Disciplining the Bodies of Single Women

Starting in 1802, the Napoleonic government promoted the education of enlightened midwives through both the Parisian Maternité and departmental schools. The Gers, in the southwest, repeatedly tried and failed to open a school that would graduate well-trained midwives. Its failure by 1839 rested on the male authorities' inability to conceive of and support spaces where three interrelated groups of women could cohabitate safely in this rural and Catholic department. Young, innocent midwifery students needed protection from the mostly unwed mothers available as bodies for practice. In turn, both the unwed mothers and the midwifery students, due to their knowledge of procreation, threatened the purity of the nursing sisters who controlled charitable spaces. Ultimately, despite attempts to redefine the bodies of unwed mothers and reconfigure the spaces to run a legitimate school, the authorities abandoned the goal of providing skilled midwives for the women in labor who needed them most. A partir de 1802, le gouvernement napoléonien a promu la formation de sages-femmes à travers l’école de la Maternité à Paris et des écoles départementales. Le Gers a essayé à plusieurs reprises, mais en vain, d'ouvrir une école qui formerait des sages-femmes diplômées. Son échec repose sur l'incapacité des autorités masculines de ce département rural et catholique à concevoir la coopération et la cohabitation de trois groupes de femmes : les étudiantes sages-femmes, les religieuses, et les filles-mères. Les étudiantes sages-femmes—jeunes, innocentes, et célibataires—avaient besoin de protection contre la contamination morale des filles-mères dont les corps étaient nécessaires pour l'instruction. A leur tour, les filles-mères et les étudiantes, en raison de leur connaissance de la procréation, menaçaient la pureté des sœurs infirmières qui contrôlaient les hospices. En fin de compte, malgré les tentatives de redéfinir le corps des mères célibataires et de réaménager les hospices pour créer une école légitime, les autorités ont fini par abandonner l'objectif de former des sages-femmes diplômées pour servir les femmes en couches qui en avaient le plus besoin.

“Not Only with Thy Hands, But Also with Thy Minds”: Salvaging Psychologically Damaged Soldiers in the Second World War

This essay breaks new ground in exploring the tensions in female nursing during the Second World War as the mental health needs of the injured were increasingly acknowledged. Advances in weaponry and transportation meant that the Second World War was a truly global war with mobile troops and enhanced capacity to maim and kill. A critical mass of female nursing sisters was posted to provide care for physical trauma, yet the nature of this uniquely modern war also required nurses to provide psychological support for troops readying for return to action. Most nursing sisters of the British Army had little or no mental health training, but there were trained male mental health nurses available. Publications of broadcasts by the Matron-in-Chief of the British Army Nursing Service detail the belief that the female nurse was the officer in charge of the ward when the patients had physical needs. However, that the nursing sister held this position when the patients’ requirements were of a psychological nature was at times tested and contested. Through personal testimony and contemporary accounts in the nursing and medical press, this essay investigates how female nursing staff negotiated their position as the expert by the psychologically damaged combatants’ bedside. The essay identifies the resourcefulness of nurses to ensure access to all patient groups and also their determination to move the boundaries of their professional work to support soldiers in need.

Challenging nursing spaces

The creation of spaces conducive to healing is a critical aspect of the provision of good nursing care. The nursing sisters of the British Army, having trained in the British hospital system would have been well versed in the need to create and maintain and environment in which healing could take place. The zones into which they were posted during the Second World War and the spaces they were given in which to care for their patients, were however, rarely either favourable to health or to the ‘serenity and security’ needed for recovery. Extreme weather conditions, limited water supplies, equipment and electricity combined to hinder all aspects of patient care. The often hostile places in which nurses worked demanded that they develop clinical skills and the ability to improvise and innovate in order create healing spaces for their soldier-patients. However, as the chapter argues it was the highly feminised home-maker work that created these spaces, which the nurses themselves credited to be an essential aspect to the healing process in which they were the critical performers.

Reasserting work, space and gender boundaries at the end of the Second World War

The chapter considers the civilian world into which the Q.A.s returned at the end of the war and explores the options they faced. It begins with the immediate aftermath of war and the opportunities for interesting and worthwhile work that would only exacerbate the nursing sisters’ difficulties on demobilisation. This is followed by a consideration of the return to Britain and the options open for professional practice. The chapter argues that for some the option of interesting work remained, either in the colonial service or the military. However the main professional opening for returning nurses was the crisis ridden civilian hospital system that wanted and recruited cheap, malleable workers; this was not an attractive choice for demobbed nursing sisters. The chapter argues that despite nursing being a female dominated profession, the ideology that encouraged women to return to the home in the aftermath of war had significant ramifications for demobilised nurses. The social structure precluded married women from working outside the home and funds for postgraduate training available to returning male doctors were not offered to nurses. As the chapter maintains, most nursing sisters married, leaving the profession without their considerable talents and new ways of practicing.

Nursing presence

Military success in war was contingent on men sustaining a determination to fight. Persuading men to continue fighting or returning them to combat after illness or injury depended on maintaining their morale. The use of female nurses in upholding this resolve was integral to the war effort. The chapter explores the value of the presence of women in hospital wards and in social environments on active service overseas. It considers the occasional antipathy of military authorities and male colleagues to the location of female nurses in war zones. However, it is argued through the provision of expert clinical care, domestic acumen and the use of their ‘female-selves’, nurses were able to salvage men in readiness to return to battle. Nursing sisters thus created a space for themselves in frontline duties. However, the chapter argues, this was not without its difficulties. As single, white women in far-flung places, this position situated nurses in a liminal place between the respectable European colonial wife and the ‘biohazardous’ local women. The chapter acknowledges these difficulties, but also demonstrates how the nurses negotiated their way through these contradictions to their advantage and for those in their care.

Negotiating the boundaries of nursing practice

The chapter examines the changes to the dominion of nursing work on active service overseas. The chapter first explores the extensions to the nursing role, most particularly the care of wounds and burns. This is followed by a discussion of the expansion of nursing duties into those that had hitherto been the domain of medicine. These roles include the commencement and management of blood transfusions, surgical work and anaesthesia. Finally the chapter considers ‘new work’, the most critical of which was the administration and use of penicillin. The constantly shifting requirements of war nursing prevented Army nurses from remaining in a professional comfort zone of accepted roles and regimes. The experience of living with uncertainty may have caused anxieties for some, but the active participation in new treatment modalities suggests that nurses who went to war were keen to move beyond the normal boundaries of nursing practice and many relished the opportunity to do so. The chapter argues that the developments in practice and the increased confidence nursing sisters displayed with this new work altered their working relationships with medical officers from one of deference to one of collegiality, enabling more productive decisions for their soldier-patients’ care.

Negotiating nursing

Negotiating nursing explores how the Queen Alexandra's Imperial Military Nursing Service (Q.A.s) salvaged men within the sensitive gender negotiations of what should and could constitute nursing work and where that work could occur. The book argues that the Q.A.s, an entirely female force during the Second World War, were essential to recovering men physically, emotionally and spiritually from the battlefield and for the war, despite concerns about their presence on the frontline. The book maps the developments in nurses’ work as the Q.A.s created a legitimate space for themselves in war zones and established nurses’ position as the expert at the bedside. Using a range of personal testimony the book demonstrates how the exigencies of war demanded nurses alter the methods of nursing practice and the professional boundaries in which they had traditionally worked, in order to care for their soldier-patients in the challenging environments of a war zone. Although they may have transformed practice, their position in war was highly gendered and it was gender in the post-war era that prevented their considerable skills from being transferred to the new welfare state, as the women of Britain were returned to the home and hearth. The aftermath of war may therefore have augured professional disappointment for some nursing sisters, yet their contribution to nursing knowledge and practice was, and remains, significant.

Menstrual abnormalities amongst female South African Hajj pilgrims: a cross-sectional study

Introduction: Hajj (pilgrimage), the fifth pillar of Islam, is obligatory for every Muslim, male or female, provided that he/she is physically and financially able to do so, at least once in his/her lifetime. One of the rituals of Hajj requires the absence of menstruation. In the current modern era, many females utilise oral contraception to manipulate their menstrual cycle so that the pilgrim can be menses free during the main rituals of Hajj. However, many such females are at risk of breakthrough bleeding. Very little information has been documented concerning the incidence of menstrual cycle abnormalities amongst female Hajj pilgrims in general and South African pilgrims in particular. This study aims to determine the incidence of menstrual cycle abnormalities amongst South African female Hajj pilgrims and the potential factors that predispose to them.Methods: A cross-sectional descriptive study was conducted amongst South African female pilgrims during the five-day Hajj period. South Africa is usually limited to 5 000 pilgrims annually with a 50:50 gender split. For most of the five days of Hajj, pilgrims, separated by gender, are housed in special tents. Data were collected using an anonymous self-administered questionnaire. The questionnaires were distributed amongst the ladies’ tents in Mina on the last day of Hajj by nursing sisters attached to the South African medical mission. A total of 470 South African female pilgrims participated in the study with 147 excluded as they were either postmenopausal or had had hysterectomies, resulting in a sample size of 323.Results: Of the 318 participants who responded to the question about hormonal menstrual manipulation (HMM), 195 (61%) attempted this and 123 (39%) did not. Of the 308 participants who responded to the question concerning menstrual cycle problems (MCP), 54 (18%) had problems and 254 (82%) did not. Of the 189 participants who attempted HMM and answered the question on MCP, 44/189 (23%) had MCP, whilst 10/108 (9%) of those who did not attempt HMM had MCP. The OR for MCP was 2.97 (CI 1.46–6.04) if HMM was attempted compared with no HMM attempt.Conclusion: Menstrual irregularities occurred more frequently in those who attempt hormonal menstrual manipulation compared with those who do not. Health education on this issue should be integrated into the pre-Hajj classes.

Misfits of War: First World War Nurses in the Daughters of Mars by Thomas Keneally

The article is an analysis of the representation of Australian nurses in Thomas Keneally 2012 First World War novel, The Daughters of Mars. Inspired by rigorous research, Keneally fictionalizes the lives of two nursing sisters in the Middle East, on a hospital ship in the Dardanelles, as well as in hospitals and casualty clearing stations on the Western Front. His novel thus reclaims an important facet of the medical history of the First World War. The author of the article situates her analysis in the context of historical research on the First World War and the Australian Anzac myth, illuminating the specifically Australian elements in Keneally’s portrait of the Durance sisters. She demonstrates that The Daughters of Mars celebrates the achievements of “Anzac girls”, negotiating a place for them in the culture of commemoration. Yet, at the same time, Keneally attempts to include his female protagonists in the “manly” world of Anzac values, privileging heroism over victimization. Consequently, they become “misfits of war”, eagerly accepting imperial and nationalist ideologies. Thus, in a way characteristic of Australian First World War literature, The Daughters of Mars fuses the tropes of affirmation and desolation.