Most of this book has been about nursing in institutions. This is an appropriate emphasis for a study of the development of the modern occupation which is so dominated by the experience of hospital work and the sheer numbers of active registered nurses employed in it. But we must keep its historical place in proportion. At the outset we stressed that most nursing work in the nineteenth century, as always, would have been performed by other members of the sick person’s household. The poor might engage a handywoman of their own class to assist while the better-off hired a private nurse to supplement their other servants. Both types of care provider became more or less extinct during the inter-war period. This chapter and the next will attempt to account for their decline and to examine how the social space which they vacated was colonized and redefined as part of the domain of the official occupation of nursing. In present day terms, we shall be considering the work of midwives, health visitors and district nurses, although it is important not to impose these categories uncritically onto the historical record. Each of these specialties has tended to be the subject of separate studies, often for the purpose of constructing a distinctive official history and furthering sectional claims to particular elements of their common work. The result is a literature which substantially overstates their differences.
For the purpose of exposition, we shall have to divide our own account, concentrating on midwifery in this chapter and the other types of home nursing in the next. Before embarking on this, however, it is essential to balance the division by signalling their common features. As we shall show, all three of these specialties exemplify the same conflict between attempts to create ‘new professions’ for middle- or upper-class women and to co-opt the handywoman class in the moral regulation of the sick and their