Friday, 29 April 2016

Medicalising Motherhood: a peek inside LHSA’s birth records

This week, Archivist Louise has been introducing LHSA’s maternity records to new audiences:

As Archivist, I’m sometimes asked to talk to organisations about the records that we have and what we do, and last week the Scottish Genealogical Society asked me to go along to give an evening lecture on birth records.

Maternity records are often confused with birth certificates, but whereas the latter are statutory records, the registers and accounts of births that we hold are very much medical ones. Our earliest records of birth date from 1825, from the Edinburgh Lying-In Institution, and we have some maternity register entries that go right up to the early 1990s. As opposed to birth certificates which give biographical detail on parent(s) and child, the records that we hold are created in the course of a mother’s treatment and care and give relatively scant biographical detail and (unless a particular factor affects pregnancy or postnatal care) do not record what happened to mothers prior to admission or to mothers and children after they left the hospital (although a forwarding address is sometimes given). This is not to say that these records hold back, though, as this detailed description of a birth attended by nurses from Elsie Inglis’ Canongate Hospice shows!
Excerpt from Records of Confinement, The Hospice, 1907 ( LHB8A/12/1).
Nevertheless, birth records have much to offer genealogical researchers, in that they can reveal certain details that the ‘official’ record leaves out – one of our enquirers found out the name and address of a child’s father from one of our 1860s’ birth registers, for example, which was not recorded elsewhere. Genealogists usually contact us following the discovery that an ancestor was born in one of our region’s hospitals after looking at statutory records, usually via ScotlandsPeople. Until the mid-1920s, that hospital is invariably the Edinburgh Royal Maternity Hospital (ERMH), later the Simpson Memorial Maternity Pavilion (SMMP). For this institution, I’d normally find a birth recorded in a Register of Births (LHB3/14), which would tell me more about the parents of the child and their background, including their native place, the age of the mother, where the parents had originally come from and where they were going to after the birth. You’ll notice that, in the image below, there’s a column for the occupation of the mother if illegitimate, and the occupation of the father if the child was legitimate.
Page from ERMH Register of Births, 1885 (LHB3/14/4)
This emphasis on legitimacy gives us a clue about the purpose of the hospital: the ERMH was originally founded in 1844 as a place where poor women could give birth in a medicalised environment. It started off in Nicolson Street, but by 1879 settled in a new building in Lauriston Place, becoming Edinburgh’s first purpose-built maternity hospital. The original rationale for the hospital meant that it treated women with few other places to go. The ‘Mother’s occupation’ column in these registers in and after this period is peppered with shop assistants, farm workers and domestic servants, for example – (usually) young working women with no option to give birth at home, as most other women did until the mid-1920s when hospital births grew in popularity in the city. The relatively high number of illegitimate births in the ERMH could also be explained by the close proximity of the Lauriston Home (later the Haig Ferguson Home), a home for unmarried women undergoing their first pregnancy, founded by Dr James Haig Ferguson in 1899.

Constitution of the Lauriston Home, 1913 (GD1/7/1)

 Although we have some administrative records from this home, no records of the pregnant women confined there have survived. The ERMH Registers of Births will tell you if a mother came from the home though, giving a clue as to her circumstances. If you’d like to read about one LHSA researcher’s discovery of the Lauriston Home’s role in her own ancestor’s past, you can read an excellent account here

The next thing that I’d look for is an account of the birth itself – which focuses on medical facts, about mother and child. In this record, an Indoor Casebook from the ERMH, you can see the names and ages of mothers, but also stages in the processes of pregnancy:

Entries from ERMH Indoor Casebook, c. 1870s (LHB3/16/1)
With a bit of research into acronyms, you can see how the child was born and the health of mother and child after the birth. An interesting point for genealogists is that previous numbers of pregnancies were recorded – hinting whether there might be further ancestors to explore. The way in which this information was written varies through the years, but the type of detail remains very similar – even now, some people who have never known facts about their birth like to look at their own register entry to see how heavy and how long they were as a newborn, for example!

Of course, as medical science progressed and years went on, the style in which births were recorded changed. In my talk, I found that this table from the front page of a 1971 admissions book for the SMMP (descendant of the ERMH at the Royal Infirmary of Edinburgh) was a sharp illustration of this:

Front page from SMMP Admissions (LHB3/12A/21).
Key information about the length of pregnancy is symbolised by letters, and medical information about mother and child codified in a key with 82 possible numbers – used in SMMP recording of births from 1955. As I progress through to our more recent records of births, they become far more ‘medicalised’ and less obviously biographical and researchers might need some extra information or help to decipher them.

Birth records differ from other patient records that we hold in their slightly more complicated access conditions. Since entries in birth registers hold information for at least two people (the mother and the child[ren], and sometimes a father), each separate individual represented there has information rights, either under the Data Protection Act (1998) if living or through NHS Scotland guidance on the health records of deceased patients. Because our closure periods on adults and children differ, researchers looking at birth records after 1915 would need to talk to me about how they can access information from them – and it may be that they can see certain details in a birth register, but not others.

As well as registers from ERMH/SMMP and the Hospice, we also hold accounts of births from the Elsie Inglis Memorial Maternity Hospital, Bruntsfield Hospital, Deaconess Hospital, the Western General Hospital and the Eastern General Hospital – although the records that we hold may not cover everyone. If an ancestor was not born at home (as most people weren’t before hospital births became the norm in the 1950s), we also might be able to help. If a midwife from an institution attended a home birth, we also have some records of these visits, such as these Outdoor Casebook entries from ERMH from the 1840s:
ERMH Outdoor Casebook (LHB3/18/1)
We also have birth notification registers, giving skeleton information on all births in the City of Edinburgh – although there are a few gaps, we have these registers covering dates from 1916 until 1962. After the Notification of Births (Extension) Act 1915, local authorities were required to record all registered births as part of a duty to care for pregnant women, mothers and children under five. These registers also can tell us about other institutions that provided care for pregnant women (such as private nursing homes), but because of the lack of affiliation of most of these homes to what was to become the NHS in 1948 (meaning that they won’t be represented in our archive holdings), we cannot usually trace any further surviving records.

I always enjoy talking to groups about LHSA. We do offer a remote enquiries service, too, though – so if you think you can use the birth records that we hold, please don’t hesitate to get in touch.

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