This month, Pioneers profiles the life and work of RCOG Fellow Margaret Mary Basden. Basden was a leading obstetric and gynaecological specialist, treating women around London, including in its poorest boroughs in the early 20th century. One of her greatest contributions to maternal health and wellbeing involved getting mothers up and out of bed during the Second World War. Her advocacy for the health benefits of ambulation after birth changed the landscape of postnatal care in Britain forever.
Basden was born in Nottingham on 3rd April 1886. During her childhood, her family moved to Hampstead where she attended King Alfred’s School. She chose to study medicine after being told the story of a medical ancestor of hers who had attended King George III.
Like many female medical students at the time, Margaret went on to study at the London School of Medicine for Women. During her studies, the Royal College of Surgeons opened up its examinations to women for the first time and she leapt at the chance to take it. She succeeded and later became a Fellow of the RCS in 1919. She was also an early Fellow of the British [later Royal] College of Obstetricians and Gynaecologists in 1931, having taken up obstetrics and gynaecology following her appointment as a resident accoucheur at the London Hospital.
She later became consultant gynaecological surgeon to the Bethnal Green and Mildmay Hospitals, obstetric surgeon to the Mothers’ Hospital in Clapton, and then surgeon to the South London Hospital for Women and Children.
Margaret continued to work at the Mothers’ Hospital during the Second World War, whilst many other London hospitals were closed and their patients evacuated to outside the city. The Mothers’ Hospital remained open partly due to its onsite air raid shelter, which was capable of accommodating all of its patients. Margaret was a resident at the hospital and its only obstetrician.
With the frequency of air raids and air raid warnings increasing throughout the Blitz, Basden decided her pregnant and nursing patients would be less anxious if they were allowed to leave their beds. This was a revolutionary idea at the time; the practice before then was for women who had given birth to be confined to bed for several days.
At dusk, each day, with their coats, gas masks, blankets and babies in hand, the patients would file into the shelter, led by Margaret and the rest of the hospital’s staff. Some would be wheeled in on chairs or stretchers. Once in the shelters, patients and staff would sit or sleep side-by-side with their babies tucked into special shelves above their heads. Only women in labour would remain inside the hospital building, protected by a specially reinforced labour room.
Not only did this boost patient morale, creating a ‘carefree and happy’ mood of camaraderie among patients, but it had noticeable medical benefits. Women who walked around for short periods in the days after birth reported feeling physically stronger when they were discharged from hospital. Margaret observed less maternal morbidity, better reduction of the uterus to its regular size and far fewer incidences of venous thrombosis.
In October 1940, Margaret Basden wrote an article for the British Medical Journal about her experiences.
“It was felt that the patients would feel-happier and less nervous if they were not completely bedridden but knew they could get up and be independent in case of emergency, and we therefore decided from the beginning to allow them to get out of bed for a few minutes the day the baby was born and thereafter to do a little more each day.
Abdominal operation cases, including Caesarean section, were allowed up on the fifth day, and I have no doubt this played an important part in creating the carefree and happy atmosphere which prevailed.
The other results of the treatment were very interesting. There was less morbidity, better involution, and considerably less venous thrombosis. The patients seemed far better and stronger on their discharge-an important consideration in these times of stress-and the ward sisters, who always tend to be conservative in their outlook, were enthusiastic about the good results.
When, therefore, the shelter was completed we had no hesitation in arranging to allow most of the patients to walk to it.”
After her retirement, Margaret went to Uganda for a time to serve on the staff of the Mengo Hospital in Kampala in 1951. She continued to be an imposing figure in her social circle and was remembered for her compassion, kindness and great anecdotes. One of her main pastimes was reading aloud to the blind. She died on 8th September 1974, aged 88.