British Hospitals for Mothers and Babies Woolwich, Kent, England

Kai Tiaki : the journal of the nurses of New Zealand, Volume XV, Issue 3, 1 July 1926, Page 107

British Hospitals for Mothers and Babies Woolwich, Kent, England

Sister Kirkpatrick

(By

).

It may be of interest to nurses taking a training m New Zealand midwifery schools to know something of the hospital which has frequently been referred to me as the most up-to-date midwifery hospital using the most scientific methods m regard to both mother and babe m England.

I refer to the above, which had its origin twenty years ago m a house not specially designed for the purpose, and fruited three years ago m a modern building carefully planned to meet the most exacting demands of public health and hygiene. Hospitals sometimes grow m a haphazard way to meet the needs of the community, but more ideally they eventuate as entirely new buildings calculated to meet all requirements.

To get this, one must have great foresight, enormous confidence, unbounding enthusiasm and ideals of so fine a quality that no personal sacrifice is too great to be made.

Of such stuff the three people who sponsored this great piece of work are made. They are: Mrs. Parnell, Matron; Miss Gregory, Honorary Treasurer and head of district work; Miss Cashmore, Sister Superintendent.

During eight years of district midwifery work m the country, Miss Gregory realised the necessity of a training school specially dedicated to the needs of educated women who proposed to devote themselves to this work. She therefore set herself to collect the necessary funds, and with her two friends, Mrs. Parnell and Miss Cashmore, opened the home for Mothers and Babies m an adapted house m Wood Street.

In 1915 the home amalgamated with the oldest maternity m London, the British Lying-in Hospital, Endell Street, which had been obliged to close owing to the inadequacy of its buildings. Later on a large piece of waste land was secured, and the building of which I make a rough diagram was completed m 1921.

It consists of three stories all connected by lift, and having a very delightful roof on top with a view of the Thames. The wards are on the first two stories, two on each flat, each having eight beds, but capable of taking at least one more. Altogether 34 m the main building and an additional six m the annex.

The windows are large, and open low. On one side they look over the mothers' garden, which has been designed with much loving care and a very good idea of artistic arrangement.

The walls of the ward are palest cream, and the floor covered with thick dark green floorcloth, which effectively deadens sound and satisfies one's aesthetic side rather more than severe boards.

The screens are made of charming floral stuff, and match or contrast prettily with the counterpanes.

The lockers are of white enamelled metal with glass tops, easily kept very hygienic and having rubber wheels are easily and soundlessly moved.

Each ward is provided with a little room fitted up with elbow taps and porcelain basins, which are used for the preparation of hands, etc., when the nurses are giving treatments.

Branching out is the corridor with accessory rooms. On one side, screen, cupboard, Sister's room, kitchen, side ward and nursery. On the other, linen cupboard, sink and basin rooms, and labour theatre, the latter being very up-to-date with good lighting and an excellent hot and cold water steriliser, so necessary where an antiseptic system is used.

The nursery is particularly charming, with delightful baths for the babies, and opens on to a big verandah overlooking a very promising orchard. At the end of the corridor is a potential welfare centre, m use at present for kitchen, etc., until sufficient money is obtained

to build the domestic wing, when the Welfare Centre will come into its own, instead of being provided for as it is at present m the old building, which also houses a great many of the trainees. The routine will be of interest.

Expectant mothers are seen early m pregnancy when they are "booked" and given advice as to care of breasts, attention to bowels, food, clothing, personal hygiene and preparation for the infant.

At seven months they are seen again — or earlier if necessary. Particular attention is paid to the urine and the usual abdominal, and, if necessary, vaginal examination is made.

There is a Resident Medical Officer who sees some of the cases, but most pre-natal work is done by the Matron and Sisters, who give advice or refer the applicants to the R.M.0., who may, or the Matron or Sisters may, refer them to one of the visiting physicians, Dr. Mary Blair (of Dunedin). Again these patients may be referred to another physicain, Dr. Wise, who does most of the forcep and induction cases. Since being here, there have been three cases of Caesarian Section, and the operations were performed by a very clever woman surgeon — Miss Bolton.

The expectant mothers frequently arrive only a short time before labour begins if they live near, but those who live some distance usually prefer a little waiting period m the hospital.

As mentioned before, the hospiatl is worked on antiseptic lines. There are big sterilisers m the basement, where all the bowls are boiled daily, and these, after use, are washed, antiseptic lotion put m, and used again. Cotton wool is broken up with clean hands and put into large jars with perchloride of mercury 1-1000 poured over.

The actual bathing is done with lysol, using swabs from these jars and followed by perchloride of mercury if being prepared for labour or immediately following labour. The main feature is the very excellent preparative of the hands. For labour scrub five minutes.

Soak m perchoride of mercury three minutes. For ordinary bathing scrub

two minutes and soak one minute. All this is followed most particularly and it can be easily seen how such methods are very adaptable to district work. Gloves are worn for labours, p.v. examinations, and all cases where there is any vaginal discharge. Any cases of pyrexia are isolated at once m a side ward, and "specialled" whether the reason is known or not. The wards are spring-cleaned very frequently — about every three months. In case of any serious infection there is an isolation block with six beds some distance from the hospital. The fact that it is rarely used and is kept more as a nurses' home speaks for the wonderful results of this hospital. The mothers are kept m for two weeks, getting up on the tenth day for the first time, unless their cnodition requires a further rest period. Aperients are not used, but liquid paraffin is given from the first day. A great deal of water is given, particularly if the mother requires better lactation. Animal protein is given on the third day, and the hot meals are brought up on a very ideal food trolley with an electric attachment. The methods of baby feeding are adapted from such famous paediatricians as Dr. Waller, Dr. Truby King and Dr. Eric Pritchard. Breast feeding is the rule for normalsized babies, with no night feeding, and three hourly for those under normal. Truby King massage is used for failing milk supply and New Zealand cream is given for making up the fat content of artificial foods. The artificial foods given are: Whey, cream, sugar of milk; peptonised milk, and Ambrosia (a dried milk). Wherever possible, though, a baby is complemented with breast milk. The babies' charts have temp, feed and stools recorded — weight also, the classic days being 3. 8. 14. Artificial food is shown by black lines, and the amount taken from the breast by red lines. The nursery or night cots are made of an oblong piece of calico slung on an ob-

long frame made of iron and painted with aluminium.

There are cots also slung at the ends of the mothers' beds for day-time, but the little ones love the nursery ones best. On sunny days the babies are put out on the verandah and even m winter the windows are widely opened, although the nursery is always kept pleasantly warm with steam heaters and fires. The babies are followed up at a post natal clinic, so a very complete circle is obtained.

District work here has its charm even m the most sordid homes, but sometimes the wonder of birth is rather swept aside by the material things of life. Some sort of an attempt, however, is always made to provide for the delivery and pathetic little efforts to have the very best for such occasions makes one realise the tremendous possibilities there are m such work.

Since writing the above, many weeks have passed, giving me a much wider view of what district work really means.

My happiest days (sometimes the most anixous ones) have been spent m these homes, and realisation has come to me that no institutional life can develop the instinct of the social worker as this can. One forms an intensely close bond with these people — they are fertile soil for the eager worker who is not grooved into a professional rut indispensable as that is, but alive to the fact that here are human beings by Fate often placed m the most wretched sur-

roundings, but never quite without the "divine discontent" which is the root of all progress.

The expenses of the hospital are met by the patients' fees, which vary according to their earnings, and never meet the cost of attention. Bazaars, jumble sales, street collections and a Government grant come second, and the fees of the trainees next.

The rates, however, are terrific, and have recently been increased so that the prospect of completing the hospital by adding another wing, containing wards and nurses' home is still far away.

I must finally add a word about the religious side of the hospital. There is a little chapel where the staff meet morning and evening for prayers, and where Matron asks daily that we may remember to serve with clean hands and faithful hearts, where also the mothers may go if they are able before leaving.

Evening prayers are held m the wards, and this beautiful thanksgiving said after childbirth: Oh ! Heavenly Father, we thank Thee that Thou hast vouchsafed this Thy servant a safe delivery through the great pangs and perils of Childbirth, and hast given her the great blessings of a living child. We pray Thee that Thou may give her and her husband grace to bring him up m Thy faith and fear through Jesus Christ, our Lord.