‘Of One Blood?’: Gendered Propaganda and Blood Donor Behaviour in Wartime Bristol and South West England, 1939–1945

Summary This article explores civilian responses to the British army’s blood donor recruitment campaign in wartime Britain, revealing it to be an underexplored medium for the examination of the contribution of women to Britain’s war effort. However, despite extensive gender-targeted propaganda, it reveals evidence of a significant disparity between levels of volunteering to donate and actual donation throughout the war. Wartime donor behaviour was influenced by perceptions of personal or familial risk, with donor recruitment propaganda emphasising kinship ties to those in military service and promoting blood donation as a mutual insurance policy. Ultimately, this article argues that evidence of donor behaviour further undermines the mythologised narrative of Britain’s ‘People’s War’ and provides nuance to the understanding of blood donor motivation.

As Acting Major Lionel Whitby (1895-1956) watched blood spurt from his femoral artery into the mud of the Western Front in March 1918, death must have seemed imminent-but whilst a German artillery shell nearly ended his life, a blood transfusion would save it. 1In 1938, having forged a distinguished medical career, Colonel (later Brigadier) Whitby was appointed head of the Army Blood Transfusion Service (ABTS), a self-contained unit within the Royal Army Medical Corps (RAMC) with a mission to ensure Britain's future war wounded received this life-saving intervention. 2In 1939, the ABTS set up its headquarters, the Army Blood Supply Depot (ABSD), in Bristol with exclusive permission to recruit civilian blood donors in Bristol and South West England 3 to supply the army's needs. 4Britain later entered the Second World War with the only army to have an established transfusion service, 5 with the ABSD subsequently supplying over 750,000 pints of blood to bolster supplies drawn from military personnel serving overseas. 6owever, this apparent success belies the reality of a continuous struggle to maintain an effective donor panel and overcome widespread public reluctance to donate blood 7 even though individuals were asked to donate only twice a year.While British propagandists represented voluntary blood donation as the embodiment of national unity 8 evidence of donor behaviour uniquely revealed in the records of the ABSD challenges this wartime narrative.
Much of post-war discourse on blood donation has focussed on the examination of pioneering social researcher and social policy analyst Richard Titmuss ' (1907-1973) study of blood donation in the UK and USA, and the role of altruism in blood donor motivation. 9Titmuss' conceptualisation of 'the Gift Relationship' between the donor and an anonymous 'stranger' 10 prompted Nicholas Whitfield to research 'the gift relationship' and blood donation in wartime London. 11 He identified that the phraseology and concept of 'the gift' originated not with Titmuss, but in a wartime publication that advocated donating 'the gift of life', 12 the term being repeatedly used in Life Blood (1945), the Ministry of Health's (MOH) eulogising account of Britain's wartime blood transfusion services (BTS). 13However, this term was a construct of this sole late-war publication, produced when there were problems in donor attendance and the expectation of an invasion of Japan. 14Moreover, Titmuss identified a range of donor motives, including 'duty' and personal benefit (reciprocity), 15 arguing that: No donor type can … be said to be characterised by complete, disinterested, spontaneous altruism.There must be some sense of obligation, approval and interest: some awareness of need and of the purposes of the blood gift … and some expectation and assurance that a return gift may be needed and received at some future time … 16 This article provides evidence supporting Titmuss' assertions, revealing that wartime blood donors' motives were complex and nuanced, but that perceptions of personal or familial risk appear to be key factors in the public's engagement with recruitment campaigns and subsequent donor (non)attendance.
The historiography of blood transfusion reveals the role of war as a catalyst for advances in scientific knowledge and technical developments, 17 with the ABTS recognised as improving Britain's contribution to 'manpower economy' through lifesaving battlefield transfusions. 18Blood donation is absent from discussions about Britain's 'Home Front', save for one survey of wartime health which conflated London's pre-war developments and wartime practices with blood donation nationally, 19 and two articles looking at donor recruitment propaganda. 20Crucially, the existing historiography has overlooked donor behaviour.This article consequently fills a gap in the existing literature and shifts the focus away from London.Contemporaneously, and in countless British cultural representations, the Second World War was presented as the 'People's War': a nation-building event in which every citizen was mobilised in support of the state and its armed forces.This idea was fostered by government propaganda suggesting that the British public developed a unifying collective wartime consciousness acknowledging the need to make personal sacrifices, work together and abandon self-interest for the common good. 21evisionist historians have since undermined the narrative of a homogenous and unifying 'People's War', noting widespread evidence of social division, rising crime, and resentment at the imposition of enforced collective sacrifice and state controls on everyday life. 22However, Sue Grayzel argued that the threat of aerial bombing redefined civilian identities and roles and raised awareness of the need to mobilise women on the Home Front. 23Volunteering represented the embodiment of citizenship, and the subjugation of personal interest to that of the common good, but, as Sonya Rose's work on wartime attitudes reveals, gender determined the activities women were tasked with. 24ucy Noakes has shown that the recruitment of women to 'passive' Civil Defence roles such as Air Raid Precaution wardens, fire service administration and first aid were similarly 'an extension of women's domestic, nurturing role'. 25his article focuses on donor recruitment by the ABTS in England, excluding its activities overseas and those of the civilian Emergency Blood Transfusion Service (EBTS) system operating in other parts of the UK. 26 Central to this study are records of the ABSD held in the Museum of Military Medicine.However, a key source is the 'bleed' session log kept by Ethel Whitby, wife of Lionel Whitby, held at the Imperial War Museum. 27It records the 531 sessions she undertook as a Medical Officer between September 1939 and July 1944, recording the date, location, number of registered donors requested to attend, and actual attendees.However, it does not contain other contextual information such as the gender or age of donors.Recognising that records of the donor's experience and contemporaneous questioning of donor motivation were largely absent from archives, requests for information from surviving wartime blood donors were placed in numerous South West regional newspapers, as well as The Donor magazine issued to the 1.2 million registered National Health Service blood donors in the UK.Unfortunately, this resulted in only one interview of a wartime donor recruited by the ABTS.This article, therefore, uses contemporaneous newspaper reports, official documents, diaries, and speeches to identify evidence of donor attitudes, behaviours and motives.
This article is divided into three sections.The first focusses on the pre-war system of blood donation and the recruitment of donors during the 'Phoney War'-the prolonged period between the declaration of war in September 1939 and onset of combat operations in May 1940: it reveals an immediate disparity between levels of volunteering to donate and actual donation.The second section examines donor responses to propaganda campaigns aimed at addressing this disparity, arguing that rates of registered donor non-attendance were linked to perceptions of personal and familial risk.The final section explores the role of women in the 'blood for Victory' campaigns run in the South West in the prelude to D-Day-the landing of Allied forces on occupied France on 6 June 1944-indicating that despite gender-targeted propaganda many were only transiently engaged.Evidence of persistent civilian ambivalence towards donor recruitment campaigns consequently undermines perceptions that Britain's wartime population 23  was 'of one blood'. 28Examining blood donation as a previously unexplored form of gendered war-service voluntarism, this article reinforces the revisionist historiography of 'the People's War' and exposes the temporality and limitations of viewing altruism as the primary motive for wartime blood donation.

'For He Today That Sheds His Blood With Me Shall Be My Brother'
Blood transfusion was recognised contemporaneously as the most important medical advancement of the First World War, and had been enthusiastically adopted by the British Army by the summer of 1918. 29However, the lessons learned and the good intentions for the development of an ABTS, proclaimed at the war's end, were forgotten as demobilised medical personnel returned to civilian roles: most interwar innovations in blood transfusion subsequently occurred within the civilian health sector. 30Kim Pelis has argued that it was the dominance of charitable blood donation in the interwar years that enshrined the voluntary element in Britain's post-war system. 31Nonetheless, in the interwar period, blood transfusion remained relatively rare, with limited public awareness or engagement, and was dependent upon a mixture of volunteer and paid donor schemes organised to support local hospitals. 32In Bristol, the Christian faith voluntary organisation 'Toc H' co-ordinated the initiation of a blood donor service in 1935, recruiting 150 volunteers out of a population of 413,000. 33'Toc H' had been set up on the Western Front in 1915 to provide a Christian recreational centre for troops, 34 and promoted activities of benefit to British society as a 'living memorial' to the war dead. 35In 1936, with 149 donors, Bristol had the second largest service in the country, but by 1938 it had to appeal through the press for new volunteers due to a shortage of group O donors. 36y January 1939, there were only 506 members of the Blood Donors Association in the South West, 37 and an unfamiliar public who perceived blood donation to be akin to 'a major operation'. 38The international tensions resulting from the rise of Nazi Germany and the outbreak of the Spanish Civil War (1936-9) brought blood transfusion to prominence.39British medical journals publicised the innovative use of transfusions from stored blood in Spain and the importance of effective donor recruitment. 40In the expectation of war, the recruitment of blood donors in Britain began on 3 July 1939 with a nationwide radio broadcast and announcements in national newspapers, but these only publicised the scheme operating in London. 41These reports described volunteers as 'Life Donors', reporting that 'special emphasis is laid upon the suitability of women' and that women already formed 75 per cent of volunteers in one London region. 42The Daily Telegraph concluded that the number of women volunteering to donate blood 'showed that the nation is united as it could never be unless the women were taking their full part in the national effort'. 43n pre-war Britain, a consensus had developed that aerial bombing would result in the wholesale destruction of the nation's cities and inflict mass casualties. 44Military planners calculated that Britain would suffer 600,000 fatalities and 1.2 million wounded. 45vidence from Spain led to the estimation that 10 per cent of casualties would require blood transfusion, with British newspapers reporting that 1.18 million donors were required. 46Such reporting strongly inferred that blood donation was in each citizen's self-interest.

MoMM
During the Second World War, more British women remained full-time housewives than were employed full-time in war production, the armed forces or civil defence. 47The majority of non-employed women nevertheless worked at least a 12-hour day, for seven days a week, undertaking domestic tasks made more difficult by wartime conditions. 48n 1940, the social research organisation Mass Observation (MO) produced a report for the Ministry of Information (MOI) based on interviews with 230 people in Bristol and Barrow-in-Furness (a port in North-West England), 202 of them women.64 per cent of respondents said they would be unable to do work of national importance as they already had work, family commitments and other ties.49 Blood donation offered women the opportunity to contribute to the war effort without significantly increasing their commitments and was promoted as such.50 The ABTS had recruited 5,000 volunteers in Bristol by the time war was declared.51 It eventually established a network of 1,332 donor sub-centres located within a 30-mile radius of nineteen regional towns and cities. 52 In addition to supplying the Army's needs the ABTS was responsible for supplying blood to civilian hospitals in the South West, as well as the Royal Air Force, naval hospitals and larger naval units in the region.Directly, or indirectly, the ABTS supplied blood and transfusion equipment to all of Britain's armed forces.53 In 1942, the growing needs of the army meant that it was given permission to recruit donors in Oxfordshire, Hampshire and Berkshire.54 Led by a civilian manager, the ABTS' donor registration department was otherwise staffed by the Women's Voluntary Service (WVS).
The ABTS specifically used local and regional newspapers to publicise the need for donors, as they had a larger readership than national newspapers until well into the war 55 : although the initial focus was on recruiting workers at local firms it was made clear that all adult Bristolians were being asked to donate. 56In March 1940, the ABTS' work and methods of recruitment featured in popular magazines and medical journals. 57rior to this, local papers featured numerous reports on the service, including the first appointment of female doctors: Whitby's wife, Ethel, was amongst them. 58Major Ethel Whitby (1898-1994) was a trained surgeon and physician.Although the war saw female doctors serve within the British Army for the first time, they were initially excluded from the RAMC on the basis that they could not fulfil the combatant and disciplinary roles of their male counterparts; instead, they were admitted to the Auxiliary Territorial Service (ATS) or the BTS. 59The demands of a total war saw women subsequently admitted to the RAMC, but they were 'employed'-rather than 'Commissioned' as officers-by it, mimicking the 'wartime-only' status of Britain's Women's Armed Services (ATS, Women's Royal Naval Service and Women's Auxiliary Air Force) who were 'enrolled' in but never 'enlisted' in the armed forces. 60he 'bleed log' Ethel Whitby kept provides the raw data used in my analysis of donor behaviour. 61While the ABTS operated up to 18 'bleed' teams during the war this is the only identified record of this type.However, the log covers the bulk of the war and sessions held in all the geographical areas from which the army recruited civilian donors, covering urban and rural locations, with sites ranging from village halls to factories, and records over 33,000 donations.
A key decision in the operation of the ABTS was not to test the blood group of most military personnel or civilian casualties. 62Instead, the British Army opted to administer only Group O blood, then believed to be the 'universal donor'. 63Initial campaigns, therefore, concentrated on the establishment of a panel of Group O donors, and volunteers with other blood groups were excluded from donation (but were sent a blood group identification card for possible future use). 64However, from 1940, due to the discovery that blood plasma could be transfused to any blood group, donations from all blood groups were sought. 65Plasma, the straw-coloured fluid left after the oxygen-carrying haemoglobin is removed from blood, enabled the resuscitation of patients who had suffered potentially life-threatening fluid loss from bleeding or burns without the risk of transfusing the wrong blood group.From April 1940, the ABTS consequently prioritised the development and production of blood substitutes, rather than the comprehensive provision of whole blood. 66Plasma could be produced from all blood groups and harvested from unused fresh blood, as it had a longer shelf-life and required less temperature control than blood. 67The ability to transport plasma to support overseas operations without the need for refrigeration was of immense logistical and medical importance to the British war effort.Later donor recruitment publicity emphasised that blood products could be sent anywhere in the world, 68 enabling donors to envisage friends or loved ones on active service as the possible recipient of their donation.
Although comments made by the Secretary of State for Air that donors were being flown to front-line troops in France in 1939 were considered to have hindered recruitment, 69 Members of Parliament were, nevertheless, reassured that civilians were 'patriotically' volunteering to donate blood in support of the armed forces. 70But this did not mean they were actually donating.National newspaper reports and radio broadcasts urged volunteers to turn up at their local hospitals to donate. 71This was at odds with both the military and civilian systems, which called donors to attend appointments on a demand-and-supply basis. 72With Britain divided into semi-autonomous civil defence regions there was no centralised national wartime blood donor recruitment campaign, and, while the MOI acted as the conduit between the government and the public, it sometimes initiated campaigns without consulting key stakeholders. 73Uncoordinated publicity resulted in prospective donors being turned away, and this infuriated those responsible for recruitment. 74Such appeals gave the impression that blood was needed immediately, when volunteers were actually being sought to provide estimated future blood needs, and left potential donors disgruntled when not summoned immediately. 75ionel Whitby consequently considered national publicity to be ineffective, focussing instead on local publicity and the recruitment of civic dignitaries: in wartime 'equity of sacrifice' 76 was expected of everyone, and blood donation was presented as exemplifying social egalitarianism and national unity (Figure 1).
The ABTS actively sought to promote the visibility of its volunteers from the beginning of the war, but with limited success: wartime financial restrictions thwarted a proposed initiative to provide a metal badge. 77Co-opting national cultural references, the ABTS instead issued a 'Thank you' certificate contained within a booklet that included a map explaining 'where your blood may go', and which quoted Shakespeare's Henry V (Figure 2). 78Blood donation symbolised fraternity, the civil-military bond, and the opportunity for donors to 'serve' their country and save the lives of Britain's military personnel.
However, ABTS publicity promoted a variety of motives for donating.Examples of reciprocity are evident in local coverage of a Bristol man donating because his life had been saved by a transfusion during the First World War, and in the widely reported case of a railway worker becoming a donor after losing his legs in an accident. 79Crucially, gender-targeted publicity was apparent from early in the war.The visit by Queen Mary to the ABSD in February 1940, which highlighted that most donors were women, prompted one, writing under the pseudonym 'Housewife Donor', to declare 'If every housewife in Bristol became a donor how that would help the Home Front!'. 80Local press coverage of donor appeals predominantly featured female volunteers. 81A female correspondent to a newspaper also emphasised the opportunity for women aged over 55, excluded from registering for war work by the 1939 National Register, to contribute by donating blood. 82However, while the targeting of women as donors was established early in the war, so too were ambivalent responses to requests for actual donation.
While donors had enrolled at a rate of 1,000 a day in the first week of the war, newspapers soon reported difficulty in attracting volunteers, notably in rural areas. 83oreover, many volunteers failed to turn up when called to donate. 84The log of the 531 donor sessions supervised by Ethel Whitby reveals that of the 26 sessions held in Bristol and Wiltshire between September 1939 and early May 1940, less than half had 100 per cent attendance. 85In Dorset, the Southern Times reported that: Months ago, full of National Service, they volunteered to give their blood for transfusion.A few days ago they received notification from Bristol that they would be needed at Weymouth District Hospital on Thursday to make good their offer: And when the day came, 21 were absent. 86oser to Bristol, 'PRO PATRIA' complained that 29 out of 70 families canvased as donors in their village had not replied and had 'pocketed' the stamps and envelopes supplied to enable them to do so. 87y the onset of the German offensive on 10 May 1940, the ABTS was producing 385 pints of blood a day. 88The donor registration department had enrolled 50,000 potential donors, but was appealing for another 50,000, highlighting the positive response of female factory workers in the press and emphasising the need for volunteers to donate when requested. 89However, the response was muted.Of 22 donor sessions led by Ethel Whitby from 11 May to 25 June 1940, only three had 100 per cent donor attendance, five had attendances below 75 per cent, and the lowest had 50 per cent. 90During this period, the British Expeditionary Force was evacuated from France having lost 66,000 men. 91Penny Summerfield has argued that in the popular memory of the war, this is the point at which the 'real' war began, 92 but it did not engender public enthusiasm to donate blood.Air raids on Britain did not begin until July 1940, and the British Army was still a professional volunteer army, not the 'citizens' army' it would become. 93Most civilians, therefore, lacked a sense of personal endangerment and were deprived of a key personal motive for donation: kinship or social ties 94 with those serving in the forces.
However, prior to the onset of hostilities, press coverage of blood donation was already encouraging civilians to envisage the prospective recipient of their blood.A March 1940 Illustrated magazine article featured the donation of blood by a secretary in London who had enrolled with the civilian EBTS, the transportation of her blood to the ABSD in Bristol and its 'life-saving' administration to a soldier in France. 95The article emphasised how a named female donor's blood was transfused into a named serviceman and included a photograph of their meeting, suggesting that recipients of donations were not anonymous and that civilian donors and wounded serviceman were 'one'.The Journal Herald adopted a similar theme, promoting the idea that Britons shared 'One Blood'. 96However, responses to donor appeals would show that this idea was not universally or consistently embraced, even when the bombing of Britain commenced in earnest.Donor nonattendance consequently provides further evidence of fluctuating engagement with ideas of self-sacrifice that were a central tenet of 'the People's War'.

'Of One Blood?': Responses to Donor Recruitment Propaganda
Contrary to claims that concerns about the motivation and reliability of volunteer donors were resolved once the onset of air raids on London demonstrated that blood donation was a 'life-saving service'-thus reinforcing the 'obligation' to attend when called 97 donor non-attendance was a consistent problem in Bristol and South West England throughout the war, with evidence this was replicated nationally. 98n 1940, Bristol and its environs experienced 10 low-scale bombing raids before suffering its first serious air raid on 25 September. 99Teams from the ABSD transfused casualties with over a hundred bottles of blood or plasma. 100The advent of attacks on Bristol, after a period in which they had overwhelmingly been concentrated on London, took many by surprise despite Bristol's docks being strategic targets, 101 and the region containing several key aircraft manufacturers. 102n 24 November 1940, thousands of bombs caused widespread destruction in Bristol, killing 200 and injuring 689. 103There were a further 19 air raids on the Bristol area up to 14 June 1941. 104Bristol was not attacked again until 1 July 1942 and, whilst there were six further raids, only one caused fatalities. 105In total, Bristol suffered 4,604 casualties, including 1,299 fatalities: 89,080 properties were damaged or destroyed. 106ivilian morale in Bristol was adversely affected not just by the physical devastation, but by poor bomb shelter provision and the perception that wartime press censorship prevented their suffering being recognised. 107Edgar Jones and others have identified that civilian morale was influenced by a range of issues but that residents in smaller cities took the destruction more personally. 108Government opinion, however, was simply that civilians were 'more concerned with self-preservation than the national war-effort'. 109n anonymous contributor to MO, living in a village near Bristol, recorded that 'we dread night coming', having witnessed bombings in late 1940 and early 1941, but did not donate blood until October 1941. 110This was despite local newspaper coverage of transfusions to air raid casualties in September 1940. 111Rates of donor voluntarism and actual blood donation appear to have been influenced by perceptions of personal endangerment: although air attacks on Great Britain during the whole war resulted in 146,777 casualties, 112 they never produced the apocalyptic pre-war forecast of 1.8 million casualties. 113n the aftermath of the 'Bristol Blitz', the ABTS 'bleed teams' were sent to rural areas to maintain supplies. 114This proved to be difficult.Alan Howkins has found that fear of bombing was as acute in county towns and coastal locations as it was in major cities but varied considerably in the countryside. 115Although Ethel Whitby claimed in a 1942 speech to nurses in Dorset that the ABTS was 'almost a household word in the West Country', awareness did not equate to engagement. 116In Barnstaple, the local paper reported that North Devon needed to 'play its part' to 'relieve the strain' on Bristol and other bombed districts and that it expected 'a 100 per cent response' because the army was completely dependent on the people of the West Country for blood. 117owever, the response was somewhat underwhelming.an average non-attendance of 31 per cent. 118Although donor sessions were scheduled to prevent over-reliance on one area, 119 in Devon, it was reported that while new donors were coming forward, previous donors were failing to attend when called. 120y 1941, the ABTS had adopted a policy of 'pruning' names of donors who failed to turn up, enabling them to estimate the 'effective' panel from those who had volunteered. 121However, although the transfusion services seemingly epitomised 'a shared sacrifice for a common good', 122 the unwillingness of many to make a personal 'sacrifice' is evident in attendance statistics.By 1942, although cyclical publicity campaigns were attracting more volunteers, the number that could be relied upon to turn up to donate was falling (Table 1). 123tarved of a publicity budget, the ABTS relied on films produced by the MOI and MOH to reach cinema-going audiences, which by 1945 numbered 30 million per week. 124In 1943, the MOI commissioned a film, Of One Blood, on the work of the ABTS, that was screened widely. 125It utilised bucolic imagery to foster civilian support for the war effort, describing blood donation 'as more than a symbol of solidarity'. 126In its village scenes, seven out of the eight donors were women.
Another film, Blood Donation (1944), featuring the production of blood plasma, ended with an image of a wounded soldier while the narrator declared 'Don't let him down': the message was clear that failure to donate was unpatriotic and might endanger the audience's loved ones in the armed forces. 127In describing the donation process, the narrator claimed donors often 'feel better for it',128 tapping into contemporary ideas of 'vitalism', the belief that bloodletting was curative or restorative of health: the underlying sentiment was that one way or another, there was also something in it for the donor.
The ABTS planned donor sessions 4 to 6 weeks in advance and they were timed to meet local needs, often being scheduled after dusk in the countryside to enable harvest workers to donate, 129 and were preceded by pre-visit publicity. 130Staff were provided with information to answer donors' questions and coached to treat them in a courteous manner. 131However, staff were acutely aware of the vagaries of donors, one writing: Then come the customers, or more politely, donors.At first they appear to drift in, as if they were on their way down to the town or a shopping expedition, had paused on seeing the notices, and had decided that they would try a basinful.Perhaps some look round, see us all waiting expectantly, and decide that after all it would be more expedient to finish the shopping and come tomorrow; that is, if we were still there, which would be extremely unlikely…of donors we get every sort, including some of the ones that can't come; like the clergyman who asked to be excused because his wife and dog were ill (I think he put them in that order). 132spite the ABTS' publicity and 'customer care' focus it did not necessarily produce results. 133Helen Russell, a Voluntary Aid Detachment member working with the ABTS, recalled that 'we did occasionally relieve each other of a pint or so, if donors did not turn up'. 134However, the extent of donor non-attendance was far greater than implied.Analysis of Ethel Whitby's log shows that it was a significant and constant issue during the war, peaking at 38.4 per cent in 1942 (Table 2).
Such responses were mirrored nationally.An appeal by the Princess Royal (the daughter of King George V and Queen Mary) produced 228,000 volunteers in Yorkshire. 135owever, by 1943, there were only 320,000 blood donors registered nationally. 136This equated to 0.7% of the population.This prompted one female letter writer to The Times to declare: 'This out of a population of 45,000,000 is a disgrace, when blood is needed urgently to save the lives of the men fighting for us'. 137s the war progressed, the government acknowledged that the war effort was dependent on civilians' physical fitness and psychological motivation. 138Although health officials expressed concern at an increase in anaemia due to wartime dietary restrictions and its impact on 'females and less fit age groups' who were blood donors, the ABTS attempted to pre-empt this issue by providing a week's supply of iron tablets after every donation from the outbreak of the war. 139 both World Wars, who were rewarded with beer. 140This was a source of contention.One Bristol resident, signing themself 'Sangy', wrote to the Western Daily Press stating that: … I have given 11, or perhaps 12, blood transfusions…Now I am not expecting or desiring any rewards in the shape of medals or illuminated addresses, but I do think the "regulars" might be offered personal vouchers or coupons which could be exchanged for a little extra milk, butter, meat or orange juice. 141 such 'rewards' were ever forthcoming.
In understanding the response to requests for donors, it is important to note that British military deaths from 1939-45 were roughly a third of those sustained in the First World War and crucially, for large periods of the war, land operations were confined to the Middle and Far East theatres where allied troops were overwhelmingly provided  from the Empire and Commonwealth. 142Whilst the ABTS continued to promote the conversion of blood to plasma for use by overseas forces, 143 the conduct of the war overseas was apparently of little interest: one MO diarist recording that the 'chief area of interest is [the] effect of air raids on this country … Foreign events, much more vital, are neglected'. 144Another factor is that although Picture Post magazine promoted blood donation as an 'inconspicuous' form of civil defence, 145 and the ABSD's blood donor grouping card stated that donors were a 'Civil Defence Volunteer' (Figure 3), blood donation was never included in the official provisions for civil defence, and was never recognised as part of that system by the authorities or society at large. 146The pre-war suggestion that blood donation be recognised as a form of national service was also never adopted, 147 depriving donors of the social recognition that is deemed crucial to volunteerism. 148Voluntary organisations, such as the WVS, thus became crucial in facilitating donor sessions.
The WVS was a national voluntary agency serving the state authorities, and had been set up specifically to support Air Raid Precaution work, 149 but was also involved in assisting blood donation. 150Employing 'traditional female skills outside the home', membership was considered to facilitate the expression of active citizenship and the empowerment of middle-class women. 151In Bristol, they evolved from an administrative role to undertaking numerous activities, eventually including assembling blood transfusion equipment in readiness for D-Day. 152Those who could not commit to full-time volunteering, predominantly working-class women, were recruited to a 'Housewives Section'. 153However, although WVS national membership increased in line with the onset of bombing and, at its peak in 1942 had a membership of just over a million women, the introduction of compulsory war service meant that by this time it was largely reliant on part-time volunteers. 154This reflected the wider impact of labour shortages and compulsory war service on war work voluntarism, with over 80 per cent of Civil Defence volunteers being part time by 1943. 155Although wartime propaganda was gendered, its effectiveness is difficult to gauge because the nature of wartime surveys raises questions about the accuracy of volunteering statistics. 156What is clearer is that although many civilians were prepared to donate their time, belongings and recycle their refuse as part of the war effort, 157 they were seemingly more reluctant to donate their blood despite publicity stating it only took 30 minutes and was undertaken in an 'atmosphere of mutual health and tenderness'. 158he MOH considered that 'quiet periods' in the war resulted in donors thinking their blood was not needed. 159An alternative explanation is that a reduced perception of threat removed the stimuli to donate provided by self-interest and kinship ties, and compulsory war work reduced their availability and motivation for further engagement with the war effort.The peak non-attendance rate in 1942 may also reflect the extent of 'war-weariness', a combination of physical privations and the psychological impact of a series of military defeats followed by a lengthy period of apparent military stagnation. 160Whatever the reasons, it was a nationwide problem: despite radio broadcasts describing donors as the 'blood brothers of our soldiers' in 1943, 161 the MOH recorded that a 'large percentage' of volunteer donors in London and the Home Counties had failed to turn up. 162A significant rise in rates of volunteering and registered donor attendance would not emerge until there was a prospect of the opening of a 'second front' in the war in Europe, wherein the prospect that the war might be brought to a rapid conclusion provided civilians with a clear motive for donating.Of crucial importance in facilitating increased volunteering in the run up to D-Day were the women of the South West.

'Don't Let Him Down': Gendering Blood Donation
Women were critical to the operation of the ABSD, providing approximately 80 per cent of its personnel, augmented by large numbers of female volunteers in support roles. 163n 1941, the National Service Act (No.20) conscripted unmarried and childless married women into the Services, Civil Defence or Industry to address 'manpower' shortages.164 Women thus became a larger proportion of factory workers, the preferred ABTS location for donor sessions.
Although the transfusion service's primary purpose was treating war casualties, in 1942, the MOH formally communicated that transfusions should be available to 'maternity cases'. 165Haemorrhage during childbirth was one of the main causes of pre-war maternal mortality but blood transfusion was rarely available: by 1945, it would be commonplace and result in a dramatic reduction in maternal deaths. 166Becoming a donor was in the self-interest of all women of childbearing age, for whom childbirth raised 'the spectre of death'. 167In a speech to nurses, Ethel Whitby described blood donation 'as an insurance … for none of us know when it may be our turn'. 168Although women constituted 48 per cent of civilian air raid casualties, 169 Britain's 17 million adult women were also specifically targeted through their physiological role as bearers of life: recruitment propaganda frequently used the term 'life donor', and films mentioned blood transfusion in 'maternity cases'. 170olunteering as a blood donor imbued women from all social strata with a sense of engagement in the war effort, whilst also facilitating the adoption of an ennobling narrative in propaganda wherein blood donation was represented as a traditional female 'caring' response, motivated by patriotism.National media publicised appeals for blood donation through the reporting of 'celebrity' female donors, notably the Princess Royal, who became a donor in Yorkshire in 1941. 171The ABSD was also visited by Queen Mary, followed by the Princess Royal who also witnessed factory workers donating blood. 172ropaganda also played on familial connections in the armed forces, exploiting 'the kinship premium'. 173In The Army Blood Transfusion Service film (1943), the narrator declared, 'Mrs Jones gives regularly', explaining she had brothers serving overseas. 174Reciprocity was also featured: the wife of a factory worker severely injured in an air raid became a regular donor 'to show her gratitude'. 175However, donor non-attendance remained an issue.
A 1944 ABTS publicity brochure tellingly began by stating that up to 50 per cent of volunteers did not turn up, and that many who donated once 'consider their duty is done'. 176This heavily illustrated brochure contained case studies of battlefield casualties, accompanied by a picture of a woman donating blood and asked, 'CAN THEY DEPEND ON YOU?'. 177The Public Relations Officer of the ABTS wrote to one newspaper: To those who have dear-ones -brothers, sons, sweethearts or husbands -in our fighting forces, it will surely be an enormous consolidation that they are enabled to give something of themselves, their very life-blood, to save a sailor's, a soldier's, or an airman's life. 178f One Blood (1943) went further, urging women to 'save the life of a man you love'. 179his theme was continued in Blood Will Out (1943): panning across a cinema audience of largely female members, its narrator declared blood donation could save the lives of 'perhaps your husband, your son, your brother, your sweetheart'. 180Women were thus encouraged to envisage their 'loved one' as the recipient of their blood.
The D-Day Casualty Planning Committee assessed that 30,000 pints of Group O blood would be needed. 181In February 1944, the ABTS consequently ran its largest recruitment drive in Bristol, aiming to recruit 50,000 new volunteers in the city, some 12 per cent of the population. 182Similar 'Blood for Victory' campaigns were also run throughout the South West region.This was the first occasion that the ABTS received direct support from the MOI: 3,500 door-to-door canvassers were recruited, predominantly women; the provided daily publicity; thousands of posters, banners and shop front displays appeared across the city (Figure 4); Of One Blood was shown in cinemas and civic centres; loudspeaker vans toured the city; Guy Gibson V.C., of 'Dambusters' fame, opened the campaign by donating blood; and a radio appeal was directed to women war workers in Bristol, followed by a radio appeal for donors nationally. 183he radio appeal to Bristol's female war workers included an account of a donor session in Bristol: A girl railway porter has come straight from work.She was giving hers for the tenth time.Her two brothers are in Italy.The mother of an airman was giving her twelfth donation.A girl on her way to night-work in an aircraft factory was giving hers the sixth time.A mother and daughter told us they had given 27 lots between them because they had sons and brothers overseas. 184male donors were clearly targeted through the 'kinship premium' 185 and encouraged to envisage the recipient of their donations.
In the drive to meet expected blood demands the requirement for donors to be aged 21-65 was 'overlooked'. 186However, not all civilians embraced the appeal: excuses for refusing to donate included many claims of anaemia, one of flat feet, and one who commented 'I want my blood for myself'. 187Another refused to allow her daughters to donate 'whilst there's a war on'. 188The poor initial response raised the ire of one serviceman who also decried the dearth of male volunteers, a newspaper reporting that 'One of our many fighting men, calling himself 'Son of Bristol', asks why the citizens so brave in the blitzes of 1940-41, are now failing him and his comrades-in-arms in the present campaign'. 189ABTS staff went some way to fill the deficit by donating themselves. 190However, mass publicity eventually led to an improved response (Table 3).Or so it seemed.
This campaign recruited 65,205 new potential donors. 191There had been 20,000 'effective' donors-those who could be relied upon to donate-before the campaign, 192 but by the end of 1944, there were only 40,000 'effective' donors in the Bristol area. 193his was not an issue specific to Bristol.In Nottingham, registered donor non-attendance from June 1944 to April 1945 ranged from 5 to 67 per cent. 194At the end of the war, Lionel Whitby wrote to officials in towns and cities thanking them for their citizens' help: in Plymouth, 21,124 donations were provided during 250 ABTS visits, equating to 84.4 donors per visit from a population that ranged from nearly 200,000 in 1940 to  195 Although 529,529 people in the South West initially volunteered to give blood, the ABSD only distributed the equivalent of 756,046 pints of blood in the 6 years of the war-significant amounts of which were obtained from other sources. 196y the end of 1944, the ABTS estimated an effective panel of 153,074 in the South West, less than a third of those that initially volunteered. 197Although women had been specifically targeted as donors, rates of donor non-attendance indicate that many were only transiently engaged.Ethel Reed was amongst those who stopped giving blood: she began donating by happenstance, having come across the ABTS recruiting outside a shop in 1941.Workplace sessions made donating easy, and were made attractive by the 30-minute rest and free cup of tea they afforded.When interviewed, she 'supposed she felt proud' to have been a blood donor, but tellingly she stopped as soon as her fiancée returned from overseas military service and never donated blood again. 198he allied military campaign in Europe during 1944-5 produced a demand for blood in excess of that estimated. 199However, the unprecedented demand was not met solely by British civilians.The ABTS simply recruited French civilians alongside allied military personnel as they advanced across Europe.200

Conclusion
As episodic contributors to the war effort, civilian blood donors were neither formally recognised contemporaneously, nor subsequently acknowledged in the popular memory of the 'People's War'.Revisionist historians have successfully challenged the view that the war was a unifying event, with a universally proactive response to the demands made of the civilian population.However, in their efforts to expose the 'myths' of the war, they were subsequently criticised for the development of a new orthodoxy of thought in which the self-interest, ambivalence and apathy of the civilian population became the new 'myths' of the war. 201But, evidence of blood donor behaviour demonstrates the continuing need to question assumptions and explore the nuances of civilian engagement with the war effort.Wartime blood donation represented a 'blood bond', a social contract between civilians and the military.Yet, in the absence of the realisation of the pre-war predictions of apocalyptic bombing, initial enthusiastic volunteering was never matched by levels of donation.Wartime donor recruitment propaganda was gendered, co-opting the long-standing cultural association of blood with kinship, directly appealing to women to envisage their male loved ones on active service as the recipient of their blood and manipulating the traditional image of women as carers and 'life givers'.Blood donation was portrayed as the opportunity for women to prove they were 'good citizens', 202 whilst referencing the underlying self-interest of women fearful of haemorrhage during childbirth.Moreover, blood donation was promoted as 'insurance' for civilians threatened by bombing.However, civilians were not universally or consistently responsive: they were apparently not all 'of one blood', or at least not all the time.
The initiation of the National Blood Transfusion Service in 1946 was largely the work of former ABTS staff. 203Subsequently absorbed into the National Health Service, the voluntary donation-dependent BTS remains central to the UK's health system.However, blood donation was, for many, a purely wartime expediency and, with the cessation of fighting, the stimulus provided by war rapidly dissipated. 204By 1946, there were only 267,057 donors in the UK, including those in the armed forces-equating to 0.54 per cent of the population 205 : less than half of the percentage of donors today. 206In the immediate post-war period, the BTS struggled to supply Britain's hospitals. 207n the absence of the contemporaneous questioning of donors as to their motives, and the dearth of surviving wartime donors today, this article has examined wartime blood donor behaviour: revealing a surprising degree of persistent ambivalence towards pleas to donate.Historically and culturally, blood has symbolised 'life', 208 imbued with the sentiments of strength, kinship and national unity, whilst bloodletting was considered therapeutic: recruitment propaganda referenced them all, but the ABTS still struggled to maintain an effective donor panel.Donors were seemingly motivated by a combination of patriotism, pragmatism and self-interest based around kinship ties and perceptions of personal risk.As such, evidence of donor behaviour adds to the continuing revisionism and understanding of 'the People's War' and nuances the discussion of blood donor motivation.

140
Peter H. Pinkerton, 'Norman Bethune, Eccentric, Man of Principles, Man of Action, Surgeon, and His Contribution to Blood Transfusion in War', Transfusion Medicine Reviews, 2007, 2, 255-64, 258; Emily Mayhew, Wounded: A New History of the Western Front in World War 1 (Oxford: Oxford University 141 'Blood and Moans', Western Daily Press and Bristol Mirror, 18 April 1944.

Fig. 4 .
Fig. 4. 'Blood for Victory' window display in the 'Women's Wear' department of a Bristol shop.MoMM, RAMC 1816/6/1/2/2 Sue Grayzel, At Home and Under Fire: Air Raids and Culture in Britain from the Great War to the Blitz (Cambridge: Cambridge University Press, 2012).
26 J. M Vaughan and P. N. Panton, 'The Civilian Blood Transfusion Service' in C. L. Dunn(ed.),History of the Second World War, United Kingdom Medical Services: The Emergency Medical Services, Vol. 1 (London: HMSO, 1952).
Mid Devon Advertiser, 16 March 1940. 84'Why West Country People Are Good Blood Donors', Poole and East Dorset Herald, 3 April 1940.Documents 18892, Untitled Register of Bleed Sessions, entries from 29 September 1939 to 6 May 1940. 86'Were 21 Weymouth People Scared to Give Blood?Enthusiastic Promises Not Kept When Asked', Southern Times, 3 May 1940. 87'The Other 29', Evening Post, 23 January 1940. 88MoMM, RAMC1816/1/2/3/1, Report of the work of the Army Blood Supply Depot from the outbreak of war, 3 September 1939 to 31 December 1940, 3. 89 'Life in Store: The Army Blood Transfusion Service', The Bystander, 22 May 1940, 232; 'West Calls for 100,000 Blood Donors: Factory Girls Sacrifice', News Chronicle, 18 May 1940; 'The Call for Blood Grows More Urgent', Evening Post, 24 May 1940. 90IWM, Documents 18892, Untitled Register of Bleed Sessions. 91Mark Connelly and Walter Miller, 'The BEF and the Issue of Surrender on the Western Front in 1940', War in History, 2004, 11, 424-41, 424. 85IWM, Between March and December 1941, Ethel Whitby recorded 99 donor sessions, all outside Bristol, at which there was 117'Appeal to North Devon Blood Donors', Express and Echo, 7 March 1941.
However, donors did not receive any other benefits, unlike those in the Spanish Civil War, who had received food tokens, and British soldiers in The Demand on the Blood Donor', L. E. H. Whitby to the British Medical Journal, 1942, 2, 343, 381; Edith Read, interviewed by John Beales 23.9.2017. 139'

Table 2 .
Annual percentage of registered donor non-attendance