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Analysis

The Midwives Act 1902: an historical landmark

30 June, 2008

The Midwives Act 1902: an historical landmark

The 1902 Midwives Act had far-reaching implications for every midwife in England and Wales. This paper explores the legal aspects of the Act and what it meant for practising midwives then and now.
 

The 1902 Midwives Act had far-reaching implications for every midwife in England and Wales. This paper explores the legal aspects of the Act and what it meant for practising midwives then and now.

 

Midwives magazine: November 2002

 

Background

 

The very word ‘midwife’, can be traced back to Anglo- Saxon times. Yet the legal recognition and regulation of midwifery is as recent as 1902. Indeed, parts of the Midwives Act 1902, which Parliament passed on 31 July 1902, did not become fully effective until 1 April 1905.

 

The Act makes quaint reading because it was drafted against the background of Edwardian society and at a time when some practitioners were prostitutes who were reputedly paid in gin. Like surgeons of an earlier age, prior to the Act, they were untrained, unqualified and uncertified. Any woman, or for that matter, any man could practise midwifery.

 

Further statutory provision for training and training grants by local supervisory bodies did not come in until 1919 by virtue of the later Midwives Act 1918: s11.

 

The purpose of the 1902 Act

 

The stated purpose of the Act was ‘to secure the better training of midwives and to regulate their practice’. A woman could not call herself, nor practise as a midwife, unless she was certified under the Act. If she contravened this, she was liable to be fined by her local magistrates’ court up to £5. However, until 1 April 1910, there was a loophole — a woman could still practice midwifery, providing she didn’t call herself a ‘midwife’ or imply that she was one.

 

One wonders how a woman could attend upon deliveries and yet not imply that she was a midwife. After that date, no woman (Parliament assumed men, unless doctors, would not be involved) could habitually or for financial reward attend a woman in childbirth unless certified.

 

However, there were some escape clauses. It was open to women who worked under the direction of a doctor to do so. Also, before 1 April 1903, any woman who could claim entitlement to certification under the 1902 Act if she held a certificate in midwifery from one of the following institutions: the Royal College of Physicians of Ireland, the Obstetrical Society of London, the Coombe Lying-in Hospital and Guinness’s Dispensary, the Rotunda Hospital for the Relief of the Poor Lying-in Women of Dublin. Added to that was the requirement that ‘she bears a good character’. By 1910, the maximum penalty for breaches increased to £10. The realities of life were acknowledged and so there remained one general defence — anyone could act in an emergency.

 

Central Midwives Board

 

The Act enabled a cabinet minister, the lord president of the council, to set up the first Central Midwives Board, consisting of four doctors, one of whom was to be appointed by the Incorporated Midwives Institute, two people — one had to be a woman — appointed by the minister, one person appointed by the county councils, one by the Queen Victoria’s Jubilee Institute for Nurses and one by the Royal British Nurses Association. The Act stipulated the need for a Board secretary and other officers as might be required.

 

Certification

 

Certification involved complying with rules and regulations. Any woman who obtained a certificate fraudulently could receive up to 12 months imprisonment, with or without hard labour. The Act contained seemingly undue restrictions. A midwife could not grant any medical certificate, certificate of death or of stillbirth. She could not take charge of ‘abnormal’ cases or disease connected to parturition — a doctor was required.

 

The roll of midwives

 

The Central Midwives Board was made responsible for issuing midwives’ certificates and for laying down the conditions for admission to a new roll of midwives, which the Act enabled to be established. The secretary of the Board was responsible for keeping the roll. If a woman’s name did not appear on the roll, she would have problems in practising. Omission amounted to initial evidence in the magistrates’ court that she was practisingwhile uncertified, which was a criminal offence.

 

The Board was charged with making rules for regulating, supervising and restricting the practice of midwives and setting up examinations. It could charge for examinations and certificates, but no more than £1.05. Every year the Board had to publish the updated roll of midwives. The Board was given fairly extensive regulatory powers, but the rules made by the Board for those purposes had to be sanctioned by the King’s Privy Council. Before that could be done, consideration had to be given to any representations from the General Medical Council. The Board had the power to remove a woman’s name from the roll, but she had a right of appeal to the High Court.

 

In those days, prior to legal aid, that would have been a cumbersome and expensive procedure, and of little help to the average midwife aggrieved by the removal of her name. In addition to the supervisory functions of the Board, county, county borough and district councils had roles in those pre-NHS and pre-line manager days. The Act made local authorities the ‘local supervising authority over midwives’ (Midwives Act 1902: s8). They had to exercise general supervision over midwives practising within their area and to investigate allegations of malpractice, negligence or misconduct. If satisfied that there was a case to answer, they had to report it to the Central Midwives Board.

 

It is perhaps a mark of the times that they could suspend a midwife from practice if it appeared necessary, ‘in order to prevent the spread of infection’ — these were not specified in the Act. Midwives had to keep clear of the criminal law, for if they were found guilty of any offence, the local authority had to report them to the Board. How would a local council know a woman was in fact practising in its area as a midwife? Before a woman, already a certified midwife, could lawfully practice in its area, she had to give written notice to the council of her intention to practice and give repeated notices every following January. If she did not she could be fined up to £5.

 

Later amendments to the Midwives Act

 

The Midwives Act 1902 was amended and added to by later midwives acts in 1918, 1926 and 1936. The 1902 Act survived into the NHS era — the National Health Service Act 1946 (section 23) retained it, but made local health authorities the supervising authorities in place of the local councils.

 

Acknowledgement

 

I would like to thank Mrs Julie Cook SRN, SCM for her assistance and encouragement in preparing this article.   

 


Robert Stevens is a barrister and lecturer in family law

   

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