| Summary: | The provision of contraceptive services has been identified as one of the most important developments in primary care. Although the history ofthe birth control movement is well documented, the contribution made to the provision ofservices by nurses and midwives and the actual development oftheir role, is conspicuous by its absence. Similarly, the history ofnursing has tended to ignore the work ofthose at the 'sharp' end ofpractice. This thesis addresses both lacunae by investigating the work of the J • ~ • midwife-nurses in the Marie StopeS' Mothers' Clinics; focusing on the London and the Caravan Clinics between 1921 and 1931. The aims 0 f the study were; to trace the historical development of birth control nursing within the Marie Stopes Mothers' Clinic locating it in its social, political, medical, professional and legal.contexts; to determine the lay and medical perspectives which influenced the development ofbirth control nursing within the Marie Stopes Mothers' Clinics. This historical study uses primary archival and secondary sources supplementedby a modified prosopographical technique and oral history interviews, to provide a distinctive record of the role undertaken by the midwife-nurses in the first birth control clinic in Britain. The role ofthe midwife-nurses was unique, providing what was arguably the first nurseled birth control service in this country. In exploring the expansion ofthe service, the thesis exposes previously unexplored links between Lamberts, a commercial organisation, Abertillery Hospital and the Stopes' clinics. An exploration of the planning and development of the Caravan Clinics uncovers the way in which the service operated and the difficult conditions experienced by the midwife-nurses. Three issues of relevance to the history of nursing and contemporary practice are also revealed; the way in which the role was established: how the training for nurses working in the field of contraception and sexual health evolved; and the identification ofthe roots ofsexual health outreach services. The consequences of a disagreement between Stopes and the National Birth Control Council (NBCC) produced two distinct approaches to the delivery of care and the role of the staff. The traditional handmaiden approach continued in dinics under the auspices ofthe NBCC. The use of the speculum acted as a means to maintain the dominance of the medical profession, a situation that continued well into the 1990s. The thesis argues that had Stopes and her organisation remained within the amalgamated organisation, she may have inculcated her nurse-led approach into the work of these other clinics, with a subsequent impact on the role and training of nurses and midwives throughout the ensuing decades. Studying this group of midwife-nurses provides insight into the realities of clinical practice within what was, at the time, a controversial area ofpractice. The study has contributed to a wider appreciation of the history of both nursing and birth control while also revealing the links to contemporary clinical practice in the field of sexual health.
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