After World War II, the United Kingdom created the National Health Service, which provided medical care free of charge to its citizens. This was a marked change for the poor, and for the first time, many women were able to receive pre-natal care and to have trained assistance in delivering their babies. This was a boon that caused a huge drop in both maternal and infant deaths, and also a huge demand for nurses and midwives.
Ms. Worth was a licensed district nurse and midwife in the 1950s in London's East End. The population of the area was working class and often poor. Large families lived in small two- or three-room apartments, often sharing communal bathrooms with other families, and conditions were rarely up to modern sanitary standards. Few people had telephones in their homes; if you wanted to make a call, you had to walk to the nearest public phone which was sometimes several blocks away. Many building damaged by bombings during World War II were still standing, and tenements that had been ruled unfit for habitation were often occupied regardless.
Ms. Worth, or Jenny Lee as she is known in the book, starts her career completely out of her element. The environment is a stark contrast to her middle-class upbringing on the other side of London, and at first she is barely able to conceal her confusion at the Cockney dialect everyone speaks, and her contempt and disgust for some of her patients and the living conditions that surround them. Jenny Lee, who describes herself as uninterested in religion, was also flummoxed to find herself based out of a convent instead of the small, private hospital she was expecting.
Over the course of her time and work with the Sisters of St. Raymond Nonnatus, Jenny Lee grows up quite a bit. At first aghast at living in a convent, fully staffed with nuns, she says, "convents were for Holy Marys, dreary and plain. Not for me." Then, as she becomes acquainted with the sisters, she begins to admire them each greatly. "All nuns, by the very fact of their monastic profession, are exceptional people. No ordinary woman could live such a life. There must inevitably be something, or many things, that are outstanding about a nun." Even those with whom she doesn't get along particularly well, she highly respects for their individual skills and talents. Her attitude toward religious life changes, too. By the end of the book, Jenny often sits in the chapel while the sisters sing their offices and finds peace and comfort in their faith, if not her own.
Jenny also has many opportunities to learn compassion for others and that life isn't always as black-and-white as we'd like it to be. In one heart-breaking story, she meets a young pregnant girl, Mary. At the age of 14, Mary had been tricked into working as a prostitute, eventually became pregnant, and ran away to avoid having her baby forcibly aborted by her pimp. After a chance meeting, Jenny befriends Mary, and helps her find a safe place to stay and have her baby, a home dedicated as a refuge for prostitutes. Unfortunately, with no family to help Mary, and no means of support for herself and her baby, Mary's baby is taken away and placed for adoption.
When Jenny learns of this she angrily stalks into the Reverend Mother's office to demand the baby be returned, only to have the Reverend Mother share her sorrow at separating Mary and her baby, but her conviction that it is best for both the child and mother. The child will be raised in a good Catholic home, she says, and without a baby, Mary will be able to find a post working in service. Otherwise, she will have no way to earn money, other than to return to prostitution. With the social realities of the time, they would not be able to survive together, but separately, they each have a good chance. This harsh truth is hard for Jenny to swallow: "I could, perhaps should, have said many things, but I was silenced by my own knowledge of the statistics of child mortality, by the depth of understanding in her worlds, and by the sadness in her eyes."
Again and again, Jenny learns that people are not one-dimensional caricatures and that first impressions can be wrong or misleading. She tells of a woman, Lil Hoskin, whom she found, well, revolting would not be too strong a word, at their first meeting. Lil's lack of hygiene and loud, brash behavior was off-putting, but the nail in the coffin of Jenny's good opinion came when Lil hit one of the children she had in tow at the antenatal clinic. "I hated her from that moment," Jenny said. The next day Jenny dreaded doing a home visit, only to realize that the Hoskin family lived in a building which had been condemned for demolition fifteen years earlier, had one a single tap for water and a single lavatory on each floor. She had a realization:
Lil seemed different in her own surroundings. Maybe the clinic had intimidated her in some way, so that she had felt the need to assert herself by showing off. She didn't not seem so loud and brash in her own home. The irritating giggle, I realised, was no more than constant and irrepressible good humour. She pushed the children around, but not unkindly...In her own surroundings, Lil was not a disgusting old bag, she was a heroine. She kept the family together, in appalling conditions, and the children looked happy. She was cheerful and uncomplaining.Yes, The Midwife: A Memoir of Birth, Joy, and Hard Times is about the women whose babies the midwives delivered and their families. But primarily it's about a young woman facing a world that is different from what she expected, opening herself up to serving and learning from it, and finding the beauty and joy that exists in even the darkest, harshest situations.
(Stayed tuned for my review of the second book in the series, Shadows of the Workhouse, to be published tomorrow.)
The Midwife: A Memoir of Birth, Joy, and Hard Times