Reflecting on my Placement with George Marshall Medical Museum - a Guest Blog by Molly Schoenfeld

A common complaint that arises during student placements is that the work is not varied enough, often involving miles-high mounds of filing. I can gladly say that this was definitely not the case with my virtual placement as a Research Assistant for the hopeful ‘Birthing Stories’ project at George Marshall Medical Museum.

One of the highlights for me was being able to work as part of a team: Louise Price (the museum Curator), Nadia Stone (the Director of heritage organisation Storypinned) and Sally Boyle (a fellow student working as an Engagement Assistant). Given current social distancing measures, we have been having weekly Zoom meetings for the past eight weeks, in which we have shared the work we have been doing and planned our next steps in the project. Being able to communicate effectively online, whether through Zoom or via email, is certainly a valuable skill to have developed, especially in the current situation. Thanks to the passion of the Birthing Stories team, it almost felt like I was in a non-virtual meeting room!

My work began with some research into the oral history transcripts from the 2001 ‘Medicine in Worcester’ collection. My aim during this research was to pick out any information related to birth and obstetrics in Worcestershire and provide detailed summaries of the information I found. I had never read an oral history transcript before this placement, so learning about the processes behind recording and transcribing oral histories was fascinating.

The stories told in the oral histories ranged from the hilarious to the very gloomy, providing a wide range of opinions on twentieth century medicine. I had not properly studied medical history before my research began: the knowledge I have accumulated in this area shall certainly be useful during my current History degree.

After I had completed my research, Louise gave me a very useful lesson on how to schedule posts on Facebook, Instagram and Twitter. Using Audacity, I would edit and clean various audio clips from the oral histories before using editing software to add subtitles and bind an image to the audio, thus creating a video. With the world heading in a digital direction, this social media and video editing experience was very valuable. After sharing the social media posts, I thoroughly enjoyed seeing followers engage with the content through likes, retweets and comments. During the ongoing pandemic, social media is now the major platform for local communities, and I felt very lucky to be a part of the Worcestershire community in this way.

Additionally, I have been writing blogs on my findings from the oral histories for the Worcester Medical Museums website. In order to achieve this, Louise gave me and Sally a tutorial on how to use the website’s software, Squarespace, and publish blogs. Given my love of writing, I very much enjoyed being able to write up my findings. Using my newly acquired Squarespace skills, I then created a Birthing Stories web-page (which can be found here) providing more information on the project. It was so rewarding to be able to draw together all our work so far into one concise web-page and then share this on social media.

For anyone who has a passion for history or is interested in working in the heritage sector, I highly recommend a placement at George Marshall Medical Museum. The work was so varied, interesting and tailored to my own interests that I often found myself exceeding the recommended 7-hour weekly dosage of work! What was so satisfying about the placement was being able to support such an important local museum during a very difficult time, and crucially being able to help build the foundations for such a valuable project. I look forward to hearing updates on the project’s progress and, provided the application for funding is successful this year, I am very confident that Birthing Stories will inform and empower many mothers and healthcare professionals in Worcestershire to come.

online conference: Sir William Osler 1849-1919

The Osler Club of London and the British Society for the History of Medicine invite you to an online conference to celebrate the legacy of Sir William Osler, concluding with the Poynter Lecture.

The speakers at the conference will be:

• Professor Dame Jane Dacre, Professor of Medical Education

• Dr Hilary Morris, Medical Historian and Educator

• Dr James Le Fanu, Writer and former General Practitioner

• Dr Daniel Sokol, Barrister and Medical Ethicist

The Poynter Lecture at 18.00 will be delivered by

• Dr John Ward , Past President of the Osler Club of London and former General Practitioner

He will speak on: "The great Republic of Medicine knows and has known no national boundaries - William Osler, the great medical internationalist".

Click here to be taken to the Eventbrite page for this online conference.

Revolutions and Resistance: Twentieth-Century Birth and Obstetrics - A Birthing Stories Blog by Molly Schoenfeld

It could be said that the twentieth century was a period of stops and starts. Major medical discoveries were made, such as penicillin, but it was often not known how these new methods should properly be harnessed. This is seen, for example, in the over-use of antibiotics encouraging antibiotic resistance. In birth and obstetrics, the same applied, with healthcare professionals having to adjust to radical changes in the field. The ‘Medicine in Worcester’ oral history collection corroborates this, with individuals struggling to cope with new procedures. Given that these oral histories were recorded in 2001, the perspectives provided by interviewees truly reflect on a vast amount of the previous century.

On the one hand, major medical changes increased birthing safety. Hygiene standards were greatly improved; one doctor working in maternity units in 1950s Worcester remembers that doctors never wore gloves, and bandages were not thrown away, but washed and re-used:

“You didn’t have gloves there was no such thing as gloves and I must say when we had to wear gloves I didn’t like it, I didn’t, I felt I could handle the case much better without gloves, but you’ve got to go with the times. […] and on that one in hospital never threw away a bandage, I mean certainly if it was very bad of course you had to throw it away but it would be washed and upstairs I think I’ve got all these bandage winder machines so the bandage could be used again and again. Throw away things, the throw-away society hadn’t come.”

— R.2001.001.0012 (15/10/2001)

From about the 1960s, this ‘throw-away society’ arrived. Dorothy A. Higgins comments on the changes in midwifery over the course of her career (from her initial training in the 1940s until her refresher course 22 years later). In particular, she discusses the introduction of disposable equipment, such as needles and catheters, and how it was difficult to get used to:

“I can remember the little sister who was on the postnatal ward I was working on, and I went up to her with a catheter, and I said, “Have I really got to throw this away?” Because we used to wash them through and boil them up again, you’d reuse them. Syringes we used to boil, they were glass, used to wrap them up with bits of gauze and boil them up, now you give an injection, throw it away. Everything was disposable.”

— Dorothy A Higgins (03/07/2002)

Revolutions in birthing procedures were also made, such as Ventouse extraction from the 1950s, which is associated with fewer maternal injuries during a difficult birth. Kate Bradley remembers the introduction of Ventouse extraction, which often left mothers alarmed as their baby had a temporary ‘large pimple’ on its head:

“It was like a suction cup, which was put on the baby’s head, if a woman got stuck in labour we could put this suction cup on the baby’s head and as she pushed, he pulled, er, which sometimes got the baby out a little bit, well lot of occasions got the baby out a lot more quickly obviously if it was getting in distress. These babies would be born with a sort of, a large pimple on their heads, which alarmed the mothers rather but we assured them it would go down and it did literally within an hour or two, this sort of bulge had gone.”

— Kate Bradley (21/10/2002)

In the early twentieth century, blood groups were discovered which led to the wide use of blood transfusions during births in which the mother was losing a lot of blood. In an oral history, a senior haematologist talks about the progress and benefits of blood transfusion in the 1940s and 50s:

“In early days […] they used to have this flying squad he was interested in blood, he instigated this blood transfusion and they would take the blood to the house and transfuse the lady, once the lady or the doctor, midwife said “oh gosh this girl’s bleeding to death” the, the lab, the erm, blood transfusion staff would come to the house, and they’d transfuse this girl and all the rest of it and be fine by the morning and one tale was they came out of the house one day and all the neighbours had gathered round, and as they came out they gave them a round of applause, erm I mean for saving this girl’s life, and that was purely due to the fact that we could transfuse blood safely.”

— R.2001.001.0010 (08/10/2001)

As is evident, new medical procedures meant that healthcare professionals needed to learn how to conduct them safely and effectively. With the regular use of X-rays in hospitals from the 1930s, one doctor remembers how careful one had to be when giving a pregnant woman an X-ray:

“When you were x-raying a pregnant woman with her large tummy, you put an ap, a lead apron over parts of her, but also you had to ensure that she wasn’t too close to the x-ray tube because the end of the positive and negative cathodes were connected, were open, […] uninsulated, connected by wires, to the erm, conductors, exposed conductors in the ceiling”

— R.2001.001.0017 (18/01/2002)

Additionally, Dorothy A. Higgins talks about having to adjust to more rigorous administrative procedures in the later twentieth century.

“You were always having to sign for this, and sign for that and you listened to the baby’s heart and signed that you’d seen it, we used to use a lot of, whereas the midwife in the old days used to listen with the trumpet, er, and put it down, that was it. She might sign it, but now you have the continuous readings going on, on the graph and you had to sign it every so often to say that you’ve seen them and it’s people power taking over, or I felt it was. Erm, you had to ask permission, to examine a patient, whereas in the old days, you said “I’m just coming to do your gram let’s see how you’re getting on.” But if you’d done that, you could have been sued for assault, believe it or not.”

— Dorothy A. Higgins (03/07/2002)

Helen Shirley Brice reflects on the differences between birth and obstetrics in the 1960s in comparison to the early twentieth century. Ultrasound scans were made routine from the late twentieth century:

“[I] Were they, more rare?
[HSB] Caesareans, oh yes, I mean if you had a caesarean then, you, and also I think I can remember er, people could only have two caesareans you know, they didn’t like you having any more
[I] […] Can you think of any other differences between when you had your children and what you know of giving birth today?
[HSB] Well what I’ve gathered from my daughter-in-laws and daughters, I mean I think at about 12 weeks or so they go and have a scan, and a different test are taken, and er, we just got pregnant and had our babies. We never had any special tests to find out if there’s Downs Syndrome around, and any other things that could go wrong. And er, it’s changed a lot, I mean er, so erm, I suppose it’s all for the best really, but when me and my friends and my relations were having babies we never had any of this.”

— Helen Shirley Brice (18/10/2001)

When one breakthrough is made into the unknown, often further unknowns are revealed. This certainly proved true in the twentieth century (as is evident in the above oral histories), with healthcare staff having to adjust to new procedures and navigate the associated dangers with these methods. This combination of advancement and resistance perhaps renders the twentieth century one of the most complex periods of medical progress.

Birthing Stories: Midwifery in mid-twentieth century Worcester - a Blog by Molly Schoenfeld

“If the babies didn’t come out at the same place, I’d be all at sea!”

— R.2001.001.0046, Dorothy A. Higgins (03/07/2002)

It could be said that Dorothy’s rather amusing comment sums up the huge changes in the practice of midwifery that swept across the mid-twentieth century, in everything from hygiene measures to administrative processes. Being a midwife in this period was incredibly demanding, with midwives often straddling between two eras: that of quaint home births, and that of medicalised births in hospital. This blog will be looking at some of the oral histories in the ‘Medicine in Worcester’ collection, and reflecting on the challenges, pressures and pleasures of the midwifery profession during this period.

It is no surprise that midwives worked long hours, as a midwife remembers during her training at the Ronkswood branch of Worcester Royal Infirmary in the 1950s:

“I’ve known a sister, a patient came in about five o’clock, wouldn’t think of going off duty, she would stay on seven, half past seven, make quite sure that that patient was well cared for, and had been um admitted and comfortable before she went up for her supper. We couldn’t expect that today. ”

— R.2001.001.0009 (20/11/2001)

The work itself certainly did not suit the squeamish, as Ethel (Molly) Stephens discovered. Molly remembers working with a consultant obstetrician and gynaecologist during her training at Worcester Royal Infirmary in the 1930s. The consultant was conducting an intimate patient examination, which rather shocked Molly:

“[The consultant] said “I shall want screens” […] when I saw what he was doing the intimate examination, I was horrified, I’d no idea such things went on, and this is how we went round the ward, and every four or five minutes I kept saying to him “I’ve got to make that bed up!” so after he got to the ward door, he said “we’ve done splendidly Sister, now you may make the bed up you’ve got plenty of time, you see I am doing the operation!”

— R.2001.001.0038, Ethel (Molly) Stephens (27/02/2002)

Huge responsibility was placed on midwives, both in hospital and at patients’ homes. At the young age of 26, Dorothy A. Higgins was put in charge of a maternity unit at Shrub Hill. She had to carry babies and patients up and down stone steps:

“There was a delivery room [on the ground floor] in case you had someone who couldn’t get up the stairs! […] And, we had canvas stretchers and we use to have to carry them up and down these stone steps. It was hard work – you had to be tough!”

— R.2001.001.0046, Dorothy A. Higgins (03/07/2002)

Additionally, only a midwife would be present during home births (which were often encouraged during the twentieth century – see my previous blog here for more information). If there was a serious problem, a doctor would be called (this was often done from a far-away phone booth if the home did not have a telephone installed!). Yet, doctors often took a long time to arrive meaning that the midwife had to deal with a lot by themselves. Helen Shirley Brice gave birth to her fourth child at home in Worcester in the mid-1960s and her midwife was only recently qualified. The midwife had to deal with a haemorrhage all by herself until a doctor arrived several hours later!

“I had a haemorrhage, and of course she said to me “you’ve got a haemorrhage” so I said “well what you going to do about it?” well she said “I’ll give you a couple of injections” and she said “we’re now at four o’clock” four o’clock in the morning, she said “If you lie in bed with your legs tightly crossed and don’t move” she says “I’ll get the doctor to come and see you as soon as he can” and both my husband and I were frightened to death in case my haemorrhage continued flowing, but fortunately the injection she gave me I suppose contracted, stopped that and erm, from what I can remember the doctor didn’t come to turn six o’clock or nearly seven o’clock in the morning”

— R.2001.001.0014, Helen Shirley Brice (18/10/2001)

Occasionally, though it was often discouraged, midwives themselves would become pregnant. Midwife Kate Bradley was pregnant in 1964 whilst working at the Ronkswood branch of Worcester Royal Infirmary, and had to work tough night shifts:

“The, beginning of ’64 I was pregnant, now that was a very, very cold winter […] it seemed to me that practically every night somebody was dying and I used to get home in the morning feeling quite depressed, erm. I was on, I went on to general night duty then because I couldn’t stand at the table a lot, because I was what six months pregnant then, five, six months ”

— R.2001.001.0032, Kate Bradley (21/10/2002)

We now return to Dorothy A. Higgins, who comments on all the changes she witnessed in her medical career. Dorothy took her initial midwifery training in the 1940s and 22 years later took a refresher course, in which all the changes in midwifery were made clear:

“Disposables. I can remember the little sister who was on the postnatal ward I was working on, and I went up to her with a catheter, and I said, “Have I really got to throw this away?” Because we used to wash them through and boil them up again, you’d reuse them […] And you were always having to sign for this, and sign for that and you listened to the baby’s heart and signed that you’d seen it […] in the old days, you said “I’m just coming to do your gram let’s see how you’re getting on.” But if you’d done that, you could have been sued for assault, believe it or not”

— R.2001.001.0046, Dorothy A. Higgins (03/07/2002)

Despite the pressures that a career in midwifery carried, it remained a very popular field to enter into. For Dorothy, being a midwife allowed her to feel a part of the local Worcester community:

“But, erm – I don’t know there was a – a wonderful feeling there and I still meet people who still call me Sister Walker, although I was married in 1955. “Hello Sister Walker! How are you? Do you remember this?” And, ‘this’ is probably a twenty year old- you know? And, now, I have got- some of my babies have got grandchildren. […] And I err think that’s the joy of living in the same area you work ”

— R.2001.001.0046, Dorothy A. Higgins (03/07/2002)

The role of a midwife, therefore, goes far beyond assisting with the delivery of babies. Midwives ensure mother and baby are both physically and emotionally supported all the way from the early stages of pregnancy until the early post-partum stages. Indeed, a 2013 Cochran review concluded that midwifery-led care is associated with reduced risk of miscarriage and a reduction in the use of epidurals, for example. It is wonderful that the value of midwives is being recognised, with student midwives being eligible for additional financial support from September 2020.