rcogheritage

Heritage collections relating to women's health

Something of Our Own: The Story Behind Fellows and Members Robes at the Royal College of Obstetricians and Gynaecologists

The Royal College of Obstetricians and Gynaecologists will be holding its next Fellows Admissions Ceremony at its headquarters near Regent’s Park this Friday. The ceremony marks the formal confirming of Fellowship and Honorary Fellowship status to eligible members of the College.

All obstetric and gynaecological practitioners who complete the RCOG’s membership examinations and fulfil certain training and professional development requirements are given the status of Member of the RCOG (MRCOG). Fellowship of the College (FRCOG) is awarded after a member has practiced the specialty for at least 12 years and has contributed to the maintenance and development of standards and care in obstetrics and gynaecology. Honorary Fellows are individuals outside the medical profession who have contributed to the work of the College. Past Honorary Fellows have included British and Overseas Royalty and philanthropists with special interest in College’s work.

The most striking sight you would see when stepping foot into the College on Admission Ceremony day is the sea of blue robes with College insignias filling every hall as new admissions change into their regalia. The College’s signature Members, Fellows and Presidential Robes are part of a tradition as old as the College itself. But this was one tradition that did not come about easily.

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Fantastic Finds for Friday: A Letter from Florence Nightingale

Florence Nightingale's signature from her letter to Dr Heywood Smith, 1876.

Florence Nightingale’s signature from her letter to Dr Heywood Smith, 1876.

This month’s Fantastic Find comes courtesy of the ‘Lady of the Lamp’.

There are few nurses more well known than Florence Nightingale (12 May 1820 – 13 August 1910). Venerated as a hero of the Crimean War for her management of nurses treating wounded soldiers, Nightingale was also an author. Her book Notes on Nursing: What it is and What it is Not (originally published in 1859) offered guidance to ordinary people on good practice when nursing the sick and injured, covering the importance of hygiene and responsible bedside manner.

Florence Nightingale also had a special interest in hospital design, especially with a view to preventing cross-infection between patients. Our library holds a copy of another of her books titled: Introductory notes on lying-in institutions: together with a proposal for organising an institution for training midwives and midwifery nurses, published in 1871.

Lying in is a historical term for the period after childbirth where a new mother was placed on bedrest. Lying-in hospitals were maternity hospitals where women would receive dedicated care during pregnancy, labour and during the antenatal period. Lying-in hospitals for the care of mothers after childbirth originated in 1739 with the foundation of the General Lying-in Hospital which later became Queen Charlotte’s Hospital, London. Many others followed over the next 50 years including those in Edinburgh, Dublin, Winchester, Bristol and York.

Our copy of her 1871 book was originally gifted to Dr Heywood Smith (1837-1928) from Nightingale and is inscribed by her. Dr Smith was an Oxford educated gynaecologist who became senior physician in the British Lying-In Hospital.

The title page of Nightingale's book Introductory notes on lying-in institutions: together with a proposal for organising an institution for training midwives and midwifery nurses, published in 1871. The inscription reads: ‘Offered to Dr Heywood Smith with the earnest hope and prospect of his invaluable exertions in the training of real midwives and in the formation of real and healthy [Lying-In Institutions]. With sincere gratitude for his proffered help, by Florence Nightingale, London: 1876.’

The title page of Nightingale’s book Introductory notes on lying-in institutions: together with a proposal for organising an institution for training midwives and midwifery nurses, published in 1871. The inscription reads: ‘Offered to Dr Heywood Smith with the earnest hope and prospect of his invaluable exertions in the training of real midwives and in the formation of real and healthy [Lying-In Institutions]. With sincere gratitude for his proffered help, by Florence Nightingale, London: 1876.’

In her book, Nightingale discusses the maternal death statistics of lying-in institutions and makes suggestions, with accompanying plans, for changes to hospital layouts which could reduce rates of infection and maternal death.

When it reached our collection the book was accompanied by a letter to Dr Smith (dated 10 May 1876) written by Nightingale from her home in Park Lane, London, in response to his previous correspondence with her concerning the provision of midwifery training and instruction to women. This remarkable correspondence includes comments on statistics of deaths at lying-in institutes and the possibility of women being allowed to supersede men in midwifery practice. The letter is held in the archive collections of the RCOG and was donated (along with the book) to the College by Edward Protheroe Smith in 1933.

Referencing the shocking rates of maternal death in London hospitals Nightingale writes:

(It may be asked by some – but it is -perhaps an invidious question – what is the use of bringing these cases in at if they are only to die?)

Reflecting her reputation for pragmatism, she also makes a point of focusing on rectifying the lack of training available to female midwives and nurses before all else. Of medical practitioners she writes:

At any rate, at present, need we trouble ourselves about the men, or about their means of training? For they have some and good: the women have none – none that is, that you would condescend to call by that name.

Another interesting aspect of her letter is her repeated reference to her published text as her ‘little book’. Whether a term of endearment to her own work or an effort to keep from rousing controversy among the male-led medical establishment we cannot be sure. One thing her letter suggests, however, is that she knew the importance of getting established practitioners like Dr Smith on her side if she wanted to make progress with her work to improve conditions in maternity wards. In her letter she writes:

My little book which you are kind enough to notice was simply a sort of guide post, based on melancholy experience – a sort of Town Crier, inviting further consideration -begging and crying out for further statistics, especially from men of weight like yourself.

A full transcript of the letter can be found below:

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Fantastic Finds for Friday: Midwifery and Gynaecology Examinations before the RCOG

This month’s Fantastic Find is a selection of examination papers for obstetric and gynaecological practitioners which predate the Royal College of Obstetricians and Gynaecologists by over thirty years. The RCOG was only the third royal medical college to be established in England, but it is centuries younger than its predecessors: the Royal College of Physicians (which founded and gained royal charter in 1518) and The Royal College of Surgeons (formed in 1540 and gaining royal charter in 1800).

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Conference Announcement, 7th May, Oxford: “Pregnancy and birth: Changing practices over the twentieth century”

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We are pleased to announce that The Oxford Research Centre in the Humanities and De Partu are holding a study day in Oxford on 7th May as part of a Knowledge Exchange Partnership with the Royal College of Obstetricians and Gynaecologists.

Hardly a week goes by without a story or advice about pregnancy or birth making headline news. The Partnership sets this public fascination in a broad historical context, featuring debates and controversies from early printed midwifery texts to the present day. It aims to widen awareness of the heritage collections of the Royal College of Obstetricians and Gynaecologists and of the Royal College of Midwives; and to facilitate dialogue between academic researchers and healthcare practitioners. Our study day on 7th May 2016, held in Oxford, focuses on the twentieth-century birth experience, encompassing antenatal preparation for family life, Leboyer’s theories of gentle birth, and developments in postnatal care in the twentieth century. We shall also have presentations on the RCM’s oral history collection and from the midwifery adviser to ‘Call the Midwife’.

The Event:

  • 10.15 Registration and coffee
  • 10.30 Welcome (Valerie Worth-Stylianou and Janette Allotey), and presentation on ‘Revisiting The Midwife’s Tale: an oral history collection at the Royal College of Midwives’ by Carly Randall, (Archivist, RCOG)
  • 11.00 Guest speaker: Dr Marie-France Morel (Ecole Normale Supérieure, Paris): ‘Gentle birth: Leboyer’s theories and subsequent changes to how babies were birthed in France in the 1970s’
  • 12.00 Seminar A: Professor Mary Nolan (University of Worcester) ‘Birth and Parent Education post Dr Spock, 1970-2016: striving to build parents’ confidence rather than destroy it’
  • 12.00 Seminar B: Professor Debra Bick (King’s College London): ‘’Context, culture and contribution of postnatal care over the last century: a missed opportunity for women’s health’
  • 1.00 Lunch
  • 1.40 Seminars A and B repeated ( to allow all delegates to attend each seminar)
  • 2.40 Tea and coffee
  • 3.00 An update on De Partu (Janette Allotey)
  • 3.15 Terri Coates (midwifery adviser for ‘Call the Midwife’): ‘Call the midwife: communicating the art of midwifery though a BBC period drama’
  • 4.15 Concluding remarks and end of study day

Lead contacts for the Partnership:

Valerie Worth-Stylianou, Senior Tutor Trinity College, University of Oxford, and Mellon-TORCH Knowledge Exchange Fellow

Janette Allotey, Chair of De Partu, Honorary Lecturer, School of Nursing, Midwifery and Social Work, University of Manchester

To Book

The seminar is limited to 60 places and entry costs £20 (to cover all refreshments, including lunch). There is a reduced price of £10 for graduate students / student midwives or doctors.

Click here to visit the TORCH website and to download a booking form

Fantastic Finds: the Case Book of Robert Barnes, 1857-1868

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Fantastic Finds for Friday: Satirical Drawings from the Archive

This month’s Fantastic Finds post showcases some of our archive’s satirical drawings and caricatures.

Topics such as death, disease and medical reform are fertile ground for dark humour and satire. Medicine can also serve as an affective metaphor for criticising unpopular legislation and political decisions. Likewise, prominent figures in healthcare and politics have long been subject to caricature, their fame, influence and privilege making them both recognisable and easy to parody (sometimes affectionately, sometimes brutally).

Caricature of Sir Comyns Berkeley (archive reference RCOG/PH23/20)

Caricature of Sir Comyns Berkeley (archive reference RCOG/PH23/20)

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Fantastic Finds for Friday: the Anatomical Drawings of Andrew McWhinnie

This month’s Fantastic Find is a collection of anatomical diagrams and sketches drawn with painstaking precision by the anatomist and general surgeon Andrew Melville McWhinnie.

Here at the RCOG archive we hold six plates taken from one of McWhinnie’s surgical publications. They were transferred to the Archive in 2012 during a reorganisation of the heritage collections and originally belonging to the late Mr Barnett (FRCOG) of Southsea. The plates feature in the library’s historic volume ‘A series of anatomical sketches and diagrams’ (1843) by McWhinnie and Thomas Wormald.

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Louise Bourgeois’s Observations: the earliest printed work by a midwife

This month our blog features a guest post from Valerie Worth-Stylianou. Valerie is a Senior Tutor at Trinity College and the Mellon-TORCH Knowledge Exchange Fellow at the University of Oxford. This blog post features an in-depth look at one of the RCOG’s early printed books which featured at the recent Knowledge Exchange workshop hosted by the Royal College of Obstetricians and Gynaecologists in partnership with The Oxford Research Centre in the Humanities and the De Partu History of Childbirth Group.

The Library of the RCOG holds a rare copy of the first edition of the Observations of Louise Bourgeois (1563-1636), midwife to the Queen of France (Marie de’ Medici, 1575-1642).

Portrait of Louise Bourgeois, from 1609 Observations The portrait was engraved in 1608 by Thomas de Leu, a court artist. Her status as royal midwife is indicated by her velvet collar, velvet cap and gold cross. Her age (forty-five) suggests her experience. The four lines of poetry pay a conventional compliment (‘In this perfect portrait, the limits of painting/ Are clearly evident to our eyes today/ Because we see only the representation of the body/ Not the mind that is admired as a masterpiece of creation.)

Portrait of Louise Bourgeois, from 1609 Observations
The portrait was engraved in 1608 by Thomas de Leu, a court artist. Her status as royal midwife is indicated by her velvet collar, velvet cap and gold cross. Her age (forty-five) suggests her experience.
The four lines of poetry pay a conventional compliment (‘In this perfect portrait, the limits of painting/ Are clearly evident to our eyes today/ Because we see only the representation of the body/ Not the mind that is admired as a masterpiece of creation.)

As far as we know, the book, which appeared in Paris in 1609, was the first published work by any midwife. Bourgeois authored two more volumes of Observations, in 1617 and 1626, and in 1635 also published a collection of cures she had used throughout her working life. The Observations were immensely successful, being reprinted regularly in France for some 50 years, and translated into German and Dutch. Extracts were lifted and put into English in the very popular anonymous compilation entitled The Compleat Midwifes Practice (first edition, 1656). When the French-American artist and sculptress also named Louise Bourgeois (1911-2010) discovered her namesake, it inspired her to produce several colour plates.

Apart from their place of honour in the Library’s collection as the earliest printed work by a midwife, the Observations give fascinating insights into an early modern midwife’s thoughts and practices. Bourgeois reckoned that in the course of her career she attended over 2,000 deliveries in and around Paris, and her approach – as the title suggests – draws on her personal experience, often using case histories as the means to understand more general principles of diagnosis and treatment. I have selected a few short extracts from the second chapter of the 1609 volume, on the subject of miscarriages and premature births, to show how Bourgeois’ approach is refreshingly personal. The translations into English are mine, and I’ve tried to convey something of Bourgeois’ individual style, suited to a reflective work published in the vernacular rather than a learned medical tome in Latin.

In this first extract, she is very interested in the association between a pregnant woman’s emotional state and her physical wellbeing. In particular, she proposes (echoing many doctors, and the celebrated surgeon Ambroise Paré, 1509-1590) a close correlation between anger and miscarriage. She believes anger disturbs the humoral system of the body, affecting the blood and interrupting the foetus’s development. Because she is writing primarily for student midwives or a readership without medical training, she often draws comparisons with natural or commonplace objects to make her accounts clear and vivid, as here where the products of the miscarriage are ‘formed like a duck’s egg’:

‘The most frequent reason for a woman to give birth [prematurely] is anger, which sometimes occurs while the child is being formed … So I saw a woman who believed she was pregnant and carried her burden for four and a half months, whereupon she suffered pains and delivered a dense membrane, thicker at one end than the other, formed like a duck’s egg, and containing reddish water and many white strands, with three swellings like small grains of crystal, the one higher up being larger than the other two, which were of different sizes. I therefore asked the woman whether, when she thought she might have become pregnant, she has perhaps experienced fear or anger. She told me that she had been extremely angry and troubled just after she had missed her period and had already experienced some changes, such as trembling and nausea. From this I judged that her anger had occurred at this time, according to what Paré notes in his Book on Generation, where he speaks of the three swellings that become the heart, liver and brain.’

The title page of the 1609 text gives a full account of the volume’s subject matter, as well as emphasising that Bourgeois combines theoretical insights and impressive practical experience. English translation of the title page: Diverse Observations on Infertility, Miscarriage, Fertility, Childbirth and Illnesses of Women and of Newborn Infants. Fully discussed and successfully practised by Louise Bourgeois, also called Boursier, midwife to the Queen. A work useful and necessary for everyone. Dedicated to the Queen. Paris, printed by A. Saugrain, rue St Jacques at the sign of the Silver Ship, in front of St Benoît. 1609. With the King’s privilege.

The title page of the 1609 text gives a full account of the volume’s subject matter, as well as emphasising that Bourgeois combines theoretical insights and impressive practical experience.
English translation of the title page:
Diverse Observations on Infertility, Miscarriage, Fertility, Childbirth and Illnesses of Women and of Newborn Infants. Fully discussed and successfully practised by Louise Bourgeois, also called Boursier, midwife to the Queen. A work useful and necessary for everyone. Dedicated to the Queen.
Paris, printed by A. Saugrain, rue St Jacques at the sign of the Silver Ship, in front of St Benoît. 1609.
With the King’s privilege.

In another extract from the same chapter, where she is examining the causes of miscarriage, she relies on her own extensive experience to evaluate the significance of nature versus nurture. Her conclusion that countrywomen’s daily activities prepare the body for pregnancy and birth is similar to much modern thinking: see the RCOG’s statement number 4, January 2006 on ‘Exercise in Pregnancy’:

‘I used to be astonished to see that right up to the day of giving birth, sometimes to twins, countrywomen would lift bundles of hay and carry them on their head, without miscarrying. But when I pondered on the reason why, I realised they have been used to this activity since they were young. So since childhood their ligaments have been stretched when their wombs were empty, and they had become strong through their work. If other countrywomen, who had grown up as children in the town before returning to live in the country, tried to work in the same way, I observed that they soon miscarried, which leads me to conclude that nurture is more important than nature in this regard.’

For those interested in finding out more, I warmly recommend Wendy Perkins’s study: Midwifery and Medicine in Early Modern France: Louise Bourgeois (Exeter: 1996). And an annotated translation into modern English of all three volumes of the Diverse Observations (edited by Alison Klairmont-Lingo and translated by Stephanie O’Hara) is due to be published in 2016 by Iter Inc. & Centre for Reformation and Renaissance Studies, University of Toronto.

Celebrating 500 years of Pregnancy and Birth

Since April this year the library and archives of the Royal College of Obstetricians and Gynaecologists has been involved in a Knowledge Exchange Partnership with The Oxford Research Centre in the Humanities and the De Partu History of Childbirth Group.

The partnership mines the college’s rich collection of over 2000 books and extensive archive material dating from the 15th century to today and utilises the expertise of a wide range of healthcare professionals and academics. The Partnership aims to widen awareness of the heritage collections at RCOG and those of the Royal College of Midwives; to facilitate dialogue between academic researchers and healthcare practitioners on the history of pregnancy and birth; and to provide a forum for debates on current issues in their historical context.

DSC_0016Guiding out a Breech (1690) from JustineSiegemund’s Die Chur-Brandenburgische Hof-WeheMutter (The Brandenburg Court Midwife)

From the birth experiences of royalty to those of the regular public, guidance on diet and exercise during pregnancy, and the medicalization of delivery, the science and experience of pregnancy and childbirth provides ample opportunity for discussion and exploration. On 4th September these debates and controversies were the subject of a study day and exhibition hosted by the College. The central theme of the day was a look at the past 500 years of innovation in the science and experience of pregnancy and childbirth. Topics covered included material comforts in the birthing room, favoured delivery positions, premature births, breastfeeding, and who used to be present at a birth. The study day was attended by researchers into midwifery, obstetrics and childbirth, qualified and student midwives, and other keen supporters of innovation and research into pregnancy and birth.

Domiciliary midwife at a birthing class

Domiciliary midwife’s class for pregnant mothers (c.1950-1960) from the Royal College of Midwives archive (ref. RCM/PH7/2/2)

The study day and its accompanying exhibition were devised and led by Professor Valerie Worth-Stylianou, Senior Tutor at Trinity College, University of Oxford and Mellon-TORCH Knowledge Exchange Fellow, and Dr Janette Allotey, Chair of De Partu, Honorary Lecturer at the School of Nursing, Midwifery and Social Work at the University of Manchester.

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Professor Valerie Worth (left) and Dr Janette Allotey during the opening talk on debates over delivery positions.

The day opened with welcome addresses by Ian Wylie, CEO of the Royal College of Obstetricians and Gynaecologists, and Louise Silverton, Director of Midwifery at the Royal College of Midwives on the history and role of both colleges in the past 500 years of research and advocacy for women, mothers and children. Professor Worth-Stylianou and Dr Allotey then led a discussion on positions for delivery. Professor Worth shone a light on the midwifery practices of 16th and 17th century Parisians, which included a fascinating account by Louise Bourgeois, scholar and midwife to the French royal family during the reign of King Henry IV and his wife Marie de Medici. Dr Allotey contrasted this historical perspective with a look at modern practices in birth positions and the autonomy of mothers in changing position and moving around during labour.

This was followed by a Keynote talk by David Hutchon, Fellow of the Royal College of Obstetricians and Gynaecologists, on the history and practice of cord-clamping across cultures, from the works of Charles White and Erasmus Darwin in the 18th and 19th centuries to modern ethical debates surrounding the use of the placenta and umbilical cord in adult stem cell research.

There were two workshops in the afternoon, one led by Dr Julia Allison, from the University of Nottingham, on maternal comforts in the birthing room in early modern England. This workshop used Parish archival records and Dr Allison’s own artwork to give us a glimpse in the birthing chambers of Elizabethan Britain. The second workshop was delivered by Professor Billie Hunter of the University of Cardiff on the maternal comforts of 20th century birthing rooms, which showcased oral histories recording women’s experiences with childbirth, midwifery services and maternity services before the establishment of the National Health Service in 1948.

The day concluded with a chance to visit a poster display commissioned for the event in the corridor of the College’s Education Centre. The twelve posters capture key moments in development of obstetric and gynaecological practice taken from the College Library’s early printed books and from its archives. The posters are grouped to contrast the differences and similarities between historic and modern approaches to pregnancy and birth. A free accompanying guidebook is available beside the display.

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In addition to the poster display there is currently a small exhibition of archive and library material in the College Library including the works of William Smellie and editions of early midwifery textbooks.

The study day was a huge success and discussion on personal and professional experiences of pregnancy and birth continued well into the afternoon. The College would like to thank Professor Worth and Dr Allotey for devising and organising the event, the De Partu History of Childbirth Group for supporting the project, and The Oxford Research Centre in the Humanities for funding the seminar and display.

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The poster display accompanying the seminar will be up in the corridor leading from the museum display to the education centre at the Royal College of Obstetrics and Gynaecology until Christmas 2015

De Partu History of Childbirth Research Group

The Oxford Research Centre in the Humanities (TORCH)

Work Experience in the RCOG Archive!

This week’s post comes from Genevieve, a 6th form student, who spent a week working with the RCOG heritage collection. Below she summarises her experience, the unexpected aspects of her placement, and her recommendations to fellow 6th formers working on their Extended Project Qualification.

I never really knew what to expect when doing work experience here as the college is not well known of people around my age (17 years old). As I am currently working on my EPQ (Extended Project Qualification) and as my question is ‘Have changes in research and technology affect childbirth for the better?’ I soon realised that this was the best place to be to for my research.

For my work experience I was based in the Archive department which was a little daunting as I would be handling heritage items and didn’t want to ruin anything I came into contact with. However when I started, my manager put all my worries to ease; as she slowly introduced me into everything I had to do.

My first task was to use the cataloguing system to find any documents that would be of interest to me and benefit my EPQ. This was a great way to ease myself in as the cataloguing system works just like Google; in the fact that I can type in a key word and any documents containing any information on that will come up. I would then be able to get a description of the document and it reference number so that I would be able to retrieve it if I wanted to. After about twenty minutes of this I had a fairly substantial list, I was then able to go to the special items archive.

This was exciting as to get there I had to descend down a narrow winding staircase which felt like something out of Hogwarts. I was then presented with 10 bookshelves in a constant air conditioned room which contained everything from Obstetrics and Gynaecology Journals from decades back, photographs and original letters from key persons in the development and changes of Obstetrics. I then spent my time looking at all the resources I had chosen and picked out the ones I wanted to reference.

One of the most enjoyable tasks I was given was to go through a box of forceps that had been donated to the college and identify what type of forceps they were. To do this I had to go through museum photographs and compare the forceps I had to the pictures. If they did match the photo I would then write down their reference number and find the forceps in the archives as well as then comparing them by size and any identifiable features. I thought this would be very easy, I WAS WRONG. With my first set of forceps I very quickly identified them and labelled them straight away. However when I had them checked I realised that even if the forceps look the same they are completely different even if it is just done to the size of the screw or the curve of the handle, but this helped me to understand that attention to detail really does matter furthermore by realising this I started noticing all the differences in each set of forceps thus making my archiving more accurate.

Meeting people from different departments in the college was a great experience as they were all able to show me all the different things the college is involved with. I was introduce to a Senior Research Fellow who showed me how the College works with the National Institution for Health and Care Excellence (also known as NICE). The college helps NICE develop guidelines which are used to create quality standards across the country. I also met staff from the Clinical Quality team who shared their wisdom with me on medical school and applying, also tips for medical school interviews. These were very beneficial as in September I will begin applying for universities and if successful I will have to undergo the interview process to be accepted.

The next person I met was engaged in the development and international work of the RCOG; her job is to help develop new projects internationally. Some of these projects such as the ‘every baby counts’ project which entails taking the statistics about the amount of stillbirths, neonatal deaths and brain injuries that occur during labour and bringing these results together to understand the bigger picture also to share the lessons learned.

Overall work experience here was not what I expected as in usual scenarios I would be making tea or filing whereas here I had a hands on experience of what a normal day is like and the privilege of being trusted to work with original documents. I would say that this has been the best work experience I have ever had and recommend it to everyone even if you are not interested in Obstetrics or Gynaecology; learning about the different roles in an establishment and how they all work together to help members and fellows.

This week has been extremely beneficial for my EPQ as working with archives has given me an unlimited amount of information. By having good quality documents it made me realise that my topic for my EPQ was too broad; having the archives helped me realise something so simple that I had been trying to figure out since December. Also by having the archives I had so much information at my finger tips that I didn’t have to use the same source over and over again or the internet as I was never limited in the information I received and it all came from a reliable source.

For any sixth formers doing research in any topic I would suggest that you try and get in contact with the British Library or any college that you think will have information of what you’re researching; they will always have something to offer you and even if they don’t (which is unlikely) there was no harm in asking. Also try and find somewhere that has archives so that your research has some depth and so not all of it will be new unproven work. I suggest you push yourself out of your comfort zone and don’t just rely on the internet because you cannot always trust what you see online.

Genevieve at work in the RCOG Archive

Genevieve Mahbeer

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