My mother was raised in poverty of Dickensian proportions. Crowded public housing, never enough money for coal, and always hungry. One sister spent much of her youth in a tuberculosis sanatorium. During the war the major source of income was selling ration coupons on the black market and when my mother was 13, she left school to work to help support her younger siblings. My grandfather was seldom discussed and what I know about him comes from snippets of hushed discussions tacked together like an unfinished quilt. He may have spent some time in the service, although something led him to be kicked out of the house and eventually he died in a Salvation Army hostel possibly of alcoholism, consumption, syphilis, or as my mother likes to think, a broken heart.

The sisters all married early. I think a lot of women of those circumstances did. A chance to get out. A chance to be loved. A chance to try.

One sister had six pregnancies in seven years. In those days there was no birth control pill patch or ring, no Depo-Provera, and no Implanon. I don’t know if anyone ever discussed an IUD. Condoms existed, but I am sure they were too expensive anyway for a mother who by now had five children under the age of seven. She worked on and off as a char lady when she could, but there was never any money. I suspect most of it was consumed down the road at the local pub. Regardless, even if there were money, how does one ask one’s partner to wear a condom after he’s broken your nose?

I don’t think there was any possible way for her to leave. Perhaps it was better with her husband than at my grandmother’s, maybe she thought she could fix things, or she might have been too afraid. Considering she had no money and there were no community resources, it would have required more momentum than any one person could possibly muster.

She was hospitalized when she was pregnant with her sixth child. No one can tell me if she was injured or bleeding or having some other pregnancy complication. I suspect they know, but no one says. Regardless, what happened was a woman in her mid twenties with a few healed broken bones, five children, and pregnant with her sixth had a hysterectomy. I’m not sure if this happened before or after abortion was legalized in the United Kingdom, but it was sometime around then. My mother doesn’t think it matters.

I imagine her doctor shaking his head. Not out of superiority, but out of absolute despair for this young woman. For her life. He would have seen her fate many times. A pregnancy almost every year unless she died in childbirth, succumbed to some illness accelerated by poverty and malnutrition, or perhaps beaten to death. I like to imagine that he sat on the end of her bed and discussed her options. That he held her hand and showed her some kindness.

That is a life without contraception and I am only one generation removed.