Benign Influence: British nurses and midwives in mid-nineteenth-century Utah

By Sheri Tesseyman, Madelyn Reese and Emma Sellers

 

Introduction

Women from England, Wales, Scotland, and Ireland made important contributions to nursing and midwifery in nineteenth-century Utah. The purpose of this study is to examine the lives of three British women, one Scottish and two English, who illustrate the influence of British women on the care of sick and childbearing members of pioneer Utah communities.  Susannah Liptrot Richards was from Lancashire, England, Mary Ann Weston Maughan from Gloucestershire, England, and Janet Downie Hardie from Leith, Scotland.

Previous studies have been undertaken regarding medicine, nursing, and medical women in nineteenth-century Utah but little has been written about British nurses in Utah or about Susanna Richards, Mary Ann Maughan, and Janet Hardie in particular.[1] This Study explores the significance of British nurses in Utah by examining the lives of these women who practiced nursing and midwifery there and addresses three questions. Who were these women? How did they come to be in Utah? Why were they so highly regarded there?  We will argue that these women were recognized for being well-educated in the British tradition and revered for bringing valuable knowledge and learning to the Utah wilderness.

Notes on Sources

Primary sources for this article include official records, autobiographies, journals, memoirs, obituaries, newspapers, and magazines. Official records include birth, death, marriage, and census records posted on the Family Search website.[2] The autobiography of Mary Ann Weston Maughan and memoirs of Janet Downie Hardie’s family are major sources. Primary material was also taken from the Deseret News, a Utah newspaper published continually since 1850. The Relief Society Magazine, a women’s periodical published by the Church of Jesus Christ of Latter-day Saints from 1914 to 1970 provided early secondary material. Records kept by the Daughters of the Utah Pioneers were also used as sources.

Records of the Daughters of Utah Pioneers, an organization to promote memorialisation of early Latter-day Saints, articles in magazines published by the Church of Jesus Christ of Latter-day Saints, family memoirs, and the autobiography of Mary Ann Weston Maughan are all biased toward positive accounts of the women discussed in this article.  More nuanced, multi-dimensional primary materials related to these women were not found and caution is therefore requisite when evaluating their lives. More information was available for Mary Ann Maughan and Janet Hardie than for Susannah Richards. Mary Ann Maughan’s autobiography and family memoirs for Janet Downie Hardie provide more insight into their lives than is available for Susannah Liptrot Richards, but Richards’ contributions to nineteenth-century healthcare in Utah warrant her inclusion in this study.

Nursing and Midwifery in America in the Nineteenth Century

Most nineteenth-century American nursing care took place at home.[3] Nursing was a familial duty performed by female relatives although people with the means to do so could hire someone outside the family to provide nursing services in the home.[4] However, destitute people without access to care at home could resort to a public hospital, such as Bellevue Hospital, which was established on the second floor of the New York City Almshouse in 1736.[5]

The first residential hospital-based nursing schools, following establishment of the Nightingale School in London, opened in the United States in the 1870s. But formal nurse training in America can be traced to programmes implemented by physicians in the late eighteenth and early nineteenth centuries. Valentine Seaman,[6] an attending physician at New York Hospital founded a nurse training programme in 1798, and Doctor Joseph Warrington[7] founded The Nurse Society of Philadelphia to train ‘adjuncts to the physician’ in obstetrical care in 1839, but few women enrolled. When Doctor Elizabeth Blackwell founded the Women’s Medical College of Pennsylvania in 1850, women who wanted to study nursing were invited to attend ‘medical lectures’ there.[8]  Doctor Marie Zakrsewska succeeded in obtaining a charter for a hospital with a nurse training school in 1862 but it did not open for another decade because of the Civil War.[9]  Thus, despite early efforts to establish nursing education in the United States, formal programmes were not well established until after the Civil War in the 1870s.

From colonial times, childbirth in America also took place in the home with family and midwives in attendance. Latter-day Saint author Laurel Thatcher Ulrich’s well-known book, A Midwives’ Tale provides a rich analysis of the life of an American midwife and the complexities of caring for a family and a community at the turn of the nineteenth century.[10]  At this time, midwives were well-known in their communities and often provided medical services for the sick in addition to their midwifery duties. They were generally held in high regard and were sometimes hired by a community and remunerated with a house, land, or money.[11]  Until late in the nineteenth century, American midwives were, for the most part, trained as apprentices to older, more experienced midwives, and it was rare for a man, including physicians, to assist in childbirth. Midwives immigrating to America from Germany in the late nineteenth century were often graduates of German, Austro-Hungarian or Polish midwifery schools and were dismayed by average ’unlicensed, uneducated, and unskilled American midwives.’[12]

The Church of Jesus Christ of Latter-day Saints

The three women included in this study were Latter-Day Saint pioneers whose lives were influenced by their experiences during the difficult early days of the Church of Jesus Christ of Latter-day Saints. While members of the church have also been known as ‘Mormons,’ the official name of the church is preferred. The Church of Jesus Christ of Latter-Day Saints began in 1830 with a handful of members in Fayette, New York. Opposition to the church resulted in Latter-day Saint migration from New York to Ohio, then to Illinois where they built the city of Nauvoo, a Hebrew word for ‘beautiful place.’  Many British converts arrived to join them there and the city grew quickly. With approximately 20,000 inhabitants in 1846, Nauvoo rivalled Chicago as the most populous city in the state.[13] Peace was short-lived, however, and the body of the Saints left Illinois in 1846, eventually crossing the plains to the Salt Lake Valley.

Many of the pioneers were from Great Britain. The first Latter-Day Saint missionaries to Britain arrived in England in 1837, and by the 1850s, tens of thousands of British Latter-Day Saint converts had emigrated to join the Saints in America.  Among curious observers was novelist Charles Dickens, who described his observations of a ship called the Amazon leaving with 800 English Latter-Day Saint émigrés on June 4^th, 1863. Dickens decided to see for himself what they were like, although he went with low expectations:

I went on board their ship to bear testimony against them if they deserved it, as I fully believed they would; to my great astonishment, they did not deserve it, and my predispositions and tendencies must not affect me as an honest witness. I went over the Amazon’s side, feeling it impossible to deny that, so far, some remarkable influence had produced a remarkable result, which better known influences have often missed.[14]

He wrote in detail about the way most of the passengers were engrossed in writing letters or writing in journals while waiting for the ship to sail. Dickens also commented on a visit he had with Richard Monckton Milnes, M. P. who had recently written a piece on the Mormons in the Edinburgh Review of January 1862.[15] Monckton Milnes was critical of many aspects of the church but stated that a British government inquiry found their emigrant ships and subsequent conveyance to Salt Lake City were exceptionally well-organised.[16] By the 1860s, over 30,000 British Latter-day Saints had arrived in the Salt Lake Valley.[17] As a result, residents of the state of Utah have a high percentage of British ancestry; in 2023, Utah had the highest number of residents with English ancestry in the United States.[18]

Utah’s Pioneer Immigrants

Immigrants from England, Scotland, Wales, and Ireland were the most populous group of foreign-born residents in Utah. According to Frederick Buchanan, between 1860 and 1880 approximately 22 percent of Utah’s population was from the British Isles and comprised 67 percent of all residents born outside the United States. Whilst most were from England, large numbers came from Scotland and Wales, with fewer from Ireland. National identities were strong, and cohesive groups formed in Utah particularly among the Scots, but church leaders encouraged intermingling, and to other people gathering in Utah, they were collectively viewed as British.[19] These British immigrants brought with them important manual, administrative, and entrepreneurial skills that had a great impact on the state’s development.[20] Buchanan notes that ‘Numerous children were also an important “product” of Utah’s society,’ and British midwives played an important role.[21]  Rebecca Bartholomew discusses British women immigrants to Utah by synthesising material from the lives of a hundred of these women. She includes only a few lines about midwives, nurses, and providers of medical care, but provides insight into the general background and experiences of British Latter-day Saint women in Utah.[22]

Latter-day Saint immigrant groups populating the new Utah Territory, whether from America or other countries, came mostly as families and thus included midwives. In her book, Our Pioneer Heritage, Kate Carter provides short sketches of just over a hundred Utah midwives. Of these, thirty came from the Northeast and Midwest areas of the United States, eleven were from Scandinavia (nine from Denmark and two from Norway), five from Switzerland, four from Canada, two from South Africa, and one from Australia. Fifty-one had been born in the British Isles, specifically thirty-four from England, ten from Scotland, four from Wales, and three from Ireland.[23]

In addition to Latter-day Saint converts, immigrants who were not Latter-day Saints went to Utah in increasing numbers throughout the nineteenth century. Immigrants from Italy, Greece, China, and other countries were, for the most part, men recruited to work on the railroad and in coal, copper, and silver mining.[24] Some became permanent residents and sent for their families resulting in stable Roman Catholic and Greek Orthodox communities. Protestant missionaries sent from Eastern states to convert ‘Mormons’ to Protestantism also established communities in later decades of the nineteenth century.[25]

Health and Sickness Among the Latter-day Saints

In the early days of the church, members generally adhered to herbal treatment of disease, healing by faith through prayer, and the laying on of hands, and typically held standard regular medicine in low regard.[26] However, by the 1870s, as the general practice of medicine became more scientific and medical education more standardised in established areas of the eastern United States, attitudes in Utah Territory softened toward regular medicine. Brigham Young, who believed that women were particularly suited to health maintenance, obstetrics, and care of the sick, wanted women volunteers to study medicine in respected medical schools in the East. Influential women’s leader, Eliza Snow, publicly asked for volunteers. Several women responded and completed medical studies at the Women’s Medical College in Philadelphia and the University of Michigan, returning to Utah as fully qualified physicians. Some of the new physicians set about formally training nurses. They conducted formal courses in nursing, midwifery, and invalid cooking. This training prepared nurses to practice in private homes, where nearly all nursing and medical care took place. Hundreds of their graduates provided medical and nursing services in communities throughout the territory. One of these physicians, Dr Margaret Roberts, taught nursing for decades in a formal program sponsored by the Female Relief Society, the women’s auxiliary of the church.[27] The first three-year hospital school of nursing opened in Salt Lake City in 1894. Others followed and became the standard for nurse training.[28] With the growth and development of professional hospital-based schools, the Relief Society nursing school closed permanently in 1924.  Some of the physicians trained hundreds of midwives to provide care in Latter-day Saint communities throughout the territory. In rural areas, midwives were often the sole providers of health services and commonly provided general medical and nursing care along with obstetric care.[29] This was also the case in other areas of the American western frontier.[30]

A few months after the Latter-day Saints’ arrival in the Valley, pioneer physician Willard Richards established a ‘Council of Health’ under the direction of church president, Brigham Young. The Council of Health instituted ‘strict hygienic regulations,’ offered instruction regarding measures to maintain good health, and provided nursing classes which became the foundation for all subsequent formal nursing education in Utah.[31] The Council also provided instructions for herbal remedies to be used in conjunction with faith and prayers. The variety of activities carried out in the Council of Health is reflected in comments from reporting in a Salt Lake City newspaper, the Deseret News. The relevant article explained that the purpose of the Council was to prevent disease and treat the sick with ‘mild’ foods and herbs, ‘according to the holy commandments of God,’ then continued,

An increased desire for the promotion of health is manifest, particularly among the ladies of the Council; and propositions are now up for improving the fashions in dress, which will tend not only to health, but happiness, comfort, ease, beauty, and everything that is delightful in female economy, and gentility…Great exertions are made by the sisters to prepare themselves to nurse each other.[32]

The editor of the Deseret News was Willard Richard and the paper contained periodic announcements about meetings followed by opportunities for the ‘afflicted’ to obtain medical advice without charge.[33]  In a later edition, the paper included a long article about speeches given at a Council of Health assembly. One speaker emphasized that the most important purpose of the Council was to provide a means for women to learn ways and means to care for themselves and ‘fill up the earth…with healthy holy beings that will be fit temples for the Holy Ghost to dwell’ and not as a means for physicians to ‘display their learning on suffering humanity,’ a reflection of prevailing negative attitudes toward regular medical practitioners.   He stressed that the mission of the Council of Health was to maintain health, which was much more important than removing disease.  To help meet this goal, members of the ‘Ladies department of the Council,’ led by the Council’s women, conducted instructional sessions for all sisters interested in their health and the health of their children and friends. In keeping with assumptions about the propriety of such discussions in mixed company, they were careful to point out that only women would be present at these sessions.[34]  The Council also performed other functions such as keeping health-related statistics.[35]

Latter-day Saints, Knowledge, and Learning

Education regarding nursing, midwifery, and medicine was part of an ideological pattern among Latter-day Saints. Obtaining knowledge and learning regarding all aspects of the Earth and the human condition was a fundamental value of the Church of Jesus Christ of Latter-Day Saints—for spiritual as well as practical reasons. Latter-day Saint scriptures include The Holy Bible, The Book of Mormon, The Pearl of Great Price, and a book of contemporary revelation called The Doctrine and Covenants which urges,

Teach ye diligently … in all things that pertain unto the kingdom of God … Of things both in heaven and in the earth, and under the earth; things which have been, things which are, things which must shortly come to pass; things which are at home, things which are abroad; the wars and perplexities of the nations, and the judgments which are in the land; and knowledge also of countries and of kingdoms—that ye may be prepared in all things.[36]

The Pearl of Great Price explains that ‘the glory of God is intelligence’ putting the importance of intellectual development in perspective—a perspective that could be humbling. Latter-day Saint missionaries to Britain in 1837 recognized the reputation of the British for intelligence and learning and found it intimidating. Heber Kimball, who described himself as ‘stammering’ was reluctant to preach to a people who were ‘so famed throughout Christendom for light, knowledge and piety . . . and to a people whose intelligence is proverbial’.[37]  We will argue that the three British nurses and midwives in this study were well-educated and revered for bringing valuable knowledge and learning to the Utah wilderness.

Susannah Lee Liptrot Richards

Susannah Lee was born at Pendleton, Lancashire, England on 29 May 1809. She married John Liptrot, was widowed, and emigrated to Nauvoo, Illinois where she married Dr Willard Richards in 1846.[38]  Sources that mention her consistently note she was a ‘trained nurse’ or ‘graduate nurse’ having completed formal nurse training in England, but what this means is not clear.[39] While Catholic sisterhoods were active in England in the early nineteenth century, we have found no indication that Susannah was involved with this group. The first Anglican Sisterhood to formally train nurses was established in 1845[40] followed by the St John’s House training program for hospital nurses and Miss Sellon’s Anglican nursing sisters in 1848, all too late for Susannah, who left England in 1842.[41] For the same reason, Susannah could not have been involved in the iconic nurse education programmes developed in connection with Florence Nightingale from 1860. Well before Nightingale, nineteenth-century reformer Elizabeth Fry was instrumental in developing formal nurse training in Britain after visiting Pastor Fleidner’s nurse training centre in Kaiserswerth, Germany in 1840. However, nurses in training at Fry’s Institution of Nursing Sisters were required to be Protestant and commit to from three to seven years of service after training.[42] Susannah became associated with the Church of Jesus Christ of Latter-Day Saints in 1838 and left England to join the Saints in Nauvoo in 1842 so it is unlikely that she was trained at Fry’s Institution.[43]

A more likely possibility is that Susannah received nurse’s training in a hospital that used the ‘ward system’. The ward system was developed to improve nursing care in hospital wards by improving the quality of the ward sisters.  Undoubtedly, some hospital nurses were highly skilled, honest, and decent. One of these was Eliza Roberts, an experienced St Thomas’s Hospital nurse whom Florence Nightingale took to nurse soldiers in the Crimea. Nightingale called her ‘a splendid nurse and excellent woman’ although her manners were rough.[44] Nevertheless, many hospital nurses did not share Roberts’ qualities.  According to Helmstadter and Godden, the number and nature of complaints about hospital nurses indicate that these qualities were often lacking.[45]  Assistant nurses, in particular, tended to share attributes of other individuals from the lower working classes of industrialising Victorian society and head nurses were often promoted from their ranks.[46]

Under the ward system, however, the hospital matron recruited women from other backgrounds, mainly shopkeepers and higher servants in wealthy households, and trained them to be ward sisters. The first hospital to use the ward system was London’s St. Thomas’s Hospital where ward sisters had been employed for some time. St. Thomas’s had large wards that required more than one nurse, so one of the nurses had to be in charge as the ward sister. The matron’s plan to recruit and train ward sisters at St. Thomas’s was successful and by 1837 only one of the sisters had begun her service as an assistant nurse. Thereafter, the ward system spread quickly to other hospitals.[47]

Along with nurses from St. John’s House and other Anglican sisters, many of the nurses who worked with Florence Nightingale in the Crimea were selected because of their hospital experience. Of the over 200 nurses on Nightingale’s register, many had been ‘trained’ at hospitals like Miss Charlotte Taylor who trained at King’s College Hospital and Ruth Dawson, who ‘trained at hospitals’ and was a ‘first rate nurse’.[48] Others were not specifically described as ‘trained’ but were noted to have had hospital experience or cared for family members. Miss Anne Ward Morton, who was particularly well qualified, had ‘attended Cholera patients at Newcastle,’ been a ‘District visitor’, was ‘trained at Westminster & other Hospitals,’ and ‘was from St. John’s House’.[49] Only a few of the women on the register were listed as ‘not trained,’ one of whom was described as ‘excellent but not useful.’[50]  In other words, even an excellent woman needed training to become a useful nurse. Those who received the highest praise had substantial hospital training or experience. If Susanna Liptrot had been prepared in this way, she could claim to be a trained nurse.

Susannah sailed from Liverpool in November 1842 to join the Saints in Nauvoo. She sailed on the Sydney out of Liverpool under the direction of church leader Dr Levi Richards, a Thomsonian physician who treated ailing members of the company with herbs as they crossed the Atlantic.[51]  Thomsonianism, a botanical medical system developed by New Englander Samuel Thomson in the 1820s, rivalled regular medicine in popularity in the United States.  Thomsonians’ criticism of regular physicians’ standard treatments, which consisted mostly of administering ‘minerals’ such as mercury and arsenic, was influential enough to be a major factor in the decline of regular medicine in nineteenth century America.[52]  Thomsonians argued that all illness was caused by cold in the body and treated it with hot baths and herbs, particularly lobelia inflata and red pepper.[53]

In Nauvoo, Susannah married Levi’s younger brother, Willard Richards, also a Thomsonian physician and church leader.[54] Willard and Susannah left Nauvoo with the body of the Saints in February of 1846, and after a stay in Winter Quarters, Nebraska, Willard led their wagon company to the Salt Lake Valley, arriving in October 1848.[55]

Soon after their arrival in the valley, Willard helped organise the Council of Health, which provided formal nursing classes. As a trained nurse, Susannah taught the ‘pioneer nurse class’ along with her husband, and sources that discuss early nursing and midwifery in early Utah are careful to point out her importance as a nurse who had been trained in England and subsequently taught the first nursing classes in the territory.[56]  She was also known as a skilled midwife.[57]  Nevertheless, little more has been written about her. She appears in an account of a Council of Health meeting, however. The account was written by one B. G. Ferris, not a member of the church. Ferris reported that the Council of Health was a ’sort of female society something like our Dorcas Societies’ and that after comments from two physicians including Dr Willard Richards and one of the sisters, ‘Susanna Lippincott’ spoke about the benefits of lobelia.[58] No record of a Susannah Lippincott has been found in the pioneer records, and it was most likely Susannah Liptrot who spoke that day.

The Council of Health was a source of nursing and medical training in Utah Territory for many years, and many prominent pioneer women attended Susannah’s classes.  Years later, a twentieth-century journalist stated that all the nursing work that came afterward developed from the pioneer nurse class, observing that ‘there were giants in those days.’  Susannah Liptrot Richards was listed as one of them.[59]

Mary Ann Weston Maughan

Mary Ann Weston was born on 10 March 1817, at Corse Lawn, Gloucestershire, England to a prosperous middle-class family.  In her autobiography, written with the aid of journals she kept off and on throughout her life, she described her family background.[60] Her mother’s family, the wealthy and influential Thackwells, included a cousin named Sir Charles Thackwell, and her grandmother owned a mill and other substantial properties. They were ‘among the high Gentry’ in the area whose ancestors were buried in a vault under the floor in the church with a tablet on the wall bearing their names.  Her Grandfather Thackwell was a clerk of Staunton Parish for forty-seven years assisting the gentleman parson, who kept a pack of hounds for hunting once a fortnight. Mary received a good education at home, and when the family moved to Pendock Hills in 1833, she attended ‘a very good school’ at the Barrow Parsonage where she eventually became one of the teachers.

The Thackwell family’s substantial properties had been inherited by eldest sons, who as it happened, were not Mary’s progenitors. Her father, however, owned a farm and fruit orchards and established a successful store on the high street in Cheltenham. Income from the business allowed her father to buy land and build houses, and unlike her brothers, Mary enjoyed traveling the area with her father to deal in goods for the store, but when her mother had to travel, Mary would stay at home and look after the children because her mother did not trust the servant to care for them. Thus, she learned to care for others. In addition to caring for her siblings, Mary learned early about caring for the sick. An experience with one of her grandmother’s sisters, very ‘ill and emaciated’ with breast cancer, deeply affected her. She described her aunt’s daughter as a ‘kind and affectionate nurse’ who kept school after her mother died and taught Mary hymns that stayed with her for the rest of her life. In addition, her grandfather Thackwell, a watch and clockmaker, raised herbs that he used to treat family members and others in times of sickness. As an adult, however, Mary did not hesitate to call a physician when necessary.

Not long after her marriage to John Davis in 1840, the couple, who had joined the Church of Jesus Christ of Latter-Day Saints, were attacked by a mob; John was battered and developed bleeding from the lungs. Mary called in the family physician who told them to keep John very quiet in bed. The bedrest helped until some excitement occurred and he relapsed and died. At that point, Mary decided to join the Saints in Nauvoo, writing in her autobiography, ‘on the 4^th of May 1841 I left all that was near and dear to me to travel some thousands of miles alone and cast my lot with the people of God.’ Upon leaving, she gave some of her books to her sisters for them to read when she was ‘far away.’ On the ship, she was one of three passengers who did not get seasick and cared for the others and her journal included harrowing incidents associated with carrying saucepans of gruel up and down the hatches.

Mary also learned about illness firsthand after her arrival in America. She and her fellow passengers had crossed the Atlantic on a cargo ship on its way to Quebec to pick up a load of lumber. The owners built clean, new berths so they could take passengers, and they had travelled quite comfortably. But, after arriving in Quebec, they boarded an old steamship to continue their journey to Nauvoo. The steamship was filthy and infested with bed bugs ‘full of poison’ that bit her feet until they were so inflamed she could not stand on them and felt so sick she did not care if she was left behind. She asked for some ‘sugar of lead’ to make a lotion to dress her feet and legs, and some of the sisters changed the dressings often greatly relieving her suffering. By the time they arrived in Nauvoo, Mary’s feet were well enough for her to care for others again. As soon as she had taken care of her luggage, she had the opportunity to look after a couple who were prostrate with a fever they had acquired (as they presumed) from traveling in hot weather.

In November Mary married Brother Peter Maughan, a widower with five young children. Caring for her siblings earlier in life made her comfortable with her new children, and one of them would later note that she was an exemplary mother to them.[61] That winter one of her fine feather beds froze to the floor of their cabin, and she lamented that many of her nice dishes and fine China tea sets had not survived the journey, but the most serious problem was that they were ‘in constant dread of the Mob.’ Illness was a constant concern as well. Like most people living in warm weather along the Mississippi River, they contracted malaria, known as ‘ague.’ Mary noted, ‘The people living in that part of the Country expected to have it every fall and were seldom or ever disappointed.’ When the whole family had the ague, ‘some of us shook one day and some another’ and they were grateful to have quinine to treat it. Mary also came down with ‘sore eyes’ after contact with a woman who had this strange illness. She suffered with it until ‘one day the pain left my eyes and went down my throat like a knife cutting its way and settled in my bowels.’ She could not eat for five days and prayed she would not die so she could care for the children. Meanwhile, the family continued with ague and diarrhoea. Her husband, Peter, was so sick he was also lying in bed ready to die. At that point, they had a visit from Dr Willard Richards,

O said the Doctor you are not going to die. You are going with me Beyond the Rocky mountains. I want to go way out yonder pointing with this stick to the West. (this was the first we heard about going west) Why here is a weed growing in your dooryard that will cure you all. I will pick you some when I go out. After staying some time he went out and sent in a handful of small parsley, saying, put this in a cup make a tea and take a swallow three times a day. This cured the Diarrhea.[62]

Mary’s second baby was three weeks old when they left to go west in April 1850. Five days later, she recorded attending a Sister Lund in the delivery of her daughter, her first mention of assisting in childbirth. Although the weather was cold, Mary was satisfied that the new mother was ‘taken good care of’ and did well.[63] When the Maughans arrived in the Salt Lake Valley, they were advised to help settle Tooele, an area thirty-five miles further west, where they built a large log house. Soon after moving in, Mary received a letter from Dr Willard Richards calling her to be the midwife for Tooele.  She was ‘sorrowful’ at the thought of taking on such an important responsibility, especially when she had a large family to care for and needed a rest. In the letter, she was directed to go to Dr Richards’ office in Salt Lake City the next time she was in the city to be ‘ordained to that calling’ and become a member of the Council of Health. While Mary was surprised to be called as a midwife, receiving a calling was not unexpected. There was no paid professional clergy in the Church of Jesus Christ of Latter-Day Saints, and everyone was used to being called by God to specific responsibilities. So, despite misgivings, Mary dutifully began delivering babies before she had a chance to go to the city. When she did go, she was determined to argue the case to Dr Richards that she should be released.  Dr Richards responded that the call was for her. So, she was ordained by the laying of hands on her head and blessed with ‘many great blessings.’ She was especially comforted to be blessed that her family would be safe in her absence and was grateful that after years of service, her family was unharmed. She stated she was also unharmed, even when she had to ride alone on horseback in conditions where she had to depend on her horse to take her home.

When called to be the midwife for Tooele, Mary had no formal midwifery training, but she joined the Council of Health and would have received training from them. In addition, the general education and managerial skills she developed while growing up would stand her in good stead as she set about fulfilling her duties. She also had to have stamina. The Maughans moved into their new log house in Tooele in November of 1850, and in April Mary gave birth to her fourth son, Hyrum. Less than two weeks later, she was called out to ‘attend a sister in her confinement.’ At that time women were expected to rest in bed for several weeks after delivering a child, but Mary noted that no harm came to her.

Mary continued her duties in Tooele until 1856 when trouble with the Goshute people, who had been living in the area long before the arrival of the Latter-day Saint pioneers, and repeated crop failures forced them to move to a new area. They were called to help settle Cache Valley, about eighty miles north of Salt Lake City. Mary explained that they had crossed the plains with two Prairie Schooner wagons pulled by oxen with Peter driving one and Mary driving the other, and they travelled the same way to Cache Valley. Mary’s was the first wagon in the train, so she was the first person to drive a settler’s wagon there. Before they could build a cabin, Mary gave birth to her first daughter on a snowy morning in the wagon bed, the first settler born in Cache Valley. Thirteen days later she attended the birth of the second baby born to the settlers, also a girl.

Mary attended many more births in the valley and cared for many others in times of injury and sickness. Mary made her only mention of using anaesthesia in childbirth on 25 February 1873 when she was attending a Mrs. Fred Goodwin. Mrs. Goodwin was having a very difficult time and was finally delivered under chloroform by a local physician, Dr Ormsby, senior. The baby did not survive, but the mother was saved. In all of her work as a midwife, Mary told of only one death of a woman in childbirth. The death happened when Mary was sick and unable to perform her midwifery duties. For decades Mary continued with her midwifery duties, delivered hundreds of babies, ‘dressed babes,’ and cared for the sick in the northern Utah communities where she was sometimes known as the ‘Mother of Cache Valley.’[64] Mary Ann Weston Maughan was also known as a woman who ‘knew the propriety and exactness of English schooling,’[65] an important foundation for all that came after.

Janet Downie Hardie

Janet Downie Hardie was born on 10 April 1810, in Leith, Scotland. Her father, Alexander Downie, was a successful mariner, trusted to transport such cargo as the Rothschild treasure. Janet’s mother, Agnes McDonald Clark Hardie, passed away in 1829 when her youngest child, Margaret, was just four years old. But the children were well cared for and well educated.  It was said that Margaret could speak several languages.[66] The same year that her mother died, Janet married John Hardie, charismatic ship captain, fellow Scotsman, son of gentleman farmers, and friend of the family, at a ceremony in London where the Downie family was living. Janet’s father was a doting parent and when Janet married, he furnished her house with the best that money could buy including a solid mahogany dining table and chairs with ‘handsome carved curved backs’ that would seat a large company. When he died in 1841, Alexander Downie left both his daughters, Janet and Margaret, valuable assets including a quarter share in a ship called the Diadem of Dundee which would yield an income of £90 a quarter. On his deathbed, however, he is reported to have been very anxious about Janet because her husband, John, was not careful with money.  Alexander Hardie worried that because of her husband’s profligate ways his ‘daughter and her little family’ would ‘come to beggary.’

By 1842, Janet and John were back in Edinburgh, where the last three of their nine children were born and Alexander’s fears were being realized.[67] Janet’s granddaughter remembers her mother, Phyllis, telling her about Janet signing over her rights to the Diadem of Dundee saying she knew she was signing away her children’s bread but ‘could never say no to him.’[68] Janet joined the Church of Jesus Christ of Latter-Day Saints in 1845. John died of typhus two years later, four months before the birth of their last child, a girl she named Margaret Alison Mary Dall Hardie.

Janet was left ‘penniless’, so she sold her possessions (the mahogany table was purchased by the bank of Leith) and turned to wet nursing to support her young family. Sadly, baby Margaret died the same year she was born. As a solidly middle-class woman, Janet would have fit in well as a nurse for well-to-do families. Matrons of lying-in hospitals and birth attendants such as midwives and physicians likely facilitated her employment, and Janet brought in a good income.[69] One source indicates that Janet was invited to become a wet nurse for one of Queen Victoria’s children.[70] This claim is difficult to verify, but some evidence makes it plausible.  Queen Victoria gave birth to Princess Louise on 18 March 1848 a month before Janet gave birth to her last child, and Janet could have been well known because a wet nurse with middle-class sensibilities was rare. Sir James Simpson, the famous obstetrician knighted for his pioneering work in obstetrical anaesthesia, gynaecology, and hospital reform, became Professor of Midwifery at the University of Edinburgh in 1840 and was Queen Victoria’s official ‘physician to the Queen in Scotland’ by 1847.[71] In his teaching and obstetric practice at the Lying-in Hospital, it is plausible that he knew about Janet Hardie’s practice, and he placed other women in aristocratic, even royal situations. For example, he recommended Mrs. Johnston, an Edinburgh nurse, to ‘attend Princess Christian’s first confinement at Windsor’ and received communication from the Royal Physician praising Mrs. Johnston’s ‘knowledge and skill’.[72]

Surprisingly, sources state that Janet eventually ‘entered’ the University of Edinburgh, ‘studied obstetrics,’ ‘graduated under’ Sir James Y. Simpson and had a diploma signed by him.[73] One source, published in 1915, stated the diploma, signed by James Y. Simpson was still in existence at that time.[74] Her granddaughter, Kate Burton, stated that Janet ‘went to Edinburgh College, where they had ‘classes’ for obstetrics, and where she graduated, receiving her diploma, which was signed by Sir Joseph Simpson.’[75]The fact that Burton calls the institution Edinburgh College suggests that she was not reading from the previous sources and, unfortunately, her inaccurate name for Simpson suggests she was not looking at the diploma.

We have not been able to locate Hardie’s diploma but did find related documents in the Lothian Health Services Archive in Edinburgh. The two documents, which are for a midwife named Jane Todd, include a ‘Nurse’s Midwifery Diploma’ and a certificate verifying completion of midwifery training at the Edinburgh Royal Maternity and Simpson Memorial Hospital.[76] These documents are from 1885 but correspond to descriptions of Hardie’s training and diploma. The hospital training document gives details about how much time the trainee spent there observing and performing deliveries and nursing patients during the puerperal period. In the 1840s and 1850s, it was the Edinburgh Maternity Hospital or the Royal Maternity Hospital. The Edinburgh Lying-In Institution to be distinguished from the General Lying-In Hospital which was the forerunner to the Royal Maternity Hospital, opened at 13 High School Yards in 1824.[77] On the back of Todd’s diploma, we find official documentation about using it as a credential for practicing in South Dakota.

Janet Hardie reportedly practiced in the Lying-in Hospital of Edinburgh two years before she came to America.[78] Like Jane Todd several decades later, Janet apparently completed her classroom studies and then practiced for a certain period in a clinical setting where she received ‘additional valuable training.’[79]Professors had been formally training midwives in Edinburgh since the early eighteenth century.[80] Standard text books were used to supplement lectures, including one with a ‘companion volume’ first published in 1793 and still in use in 1852 called Concise Rules for the Conduct of Midwives in the Exercise of their Profession to which is Prefixed a Syllabus for the use of the Midwives Educated at the University of Edinburgh.[81] One early student, Mrs. Margaret Reid ‘completed three courses of… lectures and was awarded a Certificate in 1768’.[82]  The certificates awarded to successful students were of the utmost importance for demonstrating the midwife’s learning and skill, could be beautifully engraved and decorated, and were a great source of pride.[83] Although women were not admitted to the University of Edinburgh as undergraduates until 1892, they were being educated by University professors in Edinburgh as midwives for well over a century before.[84]

In 1851, Janet was living in Midlothian with her five-year-old son James, her sixteen-year-old daughter Agnes, and her twenty-five-year-old sister, Margaret. It was then three years since Janet’s last baby was born, and she was practicing as a ‘sick nurse’ while Margaret kept house and Agnes did needlework.[85] Baby Margaret had died before she was a year old, and the other children went to live with their paternal grandfather.[86] This support from her extended family would have made it possible for Janet to work and study. By 1852, she was practicing as a ‘lady’s nurse’ in Edinburgh.[87] A lady’s nurse generally cared for women and their newborns during the puerperal period after childbirth with the advantage that caring for women during the puerperal period rather than during labour and delivery included more regular hours and comfortable living conditions. Not every household could afford to hire a lady’s nurse.[88] From 1853 to 1856 she lived on India Street, which had a high concentration of lady’s nurses.[89]

In 1856 Hardie, her five children, and her younger sister, Margaret, left Edinburgh to join the Latter-Day Saints in America. They crossed the Atlantic on an Enoch Train ship with many of their Scottish Latter-Day Saint friends then travelled from New York City to Iowa where they joined the McArthur handcart company, made up mostly of Scottish Saints. Known as the ‘crack company’ for their exceptional cohesiveness and hardiness, they competed with the Ellsworth company – who had a two-day head start – to see who could arrive first in Salt Lake Valley.   After a spirited competition, they arrived at the mouth of Emigration Canyon at the edge of the Salt Lake Valley on 26 September 1856 to find Ellsworth’s company having a picnic with Brigham Young and other dignitaries. The McArthur company joined the picnic, then they paraded into Salt Lake City together. Only ten of the 220 members of McArthur’s company did not survive the journey.[90]

Soon after they arrived in the Salt Lake Valley, Janet began practicing midwifery. The Daughters of the Utah Pioneers record calls her Dr Hardie and states that she ‘became one of the most popular obstetricians in Utah and one of the most sought-after nurses in that section of the country.’[91] The Relief Society Magazine states she was ‘popular in her own land’ and that, ‘the sweet, gracious features of “Grandma Hardie,” her benign influence, her tender solicitude, her courage, her indomitable faith, are traditions in every home in this pioneer country …’ When she died in 1872, she was mourned by ‘thousands of grateful pioneer mothers and friends’.[92]   With certificate in hand, Janet Hardie developed an influential career in Utah.

Discussion

The largest number of immigrants to Utah from outside North America were from Britain. In the middle of the nineteenth century, 22 percent of Utahns were from the British Isles compared with 16 percent from Scandinavia, the second most common place of origin. Large numbers of Scandinavian farmers left some other pursuits more open to immigrants from American states and Britain, many of whom came from more urban areas.[93] These other pursuits included looking out for the population’s health through nursing and midwifery.

Susannah Liptrot Richards and Janet Hardie excelled in nursing and midwifery pursuits, both bringing formal training with them from Britain. If Susannah trained in English hospitals, she was as qualified for nursing work as the most admired women working with Florence Nightingale in the Crimea in the 1850s. Whatever her background, she was respected for her ability to teach nursing to others and played an integral role in establishing and maintaining the Council of Heath. Janet Hardie also brought training with her to Utah, more certain training than we can know about Susannah. Janet’s certificate signed by Sir James Simpson gave her a credential rare among the women of her day and signified formal study with the most eminent obstetrician of the time. In addition to didactic study with professors of the University of Edinburgh, a world centre of medical education, the certificate denoted rigorous practical training at a lying-in hospital in Edinburgh. Susannah’s status as a nurse trained in Britain and Janet’s status as a practitioner credentialed by one of the most prestigious institutions of the day not only made them useful in the community but sources of pride.

Mary Ann Maughan had no formal training before her calling as a midwife and induction into the Council of Heath, but her British experiences at home and in school laid a foundation of critical thinking and organizational skills that allowed her to develop her role as community health provider and childbirth attendant in addition to her role as wife and mother.  Mary Ann’s experience was much more common than Susannah’s or Janet’s, because many women were called to serve as midwives in Utah communities. While her story typifies the role of midwife in the community, it also foregrounds indications that British women were more often called to serve as midwives than their numbers alone would justify. If the just over one hundred midwives in Kate Carter’s collection of biographical sketches of mid nineteenth-century Latter-day Saint midwives is representative of the population, 49 percent of midwives were British while only 22 percent of Utah’s inhabitants were British. Ten percent of midwives were Scandinavian while 16 percent of Utah’s population was Scandinavian.  Another 11 percent of midwives were from other countries outside the United States, making 30 percent of midwives from the United States.[94] Unfortunately, we do not have the percentages of immigrants in the total population from countries other than Britain and Scandinavia, but the information we have indicates that British women were favoured in the midwife role. Mary Ann’s exacting education was a factor that characterised the British in American minds, contributing to a general impression of the British as well-educated, intelligent people, important qualities for those in the essential role of midwife.

Susannah’s, Mary Ann’s, and Janet’s lives tend to corroborate Rebecca Bartholomew’s findings regarding British women immigrants to Utah.[95] First, they had opportunities to have a career and raise children. In this respect, they are similar to Martha Ballard, the midwife in Laurel Thatcher Ulrich’s A Midwife’s Tale. We do not have journals or autobiographies for Susannah or Janet, but we know that Mary Ann struggled to deal with both her work with parturient women in need and her work at home with a large family. As a primary provider of care for the sick and childbearing, and the primary manager of her home, she was often exhausted.  Bartholomew states that while most of the characteristics encapsulated in negative stereotypes of nineteenth-century Latter-day Saint women can be found among her one hundred women, none of them is ‘close to resembling the verminal subhuman of the Eastern and European presses’, and according to available sources, neither are the three women in this study.[96] The sources used for this study tend to be one-sided in their favour, which must be taken into consideration when evaluating their lives. Nevertheless, there is evidence here of their accomplishments and influence in their communities.

Conclusion

Like the women in Bartholomew’s study, Susannah, Mary Ann, and Janet surely made mistakes, though available sources do not supply accounts of them, but their British background was a factor in their important contributions in Utah. Mid-nineteenth-century Latter-day Saints valued learning for spiritual and practical reasons and believed the British to have a high level of learning and intelligence. They valued health promotion and disease prevention, and like other people, they valued skilled nursing and medicine to treat illness and preserve the lives of women and babies experiencing childbirth.

The three women discussed in this article were revered for their British learning and their nursing and midwifery training. Susannah Lee Liptrot Richards was respected as an English ‘trained nurse,’ although we cannot be certain about what her training entailed, and she was possibly trained in an English hospital. Mary Ann Weston Maughan had little formal training, but her exacting English schooling was recognized as a solid foundation for her midwifery and nursing work.  Janet Downie Hardie’s formal midwifery credential gave her high status at a time when university related education was rare on the frontier.

All three women had significant accomplishments. Susannah Richards was instrumental in developing nursing education in the Council of Health which became the foundation for nursing education in Utah. Mary Ann Maughan became known as the mother of Cache Valley. Janet Hardie was described as a purveyor of ‘benign influence.’  Our available sources make a more critical evaluation of their roles and accomplishments difficult, and further research is indicated. Ultimately, their stories are a deserving part of the Utah story. What we can learn from the sources is that these women were admired for accomplishments based in their solid British education and training, which were rare on the frontier and particularly valued in Latter-day Saint society.

 

Endnotes

[1] Kate Carter, Our Pioneer Heritage, (Salt Lake City: Daughters of Utah Pioneers, 1959). Keith Terry, ‘The Contribution of Medical Women During the First Fifty Years in Utah’ (unpublished Masters thesis, Brigham Young University, 1964); Sandra Noall, ‘A History of nursing education in Utah’ (unpublished PhD thesis, University of Utah, 1969); Sylvia Hoffert, ‘Childbearing on the Trans-Mississippi Frontier, 1830-1900’, Western Historical Quarterly 22/3 (1991), 272- 288; Sarah Barney, ‘Nursing and health care among Mormon women: An analysis of the Relief Society Magazine, 1914-1930’ (unpublished Masters Thesis, Brigham Young University, 1993); Elaine Marshall, Learning the Healer’s Art: Nursing education at Brigham Young University(Provo: College of Nursing, Brigham Young University, 2012).

[2]   FamilySearch.  Available at: www.familysearch.org [Accessed 21 November 2023]

[3] Patricia D’Antonio, American Nursing: A History of Knowledge, Authority, and the Meaning of Work (Baltimore: The Johns Hopkins University Press, 2010), chapter 1.

[4] Susan Reverby, Ordered to Care: The Dilemma of American Nursing, 1850-1945 (Cambridge: Cambridge University Press, 1987), 12.

[5] Brian Fiani, Claudia Covarrubias, Ryan Jarrah, Athanasios Kondilis, Thao Doan, ‘Bellevue Hospital, the Oldest Public Health Center in the United States of America,’ World Neurosurgery, 67 (November 2022), 57-61.

[6] Reverby, Ordered to Care, 61.

[7] Sandra Lewenson, Taking charge (New York: Garland, 1993), 22.

[8] Philip Kalisch and Beatrice Kalisch, The Advance of American Nursing, (Philadelphia: Lippincott Williams & Wilkins, 2004), 63.

[9] Lewenson, Taking Charge, 23.

[10] Martha Ballard, A Midwife’s Tale: The Life of Martha Ballard, Based on Her Diary, 1785-1812, (New York: A Knopf, 1990).

[11] Joyce Thompson, and Helen Burst, A History of Midwifery in the United States: The Midwife Said Fear Not (New York: Springer, 2016), 6.

[12] Thompson and Burst, A History of Midwifery, 13.

[13] The Church of Jesus Christ of Latter-day Saints, [n.d.]. Nauvoo: City Beautiful.  Available at: https://history.churchofjesuschrist.org/content/trek/nauvoo-city-beautiful?lang=eng [Accessed 24 November 2023].

[14] Charles Dickens, ‘The Uncommercial Traveler, Number 21’, All the Year Round 9, 4 July 1863, 444-449.  Available at: https://www.djo.org.uk/indexes/authors/charles-dickens/the-uncommercial-traveller.html [Accessed 24 November 2023].

[15] Dickens, ‘The Uncommercial Traveler, Number 21’.

[16] Richard Monkton Milnes, ‘The City of the Saints and across the Rocky Mountains to California’, The Edinburgh Review 115/233 (1862), 185-210. Available at: https://www.proquest.com/docview/6783836/fulltext/F6A12CBDF73E4068PQ/11?accountid=4488         [Accessed 24 November 2023].

[17] Richard Jensen, ‘British Immigrants and life in Utah’, Utah History Encyclopedia (1994).  Available at:  www.uen.org/utah_history_encyclopedia [Accessed 24 November 2023].

[18] World Population Review, [n.d.], English population by state, updated 2023.  Available at: https://worldpopulationreview.com/state-rankings/english-population-by-state [Accessed 24 November 2023].

[19] Frederick Buchanan, ‘Imperial Zion: The British Occupation of Utah,’ in The Peoples of Utah ed. by Helen Papanikolas, (Salt Lake City: Utah State Historical Society, 1976).

[20] Buchanan, ‘Imperial Zion,’ 70-73.

[21] Buchanan, ‘Imperial Zion,’ 70-73.

[22] Rebecca Bartholomew, Audacious Women: Early British Mormon Immigrants (Salt Lake City: Signature Books, 1995). Bartholomew presents a discourse about the lives of one hundred British Latter-day Saint women who emigrated to Utah in the nineteenth century. Bartholomew weaves fragments of Mary Ann Maughan’s experiences throughout the book but does not mention that Maughan was a midwife. Bartholomew briefly mentions that Janet Hardie was an ‘obstetrician’ who studied under Sir James Simpson and went to Utah with a handcart company after the death of her husband. Bartholomew’s discussion of midwifery is limited to a short account of midwife Mary Elizabeth Hilstead Shipp, from Hull in Yorkshire, told through the writings of her more famous sister wife, Ellis Shipp.

[23] Kate Carter, Our Pioneer Heritage Volume 6, (Salt Lake City: Daughters of Utah Pioneers, 1963), 425-560.

[24] Helen Papanikolas, ed., The Peoples of Utah (Salt Lake City: Utah State Historical Society, 1976).

[25] Papanikolas, The Peoples of Utah.

[26] Susa Gates, ‘L.D.S. Relief Society Class for Training Nurses’ Aids’, Relief Society Magazine 7/7, July 1920, 377.

[27] Gates, ‘L.D.S. Relief Society Class’.

[28] Mountain Star Healthcare [n.d.], St. Mark’s Hospital. Available at: https://mountainstar.com/ [Accessed 24 November 2023].

[29] Carter, Our Pioneer Heritage, 361-424.

[30] Hoffert, ‘Childbearing on the Trans-Mississippi Frontier.’

[31] Gates, ‘L.D.S. Relief Society Class’, 377.

[32] Ibid. 377.

[33] ‘Announcement’, Deseret News, 29 June 1850, 4. The Deseret News began in Salt Lake City in 1850 as a weekly newspaper reporting local and national news of all kinds. The paper was published every two weeks when newsprint was scarce. When the Pony Express began bringing news to the territory in 1860, ‘extras’ were published, and with the advent of the telegraph, extras appeared nearly every day. The Deseret News began publishing regular issues daily, except Sundays, in 1865 and has been published continually from 1850 to the present. Available at: https://www.deseret.com/2010/6/14/20120706/160-years-of-history-through-the-eyes-of-the-deseret-news [Accessed 24 November 2023].

[34] Deseret News, 20 March 1852, 38.

[35] Deseret News, 8 March 1851, 221.

[36] The Church of Jesus Christ of Latter-day Saints, Doctrine and Covenants, Section 88: 78-80 (Salt Lake City: The Church of Jesus Christ of Latter-day Saints, 1981), 170. The Doctrine and Covenants was originally published in 1835.

[37] President Heber C. Kimball’s Journal [1882], 10. Available at: https://history.churchofjesuschrist.org/content/trek/the-convert-immigrants?lang=eng [Accessed 24 November 2023].

[38] Wilford Woodruff Papers, ‘Susannah Lee Liptrot Richards’.  Available at:  https://wilfordwoodruffpapers.org/subjects/susannah-lee-liptrot-richards [Accessed 24 November 2023].

[39] Gates, ‘L.D.S. Relief Society Class’, 376; [anonymous] ‘Ye Ancient and Honorable Order of Midwifery,’ Relief Society Magazine 2/8, August, 1915, 348; Kate Carter, Our Pioneer Heritage, 361; Find a Grave [n.d.], Susannah Liptrot Richards.  Available at: https://www.findagrave.com/memorial/23823202/susannah-richards [Accessed 24 November 2023].

[40] Carol Helmstadter and Judith Godden, Nursing Before Nightingale, (Burlington, VT: Ashgate, 2011), 123.

[41] Adelaide Nutting and Lavinia Dock, A History of Nursing, (New York: G. P. Putnam’s Sons, 1907), 77.

[42]  Richard Huntsman, Mary Bruin, and Deborah Holttum, ‘Twixt Candle and Lamp: The Contribution of Elizabeth Fry and the Institution of Nursing Sisters to Nursing Reform’, Medical History, 46 (2002), 351-380, 358.

[43] Saints by Sea: Latter-day Saint immigration to America [n.d.], Liverpool to New Orleans 17 Sep 1842-11 Nov 1842.  Available at:  https://saintsbysea.lib.byu.edu/mii/voyage/334 [Accessed 24 November 2023].

[44] Helmstadter and Godden, Nursing Before Nightingale, 113-114.

[45] Helmstadter and Godden, Nursing Before Nightingale, 42.

[46] Helmstadter and Godden, Nursing Before Nightingale, chapter 6.

[47] Helmstadter and Godden, Nursing Before Nightingale, 47-48.

[48] Florence Nightingale Museum [n.d.], Nurses sent to the Military Hospitals in the East, 31 and 51.  Available at: https://www.florence-nightingale.co.uk/wp-content/uploads/Register-of-Nurses.pdf [Accessed 24 November 2023]. See also Nutting and Dock, A History of Nursing, Volume 2, 77.

[49] Florence Nightingale Museum [n.d.], Nurses sent to the Military Hospitals in the East, 52. Available at: https://www.florence-nightingale.co.uk/wp-content/uploads/Register-of-Nurses.pdf, [Accessed 24 November 2023].

[50] Florence Nightingale Museum [n.d.], Nurses sent to the Military Hospitals in the East, 40.  Available at: https://www.florence-nightingale.co.uk/wp-content/uploads/Register-of-Nurses.pdf, [Accessed 24 November 2023].

[51] Saints by Sea: Latter-day Saint immigration to America [n.d.], Liverpool to New Orleans 17 Sep 1842-11 Nov 184, Journal of Alexander Wright.  Available at:  https://saintsbysea.lib.byu.edu/mii/account/1165 [Accessed 24 November 2023].

[52] John Warner, The therapeutic Perspective: Medical Practice, Knowledge, and Identity in America, 1820-1885 (Cambridge, MA: Harvard University Press, 1986), 52.

[53] Paul Starr, The Social Transformation of American Medicine: The Rise of a Sovereign Profession and the Making of a Vast Industry (New York: Basic Books, 1982), 51.

[54] Willard Richards was a leader in the church serving as secretary to church president, Joseph Smith, narrowly escaping a bullet when Joseph was martyred at Carthage, Illinois in 1844.

[55] FamilySearch [n.d.], Susanah Liptrot Richards.  Available at:  https://www.familysearch.org/ark:/61903/1:1:QK9B-HN45 [Accessed 24 November 2023].

[56] Gates, ‘L.D.S. Relief Society Class’, 376; [anonymous] ‘Ye Ancient and Honorable Order of Midwifery,’ 348; Kate Carter, Our Pioneer Heritage, 361; Find a Grave [n.d.], Susannah Liptrot Richards.  Available at: https://www.findagrave.com/memorial/23823202/susannah-richards [Accessed 24 November 2023].

[57] [Anonymous] ‘Ye Ancient and Honorable Order of Midwifery’, Relief Society Magazine 2/8 (1915), 345-350, 348. Available at: https://archive.org/details/reliefsocietymag02reli/page/348/mode/2up?view=theater[Accessed 24 November 2023].

[58] J. Cecil Alter, ‘Early Utah Medical Practice, Addendas’, Utah Historical Quarterly, 10 (1942), 38.

[59]  [Anonymous] ‘Nursing in the Relief Society’, Relief Society Magazine 2/7, July 1915, 316.

[60] Mary Maughan, Reminiscences and Journals, 1850-1898, The Church of Jesus Christ of Latter-day Saints, Church History Library, MS 8237 ITEM 2. This is a handwritten document in three volumes. All but the account of the Maughan’s trek to the Salt Lake Valley is not dated and the pages are not numbered. However, although written forty years after emigrating to Utah, the undated portions of the manuscript are detailed and periodically include dates for important occurrences indicating that she wrote the autobiography with the aid of personal diaries. See also Bartholomew, Audacious Women, 267. All quotes in this paragraph are drawn from the unpaginated autobiography.

[61] Ruth Mitchell, ‘Mary Ann Maughan, Wife of Cache Colonizer, Was Remarkable Woman’, The Herald Journal, 1 July 1956, 8.  Available at: https://www.familysearch.org/tree/person/memories/KWJB-NF3 [Accessed 24 November 2023].

[62] Maughan, Reminiscences and Journals, Volume 1.

[63] This point begins Maughan Reminiscences and Journals, Volume 2. Maughan gives a dated journal account of crossing the plains then resumes her undated autobiography.

[64] Maughan, Reminiscences and Journals Volume 3; ‘Mary Annn Maughan’, The Herald Journal.

[65] ‘Mary Ann Maughan’, The Herald Journal.

[66] Kate Burton, ‘The Family’[undated typescript], 2-5.  Available at: https://www.familysearch.org/photos/artifacts [Accessed 24 November 2023].  Kate Burton is a granddaughter of Janet Downie Hardie. Her account is based on memories of stories told her by her mother, Janet Downie’s daughter Phyllis, and other family members. All unattributed quotes in this section are drawn from this source.

[67] Family Search [n.d.], Janet Downie. Available at: https://www.familysearch.org/tree/person/details/LKT5-TKN [Accessed 24 November 2023].

[68] Burton, Family, 2.

[69] Burton, Family, 1-2.

[70] [Anonymous] ‘Ye Ancient and Honorable Order of Midwifery’.

[71] National Records of Scotland [n.d.], Sir James Young Simpson (1811-1870). Available at: https://www.nrscotland.gov.uk/research/learning/hall-of-fame/hall-of-fame-a-z/simpson-james-young [Accessed 24 November 2023].

[72] Barbara Mortimer, ‘The nurse in Edinburgh c. 1760-1860: the impact of commerce and professionalization’ (unpublished PhD thesis, University of Edinburgh, 2001), 144.

[73] ‘Ye Ancient and Honorable Order of Midwifery’, 349; Hoffert, ‘Childbearing on the Trans-Mississippi Frontier’.

[74] ‘Ye Ancient and Honorable Order of Midwifery’, 349

[75] Burton, Family, 2

[76] The University of Edinburgh Archives; Lothian Health Services Archive

Diploma of Edinburgh Royal Maternity and Simpson Memorial Maternity Hospital 1885, Nurse’s Midwifery Diploma, 1885. MAC GD 1/35/1.

Nurse’s Midwifery Diploma, Diploma for Jane Todd signed by Angus Macdonald, M.A., M.D., FRCPE, Lecturer in Midwifery and the Diseases of Women and Children In the School of Medicine. Edinburgh, 1885. MAC GD 1/35/2.

[77] The University of Edinburgh Archives [n.d.], GD1/76 Edinburgh Lying-in Institution.  Available at: https://www.lhsa.lib.ed.ac.uk/collections/GD1_76/gd1_76_tlfa.htm [Accessed 24 November 2023].

[78] ‘Ye Ancient and Honorable Order of Midwifery’, 349.

[79] Daughters of Utah Pioneers, Library and Resource Files, Pioneer Index-History Card, ‘Janet Downie Hardie’; Kate Carter, Our Pioneer Heritage, 409.

[80] Donald Thomson, ‘General practice and the Edinburgh Medical School: 200 years of teaching, care and research’ Journal of the Royal College of General Practitioners, January 1984; Allen Simpson, ‘James Hamilton’s Lying-in Hospital at Park House and the Status of Midwifery Instruction in the Edinburgh Medical School’, Book of the Old Edinburgh Club New Series Vol. 3 (1994), 131-141; Lisa Cody, ‘Living and Dying in Georgian London’s Lying-In Hospitals’, Bulletin of the History of Medicine 78/2 (2004), 309-348.

[81] Mortimer, ‘The Nurse in Edinburgh’,187.

[82] Mortimer, ‘The Nurse in Edinburgh’,179.

[83] Mortimer, ‘The Nurse in Edinburgh’,181.

[84] The University of Edinburgh n.d.], Historical Alumni, Awards to Women Students, 1876-1894.  Available at:  https://collections.ed.ac.uk/  [Accessed 24 November 2023].

[85] FamilySearch [n.d.], Janet Hardie, with particular reference to ‘Scotland Census 1851’. Available at: https://www.familysearch.org/tree/person/sources/LKT5-TKN [Accessed 24 November 2023].

[86] John Hardie, Mission Journal, 1867-1868, The Church of Jesus Christ of Latter-day Saints, Church History Library, MS 29614, 4. Available at: https://catalog.churchofjesuschrist.org/search/_simple/John+Hardie?lang=eng [Accessed 24 November 2023].

[87] Post Office Edinburgh and Leith Directory (1853-4), 98.  Available at: https://digital.nls.uk/directories/browse/archive/83100558 [Accessed 24 November 2023].

[88] Mortimer, ‘The Nurse in Edinburgh’.

[89]  Post Office Edinburgh and Leith Directory (1853-4); Ibid. (1855-6).

[90] The Church of Jesus Christ of Latter-day Saints [n.d.], Church History Biographical Database, ‘Daniel D. McArthur Company (1856)’.  Available at: https://history.churchofjesuschrist.org/chd/organization/pioneer-company/daniel-d-mcarthur-company-1856?lang=eng [Accessed 24 November 2023].

[91] Daughters of Utah Pioneers, Library and Resource Files, Pioneer Index-History Card, ‘Janet Downie Hardie’; Carter, Our Pioneer Heritage, 409.

[92] ‘Ye Ancient and Honorable Order of Midwifery’, 349.

[93] Buchanan, ‘Imperial Zion.’

[94] Carter, Our Pioneer Heritage, 425-560.

[95] Bartholomew, Audacious Women, Conclusion.

[96] Bartholomew, Audacious Women, 254.