
With no official system of regulation, midwives were normally self-appointed, self-taught,
and often illiterate. While they may have been skilled at the normal delivery of
healthy women, they had no training for dealing alone with obstetric and paediatric
complications. They also had little education of any kind and so lacked theoretical
knowledge of even basic reproductive anatomy, physiology and pathology.
As a result, the ‘profession’ was riddled with backward and dangerous practices.
The view of the “incompetent midwife” was popularised by Charles Dickens in Martin
Chuzzlewit, wherein Sarah Gamp (right) was lampooned as an alcoholic midwife, sick
nurse and layer-out of the dead .
Haunted by high mortality rates of mothers and babies, this lack of regulation could
not continue. The Midwives Act of 1902 set up the Central Midwives Board (CMB) for
England and Wales. This was responsible for the regulation of the certification and
examination of midwives, the regulation of the practice of midwives and the appointment
of examiners. The approved period of training was three months and midwives were
encouraged to keep a case book of all deliveries.
Women who possessed a recognised qualification in midwifery were automatically admitted
to a Roll of qualified midwives under the Act. Women of good character who had been
in practice for at least one year could also apply for admission to the Roll as ‘bona
fide’ midwives. All other women intending to become midwives had to take an examination
in competence before a certificate was issued which allowed them to practice. From
April 1910, no person could habitually and for gain attend women in childbirth, except
under the direction of a doctor, unless she was certified under the Act.
The dangers for mother and baby during labour before 1902
The Birth of Benjamin and the Death of Rachael - D Chiesura
Everyone, especially the expectant mother, was morbidly aware of the risks of childbirth.
In the seventeenth century, Joseph Hall, Bishop of Exeter, wrote ‘Death borders
upon our birth and our cradle stands in the grave’. Only recently has the giving
thanks to God for, ‘The safe deliverance and preservation from the great dangers
of childbirth’ been removed from the Church of England prayer book from the service
for the ‘churching of women who had recently given birth’.
Although death rates from many other conditions were high, they at least were among
people who had been ill beforehand. Death in relation to childbirth was mostly in
fit young women who had been quite well before becoming pregnant. They died, often
leaving the baby, and other children in the family from previous births, with a widowed
husband. The graph below shows the annual death rate per 1000 total births from maternal
mortality in England and Wales (1850-1970)
The main causes of maternal mortality were puerperal pyrexia, haemorrhage, convulsions
and illegal abortion. Puerperal pyrexia was thought to be due to some vapours in
the air which could be carried mysteriously from one woman to another. It was only
with extreme reluctance that the medical profession accepted that such transmission
could be by the birth attendants or as Alexander Gordon wrote as early as 1790 ‘...
it is a disagreeable fact that I, myself, was the means of carrying the infection
to a great number of women’. In America, Oliver Wedell-Holmes also avowed that ‘...
the disease known as puerperal fever is so far contagious as to be frequently carried
from patient to patient by physicians and nurses.’ Both men were vilified for holding
and promulgating this view.
Puerperal pyrexia was caused by midwives and doctors and remained a common cause
of death in childbirth until the early part of the twentieth century. Infectious
organisms on the hands of the birth attendants were transferred to the woman’s uterus.
The disease usually began on the third day after delivery. Typical symptoms included
high temperature; severe headache; raised pulse; severe abdominal pain; vomiting
and diarrhoea. Death occurs when the infection spreads, resulting in peritonitis
At Gosmore (near Preston) on 28 August 1862, my great grandfather, Thomas Currell’s,
first wife , Mary Ann (nee Watson) died of ‘puerperal fever’ leaving him a widower
with four small children.
Midwives and nurses at Preston before 1911
Information about the care of the sick, elderly and pregnant at Preston during the
years leading to 1911 is sketchy. The Fenwicks and Brands of Temple Dinsley employed
their own nurses and nursemaids. Two local farmers with young families had a resident
nursemaid. In 1901, Mary Ann Bell (64) of Back Lane was recorded as a midwife and
in that same year, Elizabeth Roberts of Sootfield Green was noted as a ‘monthly nurse’
(who attended mothers after the birth of a child). In 1851, Sarah Sharp (63) was
described as a ‘nurse’. Between 1871 and 1891, my greatx2 grandmother, Susan Currell
(born 1802) served the local community as a midwife and monthly nurse. As the mother
of Thomas Currell, was she the carrier of the organism that carried off Thomas’ wife,
In the absence of more local information, we fall back once again on the recollections
of Edwin Grey at nearby Harpenden (ten miles south-west of Preston) which likely
mirrored the circumstances at Preston in the late nineteenth century. He wrote, ‘I
don’t remember in my young days that there were any certified maternity nurses or
qualified parish nurses in Harpenden....The people seemed to depend in maternity
cases upon the elder and more experienced of the married women just round about (note
the ages of the ‘midwives’ at Preston noted above)...several of the elder of the
cottage women were very clever and efficient midwives. They couldn’t stay, but would
go to the cottage each morning and night for some little time after the birth to
attend to the mother and child, wash, change and put them comfortable. At other times,
neighbours would take turns to pop in. The fee charged by these cottage midwives
was five or six shillings, sometimes as low as 2/6d....now and again they got nothing
at all but a promise.
‘Parcels of linen (“baby parcels” or “bundles”) of clothes, sheets and counterpanes
were loaned for a month.’ In cases of sever illness when a watch was kept day and
night, ‘some of the young women and also some young men would volunteer to take on
night duty in turn so that members of the family could in turn take their rest. One
woman watcher would be in the room with the patient. Another watcher would see that
the fire was kept going and a lot of hot water (was) always at hand. They would also
be in readiness to render any assistance if required. Also, about 3.00 am a cup of
tea would be prepared for her/himself and the watcher in the bedroom.’
When a contagious disease (such as smallpox) struck, the affected family kept to
themselves as much as possible and children were told not go play nearby. When a
villager fell ill, a doctor was called or an old experienced person would advise
treatment. It was hard to isolate the patient in a small home with few rooms and
a large family. Whooping cough might be treated by inhaling sulphur at a gashouse;
eating a fried mouse; making a sandwich from the sick person’s hair and giving it
to a cat to eat – such were the old wives’ remedies.
Villagers also put faith in homely medicines such as salts and senna, brimstone and
treacle and also the healing virtues of ‘yarbs’ (herbs). Stewed groundsel was used
for poultices; marshmallow leaves, for boils; lily leaves for cuts; dock leaves for
galled feet; dandelion roots, for liver problems; ‘Yarb tea’, for general health;
old men carried small potatoes in their pockets to ward off rheumatism.
A picture of midwifery and maternal care in Hertfordshire around 1913
In 1911, Ethel Margaret Burnside (Hertfordshire’s first “chief health visitor and
lady inspector of midwives”) assembled a team of midwives and nurses charged with
improving the health of children in Hertfordshire.
A midwife attended women during childbirth and recorded the birth weight of their
offspring on a card. A health visitor subsequently went to each baby’s home throughout
its infancy and recorded its illnesses and vaccinations, development and method of
infant feeding and weaning; the baby was then weighed again at one year of age. This
information was transcribed into ledgers at the Hertfordshire county office. The
ledgers cover all births in Hertfordshire from 1911 until the NHS was formed in 1948.
(We will return to these records later.)
Two years later, the Hertfordshire Express reported that from 1 Jan 1912 to 31 Dec
1912, 3,179 cases were handled by midwives and monthly nurses (midwives: 2,491 )
(down sixty-seven on 1911; thirty-five cases of twins) and 688, by doctors. The number
of babies born alive was 3,081. Fifty-two died before the tenth day and forty-three
after the midwife had stopped attending. Medical aid was sought on 276 occasions
(11%), fifty-eight for the baby. In the county there were twelve maternal deaths
during 1912 which involved cases dealt with by midwives and monthly nurses, of which
only four were associated with midwives.
However, during 1916 in the Stevenage district, it was reported that ‘many villages
had been without a midwife’. Consequently, the local Government Board and Hertfordshire
CC, together with subscribers, formed an association of Stevenage, Graveley and Shephall
to employ two nurses – one for all sick nursing, health visiting schools and TB;
to the other fell the duties of midwife and maternity nurse. In cases of complications,
they were to call in a doctor.
The Hertfordshire newspapers of the nineteenth century confirm this view of untrained
midwives. This account appeared in the Hertfordshire Express on 27 October 1855:
Preston’s first midwife/nurse
With a flourish, in January of 1911, the St Mary’s, Hitchin Parish News announced,
“We all welcome Nurse Phillips to Preston and trust that she will be happy in her
work amongst us. Several cases of illness have quickly shown how useful it is to
have a resident nurse in the village. The generous terms of securing this help should
induce all to become subscribers”.
Some information is available about Nurse Phillips (1874 - 1947). Her full name was
Elizabeth Phillips and she was born on Boxing Day, 1874 - making her thirty-seven
years of age when she arrived at Preston. Her origins are undiscoverable, although
an educated guess is that she was Welsh - the majority of females born with that
name around that date were Welsh - and Elizabeth later lived and died in Pembrokeshire,
Elizabeth qualified as a midwife on 7 April 1909 and the following year she was a
resident at the Royal Nursing Association, London Road, Derby.
She was apponted as Preston’s first local nurse being on-hand to minister to the
needs of villagers who stumped up the necessary subscription. These were as follows:-
cottagers, 2/6d per annum, (included mother and father and children up to fourteen
years of age). Children over fourteen years of age, 1/3d pa, until the age of twenty-one.
Young men and women at home earning wages, over twenty-one years of age, 2/6d. Farmers
not less than 5/- pa.
Nurse Phillips at Preston 1/1/1911 - 31/12/1915
Something of Nurse Phillips activities in the village as health visitor and midwife
can be gleaned from relevant entries in the school logbook (which noted outbreaks
of epidemics) that follow and the known births at Preston during this period.
12 October 1911 ‘Two children from Offley Holes are down with diphtheria’. The school
was closed on Friday afternoon and desks thoroughly scrubbed. 23 October 1911 ‘The
two little Barretts are still away and no fresh cases have broken out.’ (They were
still noted as absent on 9 January 1912)
In September 1912 there was an outbreak of whooping cough and on 23 September only
47 children attended the school as a result. This was followed by an outbreak of
measles. The school was closed on 4 November and after an abortive attempt to re-open
on 2 December, school was next convened for the new term on 7 January 1913.
On 19 May 1914, there was a note that three children were sent home ‘as they smell
very badly. The village nurse has been to see the mother.’ The following morning
all were back in school – ‘they are clean now, having had a change of clothing and
a good washing’.
On 19 February 1915 Dr Day instructed that the school be closed until 8 March 1915
owing to an epidemic of influenza.
When the autumn school term began on 31 August 1915, only thirty-four attended out
of fifty-seven due to an outbreak of impetigo.
In February, 1914, the St Mary’s, Hitchin newsletter commented, ‘Several instances
of the valuable work done by the Parish Nurse in Preston and Langley have recently
come to our notice; and we take this opportunity of expressing appreciation of the
We are glad to know that so many of our parishioners are subscribers. It sometimes
happens that times of sickness come to those who have not joined, and so have no
right to the service of the nurse. Surely when a very small yearly payment is asked
for, it is not too much to hope that everyone should see to it that they become members
and can call in the devoted attention of Nurse Phillips in the hour of need.’
Next are listed children (16) born at Preston between 01/01/1911 and 31/12/1915.
These include children who attended Preston School and those who died in infancy
and who were buried at St Martin’s. It is impossible to identify those children who
were born at Preston but whose parents moved away before they went to school.
17/03/1911 WHITE, Norah Mary Arthur White Preston Green
June 1911 PRUTTON, Dennis Josiah Prutton Church Lane (buried
08/11/1911 CULLUM, Constance William Cullum Temple Dinsley Lodge
27/06/1912 CLAXTON, Ella William Claxton The Chequers
03/02/1912 HAMMOND, Hilda Ernest Hammond Chequers Lane
11/07/1912 DARTON, Reginald Harry Darton Temple Farm
June 1912 PRUTTON, John Josiah Prutton Church Lane
July 1912 THRUSSELL, Jack (buried 22/04/1913)
04/08/1912 JENKINS, Horace William Jenkins Hitchwood
07/01/1913 HAMMOND, Herbert Ernest Hammond Chequers Lane
20/02/1913 JENKINS, Willie Herbert Jenkins Hitchwood
26/04/1913 CHALKLEY, Mary Harriet Chalkley Preston
April 1913 GARNER, Edward George Garner Poynders End
28/03/1913 JENKINS, Edith Ernest Jenkins Chequers Lane
30/04/1913 CULLUM, Violet William Cullum Kiln Wood
02/02/1914 HAMMOND, Kathleen Ernest Hammond Preston Green
(Note: There is a significant gap in this list of births to Preston folk between
2 February 1914 and 31 December 1915. For much of this time, Britain was at war and
many of the village’s young men were embroiled in the conflict. Also, there was considerable
migration into and out of Preston during this time of uncertainty)
According to the ledger records, there were sixteen births recorded at Preston addresses
between 1913 and 1916. Eight (seven boys and one girl) of these were delivered by
Nurse Phillips. The remainder, by Doctors Charles Grellet (born 1842), James Gilbertson
(born 1860) and Barnes who were based at Hitchin.
In January 1916, the St Mary’s, Hitchin newsletter noted, ‘The two hamlets of Preston
and Langley are very sorry to lose Nurse Phillips, who is leaving the district about
the middle of this month. When the Nurse came, people asked “What is there for her
to do? Now she is going, the question is “What are we going to do without her?”
Nurse Phillips has unfailingly done her best. She was at the beck and call of all,
and night or day she rose to that call. We wish her every good wish, and long will
she remain in our memory.’
The following month a letter of thanks from Nurse Phillips was published: ‘To the
Parishioners of Preston and Langley. I take this opportunity of thanking you all
for the very handsome gifts given to me, and for the many kindnesses shown to me
while I have been here. I will carry away with me not only your lovely gifts, but
also memories of four very happy years.
I hope you will make the path of my successor as smooth as you have made mine. Wherever
my work may take me my thoughts will still go back to the grateful patients and kind
friends of Preston and Langley. Again thanking you all, and wishing you all good-bye.
Yours faithfully, E. PHILLIPS.’
So where did Elizabeth go? She is still noted as being at Preston in the CMB records
of 1920 - though clearly she had left four years earlier. From her letter, she planned
to continue working as a nurse. Perhaps her move was related to some war-time work.
A tentative note was made about Nurse Phillip’s replacement, ‘With regard to the
nurse for Preston and Langley, Mrs. Dawson asks us to announce that an arrangement
has been made for the present for Nurse Cummins, who has just taken up her residence
at the Kings’ Walden Nurses’ House, to undertake duty also in Preston.’ However,
one wonders if this arrangement ever got off the ground - Mary Cummins is not listed
as a midwife at Kings Walden or Preston and she is not mentioned in any documents
relating to Preston.
Elizabeth Phillips appears to be Preston’s first, and last, midwife/nurse.
Nurse Phillips leaves Preston - 31/12/1915
Nurse Phillips 1926 - 1947
Elizabeth is next found at Hook, Treffgarne in Pembrokeshire from 1926 until 1935,
when she was sixty years old. The 1939 Register describes her as single, a retired
District Nurse and living alone at Mantawel, Haverfordwest Road, Ambleston, Pembrokeshire
(shown below) which was near Treffgarne and about three miles east of the A40 which
links Fishguard and Haverfordwest..
She was still living there when she passed away on 24 February 1947 - though the
place of death was Myrtle Cottage Ambleston. Elizabeth’s estate was valued at £1,354
and was administered by the farmer, John Phillips and James Philips, who was a lorry
Another CMB-qualified midwife living at Preston
This article cannot be left without mentioning another qualified midwife who lived
at Preston, Florrie Sugden. She qualified on 24 May 1930 and worked from that time
until at least 1951 at Foxholes Emergency Maternity Home, Hitchin. In 1938, she expressed
at intention to practice at Norwich and gave her address as 58 Unthank Road. Florrie
was my aunt - Flossie (nee Wray) as we knew her - who lived with her parents and
her sister Nan at 5 Chequers Cottages..
This information is of interest to the writer as Flossie returned to Preston after
a failed marriage in Pakistan/Waziristan. She does not figure in the register of
Preston electors raised in 1929 - a fact I have wondered about. Perhaps these two
pieces of information indicate that Aunt Flossie came back to the village in around
A little-known research resource re: those born in Hertfordshire 1911 - 1948
Earlier I wrote that information about births in Hertfordshire ’was transcribed into
ledgers at the Hertfordshire county office. The ledgers cover all births in Hertfordshire
from 1911 until the NHS was formed in 1948.
As part of a nationwide search of archives, staff working at the MRC Unit, University
of Southampton, discovered the Hertfordshire ledgers. The ledgers were computerised
and linked to mortality records using the National Health Service Central Register
(NHSCR). In the early 1990’s, surviving men and women who were born between 1920
and 1930 and still resident in Hertfordshire were contacted through their General
Practitioner and those who were willing underwent detailed physiological investigations
to explore life-course influences on adult disease. 717 men and women resident in
North Hertfordshire attended home interviews and clinics where a wide range of markers
of ageing were characterised. These clinics comprised the first follow-up of the
Hertfordshire Ageing Study (HAS) which was the first to demonstrate that size in
early life is associated with markers of ageing in older people.
The important aspect of this is that there appears to be a comprehensive record of
births and early childcare of Hertfordshire people over thirty-seven years which
has remarkable details for the family historian. That’s the good news. The bad news
is that the ‘100-year’ rule probably applies to the dissemination of this information
- and only those related to the person born may have access to the data.
The arrangements also stipulated that non-subscribers could have the attendance of
the nurse for 3d. per visit, but if the nurse being required by two persons at once,
the annual subscriber had the first turn. Confinement cases were 2/6d extra to annual
subscribers of 2/6. If the nurse was required to live in the cottage, the charge
was 2/6d for the first ten days and 1/3d per week afterwards for a month. The Nurse
had to be withdrawn at the end of the month.
Visits by the nurse were made after contacting the secretary, Mrs N. Dawson, Temple
Dinsley, Preston. In the case of sudden emergency, when there is not time to obtain
leave from the Secretary, the nurse may be applied to direct, but notice must be
given to the Secretary immediately. If the nurse was required for a confinement case,
at least two months’ notice was given to the Secretary.. The nurse was not to be
given a gratuity, beer or spirits. On visiting a house, the nurse would to make the
patient and family as comfortable as possible, doing any light work.
Chris Reynolds of the Hertfordshire Genealogy web-site has kindly added the following
comments about this article: