Friday, 21 April 2017

Case Note Cataloguing Continues ...


In this week’s blog Project Cataloguing Archivist, Clair, elaborates on LHSA’s newest case note cataloguing project.

As has been mentioned in a recent blog post, I am now working at LHSA through the University Collections Facility (UCF) Rationalisation project. This means I get to take forward the case note cataloguing skills that I have developed from working on our Wellcome Trust funded, Dott and TB projects to help open up other case note collections we hold at LHSA. After a trip to the UCF I was able to see the physical extent of LHSA’s case notes and this gave me a chance to properly scope the potential collections that could really benefit from being catalogued. The choices had already been narrowed down by LHSA Archivist, Louise, according to their size as it is important that within our project timeframe we complete cataloguing of an entire collection, opening it up to item level. This was a difficult choice to make as each potential collection from different time periods and medical specialities were wholly interesting within themselves. However, in the end I chose to work on Sexual Dysfunction case notes from the Gynaecological Out-Patient Department at the Royal Infirmary of Edinburgh (1973-1994) with around 1249 individual patient case notes to catalogue.



Fully re-housed Sexual Dysfunction case notes.

This is the most modern case note collection thus far to undergo cataloguing at LHSA but we are able to adapt our now well established case note cataloguing methodology to this different medical specialism. The methodology provides a template that allows us to capture a high level of detail from each individual patient record but also enables search functionality through the whole collection. It is flexible and therefore can be adapted to suit the specific characteristics of different medical specialisms. For example, I have decided to catalogue the type of medical treatments that were provided at the Sexual Dysfunction clinic in more detail than can be found in other case note catalogues. This is because the types of treatment were extensive and could be quite varied, from a course of sexual therapy to various urogenital surgical procedures. The Sexual Dysfunction case notes are also particularly interesting because the medical conditions of many patients are often linked to other physiological conditions or reflect on their social circumstances.

Of course, as with all other case note cataloguing projects we catalogue with the highest levels of confidentiality and patient records are closed according to appropriate dates under the Data Protection Act and Scottish Government guidelines on health information of deceased patients. However non-confidential information from the case notes will eventually be able to be accessed through an online redacted catalogue and provide a new way into another medical speciality.

Thoracic-Cardiac Surgery case notes before re-housing.
The project started in February and will run until July. Within this timeframe, we will have a lot of work to do but thankfully come next week I will be joined by our latest LHSA Intern for eight weeks, who will also be case note cataloguing. The internship aims to provide a recent archives graduate with experience in developing skills in cataloguing in the digital age and basic archival rehousing. Specifically, they will be cataloguing Thoracic – Cardiac Surgery case notes (1951-1958) that came from Dr Andrew Logan’s Thoracic Unit at the Royal Infirmary of Edinburgh. Unusually from our pervious case note cataloguing projects, which have always been beautifully rehoused for us before we begin cataloguing, this collections is in its original state. Therefore our Intern will be getting their hands dirty but will learn some important techniques about collection re-housing. Look forward to hearing more about our Intern and the work they will be doing in future blog posts!

Friday, 7 April 2017

Feminist Activism and Scotland's National Childbirth Trust

Our Skills for the Future Trainee will be sharing a bit about our National Childbirth Trust records with you this week…

Hi again, it’s Samar!

At LHSA we hold the archive for the Edinburgh branch of the National Childbirth Trust (NCT), which gives us an insight into women’s experiences of childbirth and maternity care from the early 20th century to the present day. I’ve been cataloguing this collection since January, particularly focusing on the labour reports written by Scottish mothers in the 1960s.

The NCT was founded by a woman called Prunella Briance in 1956. That year, Prunella had lost her baby during childbirth, and was outraged by the way she had been treated by hospital staff during this harrowing experience. As a result, she put an advertisement in The Times newspaper calling for mothers all over the UK to work together to prevent tragedies like this from happening again – and so the NCT was formed.

Our collection holds archive material such as committee minutes, correspondence, birth announcements, newspaper clippings, financial records, event timetables and articles and journals about natural childbirth. Significantly, the collection also holds labour reports written by Scottish mothers about their experiences of childbirth and hospital care. In many of these labour reports, women share unhappy stories of childbirth that ring true with Prunella’s experience.

NCT Committee Minutes Book 1965, featuring a child's drawing [Acc 13/045]

In the labour reports, we learn that many women had gas and air forced upon them against their will:

"I think I may have managed myself had it not been decided otherwise."

“[Hospital staff] told me I was getting too much oxygen from breathing technique - yet in the end had to give me oxygen."

“[I was] half doped throughout."

Babies were taken away from mothers right after giving birth:

"I was disappointed not to be given the baby after birth."

Women were left to labour for hours alone and without beds to lay in:

"I found I wanted to push, and was rather frantic as there were no beds free. All the nurses were very busy.”

Fathers were not permitted in labour wards, even if the mother requested they be allowed:

“… if only husbands could be at delivery."

Angered that so many women shared these experiences, the NCT organised educational classes that would provide expecting mothers with a network of peer support and information on childbirth that they couldn’t get anywhere else. The expectant fathers were heavily encouraged to attend classes with their partners, so that they could help and support the women as they prepared for birth.

The NCT’s classes aimed to make expectant parents better educated on what to expect during childbirth and also promoted natural childbirth techniques based on the teachings of Grantly Dick-Read. These teachings equipped the women with breathing exercises that would help them control their contractions, relax their muscles and get the oxygen they needed when giving birth. Many women also reported that these exercises helped them stay calm and focused during childbirth. Another reason why the NCT encouraged this method was because it helped the women avoid interventions such as inductions, episiotomies (cutting of the perineum) and enemas. This activism was particularly vital, as it was shortly publicised that some doctors were inducing women early during festive periods, to ensure that they wouldn’t have to work during that period.

NCT Committee Minutes Book (II) 1970-1982 [Acc 13/045]
Many women who attended the NCT’s classes reported that they felt relaxed during childbirth, that doctors and hospital staff greatly admired the method, and that in some cases, the women managed to avoid sedation and intervention. Some women even managed to convince staff to let fathers into the wards with them too:

"This nearness to my baby's birth gave me a special kind of excitement and I found that day very useful. I cleaned my house (again); I re-packed my cases (again); and most important of all, I read and read and re-read the sheets of notes I had collected over the months at my relaxation classes."

"... the nurses were very glad to see I was managing to control the contractions. One of them commented that she wished her sister, who was pregnant, could see how well I was managing. I had been trying to tell the other women in the labour ward (4 beds) about the breathing and by this time the ward sounded like a railway station with all the puffing and blowing."

"The pupil midwives were full of praise and said I had done very well. They enjoyed having (my husband) there and said he was a great help. He was given a cup of tea before me!"

"I didn't feel at all tired and would willingly have had another baby the next day."

"Alas, my difficult son decided to make his trip into the world with one hand on his head, which not only made the transitional stage rather painful, but rather hampered his actual delivery. Having said all this, I may say that I feel the training still made all the difference in the world..."

"Both the sister, who recognised the method - and a nurse who stayed with me gave every encouragement and were most impressed."

"Had I not trained under this method, I would have been overwhelmed by genuine pain in back and tummy. It could have been a ghastly time, but I was so glad I had practiced hard and read plenty."

"Midwife told doctor that due to attending breathing and relaxing classes, I was an excellent patient."

"I seem to have rambled on and on but I was pleased to write and tell you of the success of the method - as far as I am concerned. The Doctor said to me this morning that she was sure I wouldn’t have needed the gas and air if (the baby) had been of an average weight and that the nurses and herself thought the breathing was very helpful to them and I was completely relaxed from the waist down."

"It was only the knowledge of controlled breathing and also that I was well on that kept me in control."

The NCT continues to run today, campaigning to improve maternity care and ensuring that better information, services and facilities are provided to new parents. In April 2010, they joined a campaign calling for companies producing baby bottles to stop using Bisphenol A (BPA), a chemical that could leach out of plastics into food or liquid in tiny amounts and be absorbed by the body. The NCT also had a strong influence on The Equality Act, which now gives women in Britain the right to breastfeed in public without being discriminated against. They have also repeatedly lobbied for improved parental leave, supporting campaigns for increased paid maternity and paternity leave.