one herself. Often, the task was allotted to motherly or grandmotherly hands, and the monthly nurse originated from that requirement for postnatal care. The Nursing Record reported that "there was little or no attempt at knowledge or instruction, and we know as a fact that ignorance, prejudice and neglect resulted in a goodly crop of errors, wrongs, and woes as regards the hapless infant." The Nursing Record reported that "nurses who attend the 'artisan' classes in their confinements as a rule pay a visit daily for ten days and then give up the case, as few working class mothers can afford to lie up for longer." A monthly nurse could earn more than a midwife, as the monthly nurse was employed for periods between 10 days and often much longer and might attend to several women part-time. She often "lived in." The midwife's only duty was perceived as "being trained to assist the parturient woman while nature does her own work and able to call upon a surgeon who could step in where nature fails and skill and science are required." Many certified midwives transferred to the ranks of monthly nurses to benefit from an increased income. Certification Although 'registration' was not available for women to act as midwives or monthly nurses, a system of 'certification' existed in the late 19th century and continued into the early 20th century. To qualify, a candidate monthly nurse would attend a course in a lying-in hospital for four or five weeks and a midwife for up to three months. As a rule, the prospective midwives and monthly nurses paid their own charges in respect of hospital expenses and then entered practice on their own responsibility. In 1893, Miss Gosling reported that "although the certificated monthly nurse could be relied upon as being trustworthy and efficient, there were a number of women who attend lectures for a short time and through one cause or another fail to pass their examination and obtain a certificate nevertheless enter a 'Nurses Home' or open one for themselves." As might be expected, rogue institutions issued certificates and diplomas "for a price." Another reporting on a lying in hospital and signing herself a 'victim of the system' said that she "witnessed the first phase of the system which turns out yearly hundreds of midwives and monthly nurses on an unsuspecting public. These would be nurses represented almost every grade