By the middle of the 1800's, middle and upper class women ( who could afford it), including Queen Victoria of England, were seeking relief from the pain of childbirth. They began to request anaesthetics, which were already being used in surgery, such as for amputations.
At about this time, the medical branch of anaesthesiology began to grow as a speciality, but for many more years doctors and nurses administered their own anaesthetics.
The dangers accompanying the use of these anaesthetics meant that women requesting them had to be hospitalized for childbirth, thus undermining the midwives and home birthing system, though home births were the norm until at least the 1930's except when complications were suspected. Still, unless hospitalization was recommended. doctors would sometimes accompany midwives or specially trained nurses to the patients home.
During the final two years of Robert's medical studies at Queen's (1904-1908), the last hours of the day were devoted to obstetrics, gynaecology and paediatrics. Throughout his medical career, he was always happiest when delivering healthy babies, usually in the mother's home. Midwifery was still considered very important in the early 1900's, and medical students were encouraged to learn from and support midwives, though the midwives themselves were not invited into the hospitals. Robert would have carried a small bottle of an anaesthetic, probably chloroform, in his bag, along with forceps, hoping that he would not have to use either.
Some important information about cleanliness regarding infant and maternal mortality: In 1837, a Hungarian physician cut the death rate in his maternity clinic by over 50% by insisting that the doctors, midwives, surgical assistants and nurses wash their hands in a solution of sodium chloride before treating their patients. In 1857, on her return from the Crimea, Florence Nightingale insisted on hospital cleanliness, cutting the death rate in the general wards by half.
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