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Mother Wit: Liverpool Community Health Archives · Mother Wit

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Hey guys, welcome back to our Mother Wit podcast.
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Today we are looking at the Liverpool Community
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Health Archives which are based in Central Library
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and I am here with Austela, Idiri and Chanttal
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who are members of the Black Maternal Health
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Project and our two guest speakers today are
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Andrea and Claire. How are you and would you
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like to introduce yourself everybody? Hi, yes,
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so I'm Claire Maxwell and I work at Liverpool
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John Moores University. I'm an Associate Professor
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in Maternal and Infant Health. My background's
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midwifery, I'm a registered midwife and I'm here
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today to explore this wonderful, creative archive
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in terms of community health and hopefully a
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focus on maternal health as well. I'm Andrea
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Livesey, so I'm an Associate Professor in History
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at Liverpool John Moores University. I'm a specialist
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in the history of maternal health care. I'm particularly
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interested in this history in Liverpool. It's
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long history from the end of the 18th century
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onwards. And I'm here today to talk a little
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bit about the records that we'll be looking at.
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So the material that we have. out here ranges
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from around the 1880s through to the early 2000s.
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So it's kind of a real range of material. But
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when you're working with archives, one of the
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most important things to remember is that not
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everything gets stored in an archive. So there's
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lots of gaps here. So something that I always
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say when you're in an archive, of course, look
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at what's here, but also keep in the back of
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your mind what isn't here. Whose stories aren't
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here? Whose voices aren't represented? And in
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a way, that's almost more important for us. But
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that being said, when we start to look at these
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materials, you'll see little clues and things
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that you might be interested in talking about
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a little bit more. So the first thing that I
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wanted you to look at today is this book here.
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It's incredibly fragile. You can see the front
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covers come off there. So this is some of the,
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they call them the rules and regulations of the,
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so this is the ladies charity and lying in hospital
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in Liverpool. So you can see an image of the
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hospital here. So it's, it was on Brownlow Hill.
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So this was the 1880s, but actually the origins
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of this institution go back to the late 18th
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century. So they go back another hundred years.
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also and it goes back to the ladies charity now
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the ladies charity was a group of wealthy Liverpool
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women who would donate to provide maternity care
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to poorer women in the community which all sounds
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well and good however we have to remember that
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over time there were certain stipulations put
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on who they thought was worthy of that care.
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So if we go back to the, I'll go forward to the
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1880s here, this is where the ladies' charity
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and the hospital, the lying -in hospital, had
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kind of come together. So it's a hospital, but
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we have to remember that this is before the NHS,
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so it's primarily a charity -based organisation.
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When I first came across this book, I was particularly
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struck with some of the rules that they have
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written down here. So this is, turn this around.
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So actually these, so the first report here starts
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in 1869. And they tell you a little bit about
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the people who were donated. to that institution.
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Now interestingly a lot of the names that we
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come across here are quite famous Liverpool names
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that you'll still come across today. So people
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like the Rathbone family who you know we hear
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that name. a lot, you know, we have generations
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of Rathbones, a lot of Williams, there's, you
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know, there's about 10 generations of Williams
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there. But also we have Eleanor Rathbone, who
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was a prominent reformer in the 20th century.
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But a lot of these families were merchant families.
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Now we know that Liverpool as a city was founded
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on... enslavement and colonialism now these are
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people who have made their money a lot of the
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time either directly through that or kind of
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on the margins of that that's another thing to
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bear in mind here whilst we don't have any kind
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of stipulations put on um kind of the you know
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the race of the people who were admitted to the
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hospital there are there is a lot of stuff around
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class here and kind of their expectations of
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the women who were deserving of care. So I'll
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go into this. So if we just have a little look
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through. So, and this one is in, so this is in
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1869. So the relief to be afforded by this charity
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shall be confined to poor married women and to
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poor widows whose husbands have died during their
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pregnancy, who shall produce a certificate. Okay,
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so there's stuff around trust there, isn't there?
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So they won't take your word for it. They need
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proof of that. Duly signed of their marriage
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and who shall reside within the borough of Liverpool
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or within such limits as may from time to time
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be determined. Okay, so it kind of goes on. There's
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also mention of wives of sailors and so on. We
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know, obviously, it's a real maritime city. So
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some really kind of significant issues there
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about who is worthy of care, who can access care.
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But actually, as time goes on from the 1880s,
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what we see kind of as we go into the 20th century
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is many women not wanting to go into this hospital.
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to have their children they see this as a place
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that is actually quite dangerous for them and
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so there is a real move back from kind of the
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desirability of a hospital -based birth to a
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home -based birth that is seen as more secure
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so we can start to think then okay well who is
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who is seeing who is overseeing these births
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and it's going to be people in the community
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midwives and so we've then kind of got that community
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knowledge which is re -centred again but interestingly
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I think for for a lot of us I had one of my children
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in Liverpool Women's Hospital and I know that
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there's links amongst the group as well is many
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of the institutions that we have in Liverpool
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today have what we call antecedent institutions.
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So institutions that have kind of come together
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to form these modern institutions. And this is
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one of the institutions that we can trace directly
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through to Liverpool Women's Hospital. Okay,
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so we've got these links going back and all of
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these institutions that we see today have some,
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you know, really strong link to Liverpool's.
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history so now we'll move on from the 1880s we
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spoke about those gaps didn't we so we'll jump
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there's so much here for us to look at but we'll
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jump forward now and have a look at a piece from
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the 1950s that really shows us how we can start
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to understand what's missing from the archive
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okay so this is The report from Liverpool Maternity
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Hospital, which was on Oxford Street. It's the
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medical report for 1959, but it's specifically
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on obstetric section, which means caesarean sections.
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So you'll see in this report, we've got so many
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statistics here. Now, we talked a little bit
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about archival silences, how we can understand
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what is there. but also what isn't there. And
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here we have some clues that we can pick up on.
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So we know that certain conditions are more common
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in women of African descent, so preeclampsia
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for example. So we've gotten quite a few cases
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here of preeclampsia. But what this really highlights
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to us is the fact that this is all we know about
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the experiences of these women. We don't have
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their voices. We don't have that understanding
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of what happened to them, what their care was
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and how they were treated or their experiences,
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their emotions, how they felt in that moment.
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So this is an interesting one because of those
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statistics. But in terms of really understanding
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what is happening here in Liverpool maternity
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care in the 1950s, we have to do our own filling
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in of the gaps here to really honour those experiences
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and allow those women to have some kind of voice.
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Yes, so following on from what you've just said,
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Andrea, this has really caught my eye, the management
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of the newborn baby, a guide for midwives. This
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is from 1943. So it's just pre -NHS and this
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is by Alan Moncrief, who's a physician, a paediatrician,
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looks like in London. And it's interesting because
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quite a lot of what I've read is probably still
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relevant. today in terms of sort of the physiology
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but what's missing and it is something that we've
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recognised today in maternity care is if you
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look at some of these fever in the newborn, hemorrhage
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in the newborn, jaundice in the newborn, to actually
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establish whether that's a caring and whether
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the baby's at risk or it's unwell you need to
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be able to assess the colour of the baby and
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there's nothing at all in this book about assessing
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different skin tones and we know in contemporary
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practice now that that's a really serious issue
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and it's been a real omission and that's you
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know the NHS race observatory's done a lot of
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work around this but if you think this was the
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guide I mean midwives bought it it looks like
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and it was probably going to be a really important
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companion for them so That's a real omission
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in terms of the care and the teaching, the education
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of midwives to care for those babies and also
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to impart that information to the mothers as
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well. So, yeah, very much follows on with what
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you'd said about the silences. And this has actually
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been for a long time now, you know, probably
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50, 60 years from then. It's only really just
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been visited recently. I've got a question, actually.
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So bearing in mind the time. playing with this,
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how many midwives would have been of African
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descent or non -white midwives at that time?
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What years are we talking? So it's 1943. I don't
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know, I don't even know whether we would have
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the data on that, do you know? So, I mean, we
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don't have all of the data on it. What we do
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know is that, you know... As we move into the
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middle of the 20th century, we've got increasing
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numbers of black women in nursing and midwifery
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care. The thing about the records that we have
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here in the UK, for a long time, race was not
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recorded. So whereas places like the United States
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will... You know, they were recording race from
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the 19th century, you know, for other reasons
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that we know. Because here in the UK, there were
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never kind of any direct policies that led them
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to have to record race. They didn't. Now, that
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is an issue because, you know, if we think about
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countries today that don't record race, you know,
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Canada, for example, it's difficult to understand
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where the issues lie if you haven't recorded
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it. So going back to your question, if we look
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at the mid -20th century, we know that there
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are, you know, black and flat midwives who are
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in nursing and midwifery, but we have to find
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other ways of getting. to that one way that we
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can get at it is to look at photographs right
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from that era and we do have some photographs
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to look at um we don't have the exact year um
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but again yeah it's about kind of reading those
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photographs and understanding what's there okay
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so the archives has been really interesting what
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do you guys think does anyone have anything specifically
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want to share or anything that wasn't in there
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that you want to address maybe I think that um
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I haven't had chance to look at it all in detail
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but I'd love to come back and spend a bit more
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time here and then I think you're right then
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that's when you start having more questions about
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why can't I find this in here so it's almost
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like a challenge to kind of come back and see
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whether you can find something somewhere which
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would like kind of fill in that bit of a that
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bit of a gap But no, it's been fascinating. I
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love it. You mentioned that you remember this
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paper specifically. Yeah, I'm very familiar with
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the paper, Voices. I remember growing up and
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my grandma used to go through the door and she
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used to love reading it and telling me about
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what's going on in the community because that's
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where she lived in LA. And she was very sad when
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it closed due to funding because it started off
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with... community coming together and funding
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it but unfortunately it did have to end and it's
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really sad to see because it really kept everybody
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informed of what's going on and gave you a face
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and a name to be able to share your viewpoint
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and I hope one day it will come back. We were
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talking about so many different projects and
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initiatives and things that have started that
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have kind of stopped due to funding. I think
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it's interesting that like you say the voices
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newsletter and having that come through the door
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and it being a physical thing i guess now there's
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the answer oh well you could take it online but
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you don't get the same sense of community in
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it i don't think i don't know why that is um
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but yeah i i agree there's a lot that's kind
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of disappeared and it's almost easy to say oh
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well you could just replace it with like an online
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thing instead but do people engage with it in
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the same way i don't know i think particularly
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older people as well like you mentioned and your
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grandma i think are not you know not always online
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and surfing the internet then so it's nicer to
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have those physical copies but then also i think
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with the younger generation it's probably easier
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for them to be online because it's such a normal
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part of their day -to -day so to have that access
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to the information online i feel like even that
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i mean this is just anecdotal but i think people
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aren't even reading as many physical books now
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i think a lot of things it's like audio or being
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read online um so yeah i guess it depends on
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the target age group and it's hard to have something
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that all age groups are happy happy with maybe
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builds on what you were saying another great
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thing specifically about the voices It had certain
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important points in different languages to make
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it more accessible to the community. Me and Chantelle
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were actually talking about something before
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that. She mentioned that it was a privilege to
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be able to come here and actually see the history
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come to life, so to speak. I'm not originally
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from Liverpool, but it's just really interesting
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to look back. But what I've noticed is a lot
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of the issues that we... We talk about in various
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other groups that I'm in as well. It's just a
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reoccurring thing. Nothing's changed. None of
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us have come up with any new great idea that's
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going to save the world. It's all things that
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have been discussed before around health, isolation,
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coming together, supporting each other, food.
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Even then, there's an article in the paper down
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there, and I think it was from 19... I'm going
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to say 1940. And it was like, no, women should
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be at home having the babies. They're safer with
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checks. You're going to die if you go to hospital
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kind of thing. So it's just like crazy how things
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just, they come in and then they go out and then
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they come back in again. Because at the moment,
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everyone's being convinced to go into hospital.
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Whereas I still think most women would, if given
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the choice, have their baby at home in the comfort
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of their own home with people. that they know,
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unless, obviously, there's underlying issues.
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But, yeah, it's just seeing everything come round
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full circle from all the stories. It's really,
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really amazing. Yeah, no, I agree. I think you've
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got immunisations there. That's obviously a big
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thing as well that's going on, getting your child
18:44
vaccinated and the big debate of who has and
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who hasn't. Obviously, that's MMR, all of that
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stuff coming around. You've got their new project,
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Combats Racism. I don't think that's anything
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new. That's loads of things that are also going
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around as well. Learning computer skills. We
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spoke previously about, what's it called, digital
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inclusion. Again, that's also a big thing that
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I know has been going around the community, getting
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people able to use, obviously, computers and
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things like that. And then we've got mental health
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issues. Mental health issues, yep. Another big
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one, grants available to community groups for
19:27
health improvement. The LCVS, I'm sure it's called.
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They've just launched some new funding, which
19:35
again, similar to that. So yeah, everyone's right.
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It is also things, same things coming around
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again. So yeah, I think that's the importance
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of archives and people knowing that. They're
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open to the community. You know, they're free
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to access. Anybody can book in and come to see
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archives. You know, archive materials. There's
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so much here. And, you know, it's here that we
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can see people's voices recorded and then understand
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that these aren't new issues. And even though
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we can see they're not new issues, it almost
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gives them this sense of urgency. Because it
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then makes you think, well, why haven't people
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been listening? We've been saying this for so
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long. So it almost kind of gives you the evidence
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to kind of make those arguments that, you know,
20:33
more should be done. But again, not everybody.
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And it goes back. to kind of institutions doesn't
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it and understanding kind of who has had access
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to institutions over time and not everybody will
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feel like this is their space yeah even though
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it's open to anybody um so yeah it's about understanding
20:57
how we can make these spaces more inclusive so
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people you know can access them yeah yeah maybe
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it's not about you know getting the message out
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and then that's it job done maybe the the fact
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that we see these same things recurring is that
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is the message that is what we're supposed to
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be talking about and that's supposed to be an
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ongoing like activity so it's not that okay we
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can discuss it and then okay problem solved we
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don't need to talk about it anymore but maybe
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it is about bringing those recurring themes together
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and making sure that that awareness is is kept
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and that people are still working towards that
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kind of a an idea i guess but any new grants
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that are going in you want to make sure that
21:50
you include you would check the archives so that
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you include all of the messages that have gone
21:55
before and kind of bring it together it's going
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to say be interesting to um just to ask if there
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was anything that you came into the archive wanting
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to see that you haven't seen today? What would
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you like to see in the archive? I'm going to
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be honest. I was expecting to see, like, I don't
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know why, because obviously they weren't going
22:21
to be there, but the photographs that we've got,
22:23
there's no black babies. There's only, like,
22:25
one black midwife or nurse on those pictures.
22:31
I know there's not loads of pictures and, you
22:34
know, there's only one man. in all of those pictures,
22:36
who's not a doctor. But I don't know why. I just
22:40
thought it would be like a little hidden history.
22:43
But it wasn't there, but it would be interesting
22:45
to see if there is, you know, any more of those
22:49
pictures somewhere or, you know, things like
22:52
that. But, yeah, I think that's what I was...
22:54
I wanted to see something to go, oh, yeah, but
22:58
the pictures aren't there and they're not there,
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they're not there. This is where that history,
23:03
you were hoping that history had been kind of
23:06
hidden here. But I mean, the thing about archives
23:10
is that they are very representative of kind
23:14
of who has the power in society at any given
23:17
moment. Yes, absolutely. Yeah. Sorry, history
23:22
is written by the winner. So the losers are always
23:25
written out there because whoever wins writes
23:28
their story, generally speaking. I think I've
23:33
noticed that with the sort of term, most of the
23:36
things I picked up, the medical side of it was
23:38
always written by doctors. It was led by doctors.
23:41
They were all males. There was very few females
23:43
represented at all. So from a gender perspective,
23:48
that's really limited. And then if you look from
23:50
a race perspective, it's even further, isn't
23:52
it? So it didn't surprise me really because we
23:55
know the history of maternity care, even though
23:58
women established it. and it was in our hands
24:01
it was taken out of our hands and but to actually
24:04
see all of the documents nearly every single
24:07
one with a you know a male doctor leading on
24:09
it brings it to home really I think so how do
24:13
we change that then so I kind of feel as though
24:16
maybe there are photos like you say of black
24:20
babies there are photos of you know which might
24:23
be within families and within communities but
24:26
they're not in the archive so Does that mean
24:29
we can enter things like that into the archive?
24:33
We can? Yeah. We should. I mean, I suppose there's
24:38
different ways of looking at it, and it would
24:41
be great to hear what the archivists think of
24:44
this. But I know there is work going on around
24:47
this. But, okay, so one way to look at it would
24:51
be, you know, can we look for those silences
24:55
and gaps and, you know, fill in those gaps? um
24:58
but on the other hand you have to think well
25:02
you know what other ways are there of preserving
25:06
this information is this something that kind
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of works for people you know in their own communities
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or you know is there an alternative way of of
25:17
doing of doing this if if that makes sense of
25:21
preserving this information um but yeah i know
25:26
that there are projects going on kind of in various
25:29
places across the countries to kind of identify
25:32
those gaps and make sure there's better representation
25:36
but again maybe it gives us kind of the impetus
25:39
here in Liverpool to think okay well you know
25:42
we've seen what's missing here how can you know
25:46
we work together you know because again you know
25:50
that burden shouldn't just fall on communities
25:52
to to do that you know how can we all work together
25:55
to make sure the archives are more representative
25:58
and everybody sees themselves and their history
26:01
there okay well thank you everybody for coming
26:05
today and thank you to our guests for joining
26:08
us okay thank you bye