"An abortionist city": Maternal mortality, abortion, and birth control in Sheffield, 1920-1940

Medical History

Volumn 44, Issue 1, 2000, Pages 75-96

  Mcintosh, Tania ^a  

^a UNIVERSITY OF SHEFFIELD   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; EMPIRICAL APPROACH; FAMILY PLANNING; FEMALE; GENETICS AND REPRODUCTION; HISTORY; HUMAN; INDUCED ABORTION; MATERNAL MORTALITY; PREGNANCY; UNITED KINGDOM;

EMPIRICAL APPROACH; GENETICS AND REPRODUCTION;

ABORTION, INDUCED; ENGLAND; FAMILY PLANNING SERVICES; FEMALE; HISTORY, 20TH CENTURY; HUMANS; MATERNAL MORTALITY; PREGNANCY;

EID: 0033649218     PISSN: 00257273     EISSN: None     Source Type: Journal    
DOI: 10.1017/s0025727300066084     Document Type: Article

References (140)

1. The maternal mortality rate is deaths of mothers, from birth-related causes, per thousand births.
2. He was speaking at the Sheffield National Council for Women's Health Conference; Sheffield Independent, 24/5/35, p. 7.
3. Sheffield Telegraph, 24/5/35, p. 8.
4. Fox has argued that maternal mortality never had a particularly high public profile, but in Sheffield it certainly did. The issue was canvassed in the press on a very regular basis, usually as a result of crusading statements by councillors or obstetricians. E Fox, 'Powers of life and death: aspects of maternal welfare in England and Wales between the wars', Med. Hist., 1991, 35: 328-52.
5. The latter was the figure reached even after stillbirths were included in the calculations (from 1927), which had the effect of slightly reducing the total MMR by increasing the total of births into which deaths were divided.
6. Council figures; Sheffield Independent, 24/5/35, p. 7.
7. HM Govt, Report on an investigation into maternal mortality, London, HMSO, 1937, Cmd 5422, p. 216.
8. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
9. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
10. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
11. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
12. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
13. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
14. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
15. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
16. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
17. L V Marks, Metropolitan maternity: maternal and infant welfare services in early twentieth century London, Amsterdam, Rodopi, 1996. On maternal mortality, see I Loudon, Death in childbirth: an international study of maternal care and maternal mortality, 1800-1950, Oxford, Clarendon Press, 1992; on birth control, see A Leathard, The fight for family planning: the development of family planning services in Britain, 1921-74, London, Macmillan, 1980; A McLaren, Birth control in nineteenth-century England, London, Croom Helm, 1978; W Seccombe, 'Starting to stop: working class fertility decline in Britain', Past and Present, 1990, 126: 155-88; R A Soloway, Birth control and the population question in England, Chapel Hill, University of North Carolina Press, 1982; on abortion, see B Brookes, Abortion in England, 1900-1967, London, Croom Helm, 1988; J Keown, Abortion, doctors, and the law, Cambridge University Press, 1988; A McLaren, 'Women's work and regulation of family size: the question of abortion in the nineteenth century', Hist. Workshop J., 1977, 4: 70-81. A useful study of the situation in USA is L J Reagan, When abortion was a crime: women, medicine, and law in the United States, 1867-1973, Berkeley, University of California Press, 1997.
18. C Webster, 'Health, welfare, and unemployment during the depression', Past and Present, 1985, 109: 204-30.
19. G F McCleary, The maternity and child welfare movement, London, P S King, 1935; D Dwork, War is good for babies and other young children: a history of the infant and child welfare movement in England, 1898-1918, London, Tavistock Publications, 1987.
20. G F McCleary, The maternity and child welfare movement, London, P S King, 1935; D Dwork, War is good for babies and other young children: a history of the infant and child welfare movement in England, 1898-1918, London, Tavistock Publications, 1987.
21. Report on . . . maternal mortality, op. cit., note 7 above. Sir Henry Brackenbury (Chairman of the Council of the British Medical Association) suggested that clinical issues had been over-emphasized at the expense of environmental and sociological factors; H Brackenbury, 'Maternity in its sociological aspects', Soc. Serv. Rev., 1937, 18: 37-47.
22. Report on . . . maternal mortality, op. cit., note 7 above. Sir Henry Brackenbury (Chairman of the Council of the British Medical Association) suggested that clinical issues had been over-emphasized at the expense of environmental and sociological factors; H Brackenbury, 'Maternity in its sociological aspects', Soc. Serv. Rev., 1937, 18: 37-47.
23. Report on . . . maternal mortality, op. cit., note 7 above.
24. Report of the Inter-Departmental Committee on Abortion, London, HMSO, 1939.
25. There was some support for a change in the law; Dorothy Thurtle, a member of the Birkett Committee, submitted a Minority Report in which she argued that: "it is unsatisfactory for the law to be flouted with impunity; but when such a situation has arisen, it is necessary to consider whether the law is in accordance with modern thought and tendencies." Ibid., p. 143.
26. F W S Browne, A M Ludovici, H Roberts, Abortion, London, Allen & Unwin,1935, pp. 31, 38.
27. J Gaffin, and D Thoms, Caring and sharing: the centenary history of the Co-operative Women's Guild, 2nd ed., Manchester, Holyoake Books, 1993, p. 107.
28. Br. med. J., 1932, ii: 255, 337-41.
29. Brookes, op. cit., note 8 above, p. 61.
30. 'When is abortion lawful?', Br. med. J., 1937, i: 393-4.
31. Br. med. J., 1938, ii: 225-7; Keown, op. cit., note 8 above, ch. 3.
32. Br. med. J., 1938, ii: 225-7; Keown, op. cit., note 8 above, ch. 3.
33. Loudon, op. cit., note 8 above.
34. Puerperal fever had been effectively described as a contagious disease in the mid-nineteenth century, spread by staff, family, or caused by auto-infection. However, deaths from puerperal fever did not begin to decline until 1935. The initial decline was due to a natural cyclical decrease in the virulence of the causative streptococci. The fall was intensified and given permanence as a result of the introduction of sulphonamides, which dramatically reduced deaths from sepsis after 1937; it was this which caused total maternal mortality to begin its steep decline. For documentary sources on the development of knowledge about puerperal fever, see I Loudon (ed.), Childbed fever: a documentary history, London, Garland Publishing, 1995.
35. In an attempt to tighten up notification, the term "puerperal pyrexia" was adopted in 1926 and defined as fever of any cause within 21 days of childbirth with a temperature of 38°C which was sustained or recurred within 24 hours: I Loudon, 'Deaths in childbed', Med. Hist., 1986, 30: 1-41.
36. Minutes of the Sheffield branch of the British Medical Association, 22/1/26, Sheffield Archives, LD 2384 (4).
37. E Shorter, A history of women's bodies, London, Allen Lane, 1983, p. 100.
38. Loudon, op. cit., note 8 above, p. 107; see also Fox, op. cit., note 4 above, p. 329.
39. Loudon, op. cit., note 8 above, p. 107; see also Fox, op. cit., note 4 above, p. 329.
40. Loudon, op. cit., note 8 above, p. 26.
41. B V Heagerty, 'Gender and professionalisation: the struggle for British midwifery, 1900-36', PhD thesis, Michigan State University, 1990, p. 166.
42. J M Campbell, I D Cameron, and D M Jones, High maternal mortality in certain areas: reports, London, HMSO, 1932, p. 3.
43. Committee on Abortion, op. cit., note 13 above, p. 3.
44. The doctor attached to the Rotherham Birth Control Clinic commented in 1929 on "the number of miscarriages and abortions which no official statistics record", but which women discussed with clinic workers. 'First annual report of Rotherham Birth Control Clinic, 1929-30', p. 3, Contemporary Medical Archives Centre, Wellcome Library (hereafter CMAC), SA/FPA/ A.11/36, Box 313.
45. An article on abortion cases admitted to the Derby City Hospital between 1930 and 1937, showed the difficulties in obtaining accurate figures for procured abortions. Of the 350 cases considered, only 117 were prescribed to a definite cause; nearly 50 per cent of these (63 cases) were natural, due to maternal disease or foetal abnormality. Of the remainder, 57 were adjudged "probably natural", 91 "probably procured", and a further 80, "indefinite"; R G Cooke, 'An analysis of 350 cases of abortion', Br. med. J., 1938, i: 1045-7; see also T N Parish, 'A thousand cases of abortion', J. Obstet. Gynaec. Br. Empire, 1935, 42: 1107-21.
46. An article on abortion cases admitted to the Derby City Hospital between 1930 and 1937, showed the difficulties in obtaining accurate figures for procured abortions. Of the 350 cases considered, only 117 were prescribed to a definite cause; nearly 50 per cent of these (63 cases) were natural, due to maternal disease or foetal abnormality. Of the remainder, 57 were adjudged "probably natural", 91 "probably procured", and a further 80, "indefinite"; R G Cooke, 'An analysis of 350 cases of abortion', Br. med. J., 1938, i: 1045-7; see also T N Parish, 'A thousand cases of abortion', J. Obstet. Gynaec. Br. Empire, 1935, 42: 1107-21.
47. The report specified 3 different types of abortion: spontaneous, natural abortion; therapeutic, undertaken by doctors in what they believed to be the best interests of the patient; and criminal abortions; Committee on Abortion, op. cit., note 13 above, p. 3, see also p. 9.
48. This may well have been ergometrine which was used by doctors to induce labour. It was a purified version of ergot, a mould found on rye, which had been used as an abortifacient for centuries.
49. Sheffield Telegraph, 21/3/34, p. 5.
50. Loudon, op. cit., note 8 above, p. 244.
51. Report on . . . maternal mortality, op. cit., note 7 above, p. 111. The evidence of Charles Cullingworth for London in 1898, and J S Fairbairn for Leeds in the 1920s that MMR was higher in well-off areas was accepted as proof of the dangers of high GP delivery rates. For, example, in Leeds between 1920 and 1921 the maternal death rate was 4.49 per thousand for the city, but up to 5.93 per thousand in middle-class areas, and only 3.01 per thousand in working-class areas. However, in 1929, the MOH for Leeds commented that although two residential wards had the highest MMR between 1921 and 1925, the next four highest were working-class wards. Loudon, op. cit., note 8 above, pp. 244-6. Cullingworth's map of London was reproduced in J M Munro Kerr, Maternal mortality and morbidity: a study of their problems, Edinburgh, E and S Livingstone, 1933, pp. 14-15; see also J S Fairbairn, The medical and psychological aspects of gynaecology', Lancet, 1931, ii: 999-1004, p. 1003; Discussion, 'Puerperal fever and puerperal pyrexia', Public Health, 1927, 40: 205-18, p. 210; Marks, op. cit., note 8 above.
52. Report on . . . maternal mortality, op. cit., note 7 above, p. 111. The evidence of Charles Cullingworth for London in 1898, and J S Fairbairn for Leeds in the 1920s that MMR was higher in well-off areas was accepted as proof of the dangers of high GP delivery rates. For, example, in Leeds between 1920 and 1921 the maternal death rate was 4.49 per thousand for the city, but up to 5.93 per thousand in middle-class areas, and only 3.01 per thousand in working-class areas. However, in 1929, the MOH for Leeds commented that although two residential wards had the highest MMR between 1921 and 1925, the next four highest were working-class wards. Loudon, op. cit., note 8 above, pp. 244-6. Cullingworth's map of London was reproduced in J M Munro Kerr, Maternal mortality and morbidity: a study of their problems, Edinburgh, E and S Livingstone, 1933, pp. 14-15; see also J S Fairbairn, The medical and psychological aspects of gynaecology', Lancet, 1931, ii: 999-1004, p. 1003; Discussion, 'Puerperal fever and puerperal pyrexia', Public Health, 1927, 40: 205-18, p. 210; Marks, op. cit., note 8 above.
53. Report on . . . maternal mortality, op. cit., note 7 above, p. 111. The evidence of Charles Cullingworth for London in 1898, and J S Fairbairn for Leeds in the 1920s that MMR was higher in well-off areas was accepted as proof of the dangers of high GP delivery rates. For, example, in Leeds between 1920 and 1921 the maternal death rate was 4.49 per thousand for the city, but up to 5.93 per thousand in middle-class areas, and only 3.01 per thousand in working-class areas. However, in 1929, the MOH for Leeds commented that although two residential wards had the highest MMR between 1921 and 1925, the next four highest were working-class wards. Loudon, op. cit., note 8 above, pp. 244-6. Cullingworth's map of London was reproduced in J M Munro Kerr, Maternal mortality and morbidity: a study of their problems, Edinburgh, E and S Livingstone, 1933, pp. 14-15; see also J S Fairbairn, The medical and psychological aspects of gynaecology', Lancet, 1931, ii: 999-1004, p. 1003; Discussion, 'Puerperal fever and puerperal pyrexia', Public Health, 1927, 40: 205-18, p. 210; Marks, op. cit., note 8 above.
54. Report on . . . maternal mortality, op. cit., note 7 above, p. 111. The evidence of Charles Cullingworth for London in 1898, and J S Fairbairn for Leeds in the 1920s that MMR was higher in well-off areas was accepted as proof of the dangers of high GP delivery rates. For, example, in Leeds between 1920 and 1921 the maternal death rate was 4.49 per thousand for the city, but up to 5.93 per thousand in middle-class areas, and only 3.01 per thousand in working-class areas. However, in 1929, the MOH for Leeds commented that although two residential wards had the highest MMR between 1921 and 1925, the next four highest were working-class wards. Loudon, op. cit., note 8 above, pp. 244-6. Cullingworth's map of London was reproduced in J M Munro Kerr, Maternal mortality and morbidity: a study of their problems, Edinburgh, E and S Livingstone, 1933, pp. 14-15; see also J S Fairbairn, The medical and psychological aspects of gynaecology', Lancet, 1931, ii: 999-1004, p. 1003; Discussion, 'Puerperal fever and puerperal pyrexia', Public Health, 1927, 40: 205-18, p. 210; Marks, op. cit., note 8 above.
55. Report on . . . maternal mortality, op. cit., note 7 above, p. 111. The evidence of Charles Cullingworth for London in 1898, and J S Fairbairn for Leeds in the 1920s that MMR was higher in well-off areas was accepted as proof of the dangers of high GP delivery rates. For, example, in Leeds between 1920 and 1921 the maternal death rate was 4.49 per thousand for the city, but up to 5.93 per thousand in middle-class areas, and only 3.01 per thousand in working-class areas. However, in 1929, the MOH for Leeds commented that although two residential wards had the highest MMR between 1921 and 1925, the next four highest were working-class wards. Loudon, op. cit., note 8 above, pp. 244-6. Cullingworth's map of London was reproduced in J M Munro Kerr, Maternal mortality and morbidity: a study of their problems, Edinburgh, E and S Livingstone, 1933, pp. 14-15; see also J S Fairbairn, The medical and psychological aspects of gynaecology', Lancet, 1931, ii: 999-1004, p. 1003; Discussion, 'Puerperal fever and puerperal pyrexia', Public Health, 1927, 40: 205-18, p. 210; Marks, op. cit., note 8 above.
56. Report on . . . maternal mortality, op. cit., note 7 above, p. 111. The evidence of Charles Cullingworth for London in 1898, and J S Fairbairn for Leeds in the 1920s that MMR was higher in well-off areas was accepted as proof of the dangers of high GP delivery rates. For, example, in Leeds between 1920 and 1921 the maternal death rate was 4.49 per thousand for the city, but up to 5.93 per thousand in middle-class areas, and only 3.01 per thousand in working-class areas. However, in 1929, the MOH for Leeds commented that although two residential wards had the highest MMR between 1921 and 1925, the next four highest were working-class wards. Loudon, op. cit., note 8 above, pp. 244-6. Cullingworth's map of London was reproduced in J M Munro Kerr, Maternal mortality and morbidity: a study of their problems, Edinburgh, E and S Livingstone, 1933, pp. 14-15; see also J S Fairbairn, The medical and psychological aspects of gynaecology', Lancet, 1931, ii: 999-1004, p. 1003; Discussion, 'Puerperal fever and puerperal pyrexia', Public Health, 1927, 40: 205-18, p. 210; Marks, op. cit., note 8 above.
57. Report on . . . maternal mortality, op. cit., note 7 above, p. 111. The evidence of Charles Cullingworth for London in 1898, and J S Fairbairn for Leeds in the 1920s that MMR was higher in well-off areas was accepted as proof of the dangers of high GP delivery rates. For, example, in Leeds between 1920 and 1921 the maternal death rate was 4.49 per thousand for the city, but up to 5.93 per thousand in middle-class areas, and only 3.01 per thousand in working-class areas. However, in 1929, the MOH for Leeds commented that although two residential wards had the highest MMR between 1921 and 1925, the next four highest were working-class wards. Loudon, op. cit., note 8 above, pp. 244-6. Cullingworth's map of London was reproduced in J M Munro Kerr, Maternal mortality and morbidity: a study of their problems, Edinburgh, E and S Livingstone, 1933, pp. 14-15; see also J S Fairbairn, The medical and psychological aspects of gynaecology', Lancet, 1931, ii: 999-1004, p. 1003; Discussion, 'Puerperal fever and puerperal pyrexia', Public Health, 1927, 40: 205-18, p. 210; Marks, op. cit., note 8 above.
58. Loudon, op. cit., note 8 above, ch. 2.
59. Sheffield Telegraph, 17/5/35, p. 4.
60. SWWC, Annual report, 1933-34, p. 3, Sheffield City Library.
61. Sheffield Telegraph, 21/5/35, p. 6; Sheffield Telegraph, 23/5/35, p. 6.
62. Sheffield Telegraph, 21/5/35, p. 6; Sheffield Telegraph, 23/5/35, p. 6.
63. Sheffield Telegraph, 6/2/36, p. 5.
64. MOH report, Sheffield, 1934, p. 96.
65. Spontaneous abortion ending in sepsis was very rare, so in practice, septic abortions were taken to equal illegal abortions.
66. Sheffield Independent, 18/2/37.
67. Sheffield Independent, 18/2/38.
68. L Colebrook, The story of puerperal fever - 1800 to 1950', Br. med. J., 1956, i: 247-52; J Webb and P Weston-Edwards, 'Recent trends in maternal mortality', The Medical Officer, 1951, 86: 201-4. L Colebrook and M Kenny, 'Treatment with prontosil of puerperal infections due to haemolytic streptococci', Lancet, 1936, ii: 1319-22, p. 1322; the example of the Jessop is mentioned in this paper, but I have not come across any direct evidence relating to the issue. However deaths from abortion seen at the City General Hospital in Sheffield dropped dramatically between 1934 and 1935, despite the numbers of abortion related cases rising; this might suggest a possible cyclical decline in streptococcal virulence. The sulphonamide drug prontosil was discovered in Germany in 1935, and taken up enthusiastically in Britain in the following year. This was mentioned in the Sheffield Telegraph as early as 8/6/36, p. 5, when the trial was still in progress, and illustrates the interest surrounding any possible "cures" for problems in maternity. I Loudon, 'Puerperal fever, the streptococcus, and the sulphonamides, 1911-1945', Br. med. J., 1987, ii: 485-90.
69. L Colebrook, The story of puerperal fever - 1800 to 1950', Br. med. J., 1956, i: 247-52; J Webb and P Weston-Edwards, 'Recent trends in maternal mortality', The Medical Officer, 1951, 86: 201-4. L Colebrook and M Kenny, 'Treatment with prontosil of puerperal infections due to haemolytic streptococci', Lancet, 1936, ii: 1319-22, p. 1322; the example of the Jessop is mentioned in this paper, but I have not come across any direct evidence relating to the issue. However deaths from abortion seen at the City General Hospital in Sheffield dropped dramatically between 1934 and 1935, despite the numbers of abortion related cases rising; this might suggest a possible cyclical decline in streptococcal virulence. The sulphonamide drug prontosil was discovered in Germany in 1935, and taken up enthusiastically in Britain in the following year. This was mentioned in the Sheffield Telegraph as early as 8/6/36, p. 5, when the trial was still in progress, and illustrates the interest surrounding any possible "cures" for problems in maternity. I Loudon, 'Puerperal fever, the streptococcus, and the sulphonamides, 1911-1945', Br. med. J., 1987, ii: 485-90.
70. L Colebrook, The story of puerperal fever - 1800 to 1950', Br. med. J., 1956, i: 247-52; J Webb and P Weston-Edwards, 'Recent trends in maternal mortality', The Medical Officer, 1951, 86: 201-4. L Colebrook and M Kenny, 'Treatment with prontosil of puerperal infections due to haemolytic streptococci', Lancet, 1936, ii: 1319-22, p. 1322; the example of the Jessop is mentioned in this paper, but I have not come across any direct evidence relating to the issue. However deaths from abortion seen at the City General Hospital in Sheffield dropped dramatically between 1934 and 1935, despite the numbers of abortion related cases rising; this might suggest a possible cyclical decline in streptococcal virulence. The sulphonamide drug prontosil was discovered in Germany in 1935, and taken up enthusiastically in Britain in the following year. This was mentioned in the Sheffield Telegraph as early as 8/6/36, p. 5, when the trial was still in progress, and illustrates the interest surrounding any possible "cures" for problems in maternity. I Loudon, 'Puerperal fever, the streptococcus, and the sulphonamides, 1911-1945', Br. med. J., 1987, ii: 485-90.
71. L Colebrook, The story of puerperal fever - 1800 to 1950', Br. med. J., 1956, i: 247-52; J Webb and P Weston-Edwards, 'Recent trends in maternal mortality', The Medical Officer, 1951, 86: 201-4. L Colebrook and M Kenny, 'Treatment with prontosil of puerperal infections due to haemolytic streptococci', Lancet, 1936, ii: 1319-22, p. 1322; the example of the Jessop is mentioned in this paper, but I have not come across any direct evidence relating to the issue. However deaths from abortion seen at the City General Hospital in Sheffield dropped dramatically between 1934 and 1935, despite the numbers of abortion related cases rising; this might suggest a possible cyclical decline in streptococcal virulence. The sulphonamide drug prontosil was discovered in Germany in 1935, and taken up enthusiastically in Britain in the following year. This was mentioned in the Sheffield Telegraph as early as 8/6/36, p. 5, when the trial was still in progress, and illustrates the interest surrounding any possible "cures" for problems in maternity. I Loudon, 'Puerperal fever, the streptococcus, and the sulphonamides, 1911-1945', Br. med. J., 1987, ii: 485-90.
72. L Colebrook, The story of puerperal fever - 1800 to 1950', Br. med. J., 1956, i: 247-52; J Webb and P Weston-Edwards, 'Recent trends in maternal mortality', The Medical Officer, 1951, 86: 201-4. L Colebrook and M Kenny, 'Treatment with prontosil of puerperal infections due to haemolytic streptococci', Lancet, 1936, ii: 1319-22, p. 1322; the example of the Jessop is mentioned in this paper, but I have not come across any direct evidence relating to the issue. However deaths from abortion seen at the City General Hospital in Sheffield dropped dramatically between 1934 and 1935, despite the numbers of abortion related cases rising; this might suggest a possible cyclical decline in streptococcal virulence. The sulphonamide drug prontosil was discovered in Germany in 1935, and taken up enthusiastically in Britain in the following year. This was mentioned in the Sheffield Telegraph as early as 8/6/36, p. 5, when the trial was still in progress, and illustrates the interest surrounding any possible "cures" for problems in maternity. I Loudon, 'Puerperal fever, the streptococcus, and the sulphonamides, 1911-1945', Br. med. J., 1987, ii: 485-90.
73. Attercliffe had a birth-rate of 39.7 per thousand population in 1900, compared to the middle-class district of Ecclesall which had a birth-rate of 28.6 per thousand population in the same year.
74. E M Elderton, Report on the English birth-rate; part 1 England North of the Humber, London, Dulau and Co., 1914, p. 12.
75. T McIntosh, '"A price must be paid for motherhood": the experience of maternity in Sheffield, 1879-1939', unpublished PhD thesis, University of Sheffield, 1997, ch. 3.
76. A D K Owen, 'A report on unemployment in Sheffield', Sheffield Social Survey Committee, Sheffield, 1932.
77. A D K Owen, 'The unemployment problem in Sheffield', manuscript, 1931, Sheffield Archives, MD 1228 (A).
78. J M Winter, 'Infant mortality, maternal mortality, and public health in Britain in the 1930s', J. Eur. econ. Hist., 1979, 8: 439-62, p. 462.
79. Webster, op. cit., note 9 above, p. 213.
80. M Mitchell, 'The effects of unemployment on the social condition of women and children in the 1930s', Hist. Workshop J., 1985, 19: 105-27, p. 119.
81. Even midwives were widowed rather than married; T McIntosh, 'Profession, skill, or domestic duty? Midwifery in Sheffield, 1881-1936', Soc. Hist. Med., 1998, 11: 402-20.
82. Census 1911, table 13.
83. HM Govt, 'Maternal mortality in connection with childbearing and its relation to infant mortality', LGB 44th annual report, 1914-15, Supplement, Cd 8055, p. 122.
84. MOH report, Sheffield, 1909.
85. Owen, op. cit., note 52 above, p. 25.
86. The SWWC ran a voluntary birth control clinic in Attercliffe from 1932; see next section of this paper.
87. A S Williams, Women and childbirth in the twentieth century: a history of the National Birthday Trust Fund 1928-93, Stroud, Sutton Publishing, 1997. Lara Marks has also used the survey in her work on maternity in London; Marks, op. cit., note 8 above.
88. A S Williams, Women and childbirth in the twentieth century: a history of the National Birthday Trust Fund 1928-93, Stroud, Sutton Publishing, 1997. Lara Marks has also used the survey in her work on maternity in London; Marks, op. cit., note 8 above.
89. Williams, op. cit., note 62 above.
90. The City Health Department eventually returned 363 completed questionnaires (completed at the City General hospital), the SWWC, 6 completed questionnaires.
91. Letter from Hilda Cunnington to Lady Williams, 29/3/38; CMAC SA/NBT/S.6/3.
92. Letter from Dr Rennie to Lady Williams, 1/6/37; CMAC SA/NBT/S.6/3.
93. CMAC SA/NBT/S.9/6/2. Questionnaire number 1939.
94. This is not to suggest that any of these substances were necessarily efficacious, although some, including lead and quinine, would probably have had an effect if taken in sufficient quantity. Given the estimate that 20 per cent of all pregnancies abort spontaneously, and that these women were not nutritionally optimal some abortions may have been coincidental to the taking of drugs. The intention to abort was nevertheless real. See also P S Brown, 'Female pills and the reputation of iron as an abortifacient', Med. Hist., 1977, 21: 291-304.
95. Notes made by Pyke on her visit to Sheffield, 19/10/32, CMAC SA/FPA/A. 11/38 Box 313.
96. CMAC SA/NBT/S.9/6/2. Questionnaire number 1892. Slippery elm acted by expanding when wet and thereby dilating the cervix which resulted in miscarriage.
97. CMAC SA/NBT/S.9/6/2. Questionnaire numbers 2026 and 2033.
98. CMAC SA/NBT/S.9/6/2. Questionnaire number 1891.
99. CMAC SA/NBT/S.9/6/2. Questionnaire number 2290.
100. D Pindar, Investigation into abortions; their incidence, causative factors and sequelae, Public Record Office, MH/71/28, p. 4. In Camberwell, London, it was found that the average patient age was 28.4 years. 397 of the cases had 3 or more children, 193 had 2, and 207 had 1; Parish, op. cit., note 32 above, p. 1108.
101. CMAC SA/NBT/S.9/6/2. Questionnaire number 1975.
102. Sixteen out of the 38 non-single women.
103. CMAC SA/NBT/S.9/6/2. Questionnaire number 1980.
104. SWWC, Annual report, 1935-36, p. 6, Sheffield City Library.
105. The Rotherham Clinic ran only from 1929 to 1931 when local apathy, and Council hostility combined to close it down. CMAC SA/FPA/ A. 11/38 Box 313.
106. S Szreter, Fertility, class and gender in Britain, 1860-1940, Cambridge University Press, 1996; D Gittins, Fair sex: family size and structure, 1900-1939, London, Hutchinson, 1982; Seccombe, op. cit., note 8 above; McLaren, 'Women's work', op. cit., note 8 above.
107. S Szreter, Fertility, class and gender in Britain, 1860-1940, Cambridge University Press, 1996; D Gittins, Fair sex: family size and structure, 1900-1939, London, Hutchinson, 1982; Seccombe, op. cit., note 8 above; McLaren, 'Women's work', op. cit., note 8 above.
108. S Szreter, Fertility, class and gender in Britain, 1860-1940, Cambridge University Press, 1996; D Gittins, Fair sex: family size and structure, 1900-1939, London, Hutchinson, 1982; Seccombe, op. cit., note 8 above; McLaren, 'Women's work', op. cit., note 8 above.
109. S Szreter, Fertility, class and gender in Britain, 1860-1940, Cambridge University Press, 1996; D Gittins, Fair sex: family size and structure, 1900-1939, London, Hutchinson, 1982; Seccombe, op. cit., note 8 above; McLaren, 'Women's work', op. cit., note 8 above.
110. McLaren, Birth control, op. cit., note 8 above; P Knight, 'Women and abortion in Victorian and Edwardian England', Hist. Workshop J., 1977, 4: 57-68.
111. McLaren, Birth control, op. cit., note 8 above; P Knight, 'Women and abortion in Victorian and Edwardian England', Hist. Workshop J., 1977, 4: 57-68.
112. McLaren, 'Women's work', op. cit., note 8 above, p. 78.
113. Gittins, op. cit., note 80 above, p. 16; McLaren, 'Women's work', op. cit., note 8 above.
114. Gittins, op. cit., note 80 above, p. 16; McLaren, 'Women's work', op. cit., note 8 above.
115. Szreter, op. cit., note 80 above, pp. 426-8.
116. CMAC SA/NBT/S.9/6/2. Questionnaire number 1965.
117. The old woman apparently did not charge for her services. Cunnington to Williams, 29/3/38. CMAC SA/NBT/S6/3.
118. P Dennell, 'Attercliffe Clinic: a study of a local initiative in the history of birth control, 1933-43', BA Hons Dissertation, Sheffield Polytechnic, 1989, p. 44.
119. Sheffield Independent, 8/8/35, p. 7.
120. Ibid.
121. Sheffield Telegraph, 12/10/23, p. 10.
122. Sheffield Telegraph, 16/10/29, p. 2.
123. Sheffield City Council Minutes 5/3/30. See also Soloway, op. cit., note 8 above, p. 309.
124. Sheffield City Council Minutes 5/3/30. See also Soloway, op. cit., note 8 above, p. 309.
125. Birth Control News, April 1930, p. 183.
126. Asbury explained to Margaret Pyke that the Council was afraid to challenge the Ministry of Health because "the Exchequer Grant, which amounted to £7,037 last year, would be in jeopardy." Asbury to Pyke 29/9/30. CMAC SA/FPA/A.11/38 Box 313.
127. The SWWC had originally wanted to use the premises of the Maternal and Child Welfare Clinic, but this had been refused; Sheffield Branch of NBCA, minutes, Sheffield Archives, LD 2374. The SWWC was an affiliate of the National Birth Control Association (Family Planning Association after 1939), which had been formed in 1930, and founded a local branch in May 1933. By 1938 the NBCA had set up 66 clinics across the country as a reaction to what its members felt was a failure by the state, at national and local level, to address effectively the issue of contraceptive supply.
128. Later raised to £75; SWWC, Annual report, 1937-38, Sheffield City Library.
129. This was opposed by the Conservative group on the Council, although Asbury explicitly stated that the Clinic deserved support because of the high rate of abortion in the city: Sheffield Independent, 3/1/35, p. 7.
130. Campbell, et al., op. cit., note 29 above, p. 42.
131. E Lewis-Faning, Report on an enquiry into family limitation and its influence on human fertility during the past fifty years, Papers of the Royal Commission on Population, vol. 1, London, HMSO, 1949, pp. 7-8.
132. J McCrindle and R Betterton, 'Interview with Mrs Cunnington on the Sheffield Women's Welfare Clinic', 1st November 1981, at Sheffield City Library.
133. Sheffield Independent, 6/7/37; SWWC, Annual report, 1937-38, Sheffield City Library. A clinic was set up in nearby Rotherham in April 1928, but closed in November 1930 due to a lack of funds. CMAC SA/FPA/A.11/36. Box 313.
134. Sheffield Independent, 6/7/37; SWWC, Annual report, 1937-38, Sheffield City Library. A clinic was set up in nearby Rotherham in April 1928, but closed in November 1930 due to a lack of funds. CMAC SA/FPA/A.11/36. Box 313.
135. SWWC, Annual report 1937-38, Sheffield City Library.
136. Sheffield Independent, 22/4/37.
137. SWWC, Annual report, 1935-36, p. 6.
138. The doctor in question was prescribing the tablets "to bring on delayed menses", a description which sounds very similar to the claims made for patent medicines back in the nineteenth century. A very large dose of oestrogen would have had an abortive effect, so the women who came to the Clinic were not wrong in their understanding of what was being offered; although why such a drug was being prescribed is unknown. CMAC SA/FPA/A.4/ A.14/1-5. Box 43.
139. Szreter, op. cit., note 80 above, p. 426; see also C Chinn, They worked all their lives: women of the urban poor in England, 1880-1939, Manchester University Press, 1988, p. 148.
140. Szreter, op. cit., note 80 above, p. 426; see also C Chinn, They worked all their lives: women of the urban poor in England, 1880-1939, Manchester University Press, 1988, p. 148.