When a career reaches full term

McEwan and her colleagues have often been in the vanguard of that revolution, exploring new advances and helping to steer the whole issue of women's well-being out of the wings and on to the centre podium of national debate. Sex education, pregnancy, cancer screening, menopause, osteoporosis - all these subjects are now high on medical and political agendas not just in Europe and America but wherever there is a realisation that women's health is not only pivotal to good family life but to the fabric of entire communities as well.

Yet despite the gains, Scottish statistics remain familiarly depressing and part of the reason why the overall Scottish death rate of 11.8 per 1000 people is almost on a par with those of Romania and Russia.

Women's mortality from lung cancer is higher here than anywhere else; the rate of heart disease is one of the worst in Europe; and the incidence of breast and ovarian cancer exceeds those of other small Western countries. So, on the eve of retirement, does McEwan feel her countrywomen are in any better shape than when she qualified in the 1960s? ''Oh yes,'' she says, the voice carrying the fluting emphasis of a Miss Jean Brodie by way of Jordanhill.

''When I began, the perinatal loss in Glasgow was 30 per 1000 live births and that was fairly representative of Scotland. Today the perinatal loss is around 10 per 1000, a very dramatic decrease.'' Birth control and the desire for smaller families are important factors but McEwan believes that, despite the persistence of endemic problems, women's nutrition has greatly improved. Medicine, of course, always needs the challenge of difficult territory and it is no coincidence that Scotland's actual medical reputation is second to none. In terms of doctor-patient ratios this is still the best place to be ill in the United Kingdom.

McEwan's own career has been devoted almost entirely to Glasgow but she is also widely known for distinguished contributions to research and teaching at Glasgow University Medical School. As a student herself she was one of only 30 females in a class of 180, and in her early career she learned from some of the most taxing and influential medics of the day, Charles Illingworth, Ian Donald, Hector MacLennan, and Malcolm (Calum) Macnaughton among them.

To many patients and trainees alike, Donald, an unyielding anti-abortionist, often seemed intimidating but McEwan remembers him differently. ''He was a very educated man, the world pioneer of ultrasound, although few remember that. And in a gynaecological clinic he would spend hours talking to patients about their emotional and sexual problems. In those days nobody else was doing that. When I was his senior house officer he'd occasionally say of a patient: 'Helen, she's suffering from HHG.' That was his code for Hates Husband's Guts syndrome.''

The epitome of the consultant as God was MacLennan with his meticulous dress sense. ''Hector's shirts were made with detachable sleeves so that when he examined a patient he simply unbuttoned the sleeves at the elbow. That way he avoided disturbing his gold cufflinks. He was quite an actor, really.'' However, she recalls that it was Macnaughton who really revolutionised attitudes towards family planning and later he also proved immensely supportive when she floated the idea of a menopause clinic at the Royal.

At Stobhill Hospital, David Hart had already established the first such clinic in Scotland, with the emphasis on osteoporosis, and there were two others in Birmingham and Oxford. But the aim of McEwan's team was to treat menopausal symptoms holistically, an approach rarely considered at a time when the very word ''menopause'' was still taboo. ''In fact, we used to get letters from women in Edinburgh wishing to come to our clinic because there wasn't one there. The powers that be, it seemed, didn't regard the menopause as a gynaecological subject.''

For many patients, hormone replacement therapy has changed the menopause from an inescapable dread to a quality-of-life issue. But McEwan never fails to remind women that HRT is not a youth elixir. ''It's not suitable for every woman, although in helping to prevent osteoporosis, coronaries, and maybe Alzheimer's disease, well, you must weigh those benefits against the slightly increased risk of breast cancer.'' Now 25 years old, that menopause clinic earns a proud place in McEwan's catalogue of achievements.

Also up there is The Herald Foundation Clinic for Women, established at the Royal in 1995 as the result of this paper's campaign and readers' generosity, to provide a centre of excellence for the latest one-stop treatment of menstrual and related disorders. But topping the list, of course, is Rottenrow's long-delayed replacement, the Princess Royal Maternity Hospital, now nearing full term on Alexandra Parade and to be opened officially next spring.

''I've spent most of my consultant life waiting for this moment and today my only regret is that I will not be playing an active part in the hospital. But I'm in no doubt that it will be one of the leading obstetric units in Britain.'' McEwan reflects that when Calum Macnaughton came to Glasgow as professor of obstetrics and gynaecology in 1970 he was promised a new hospital in a few years. ''Well, this is it,'' she says, ''so it's been quite a difficult confinement.''

McEwan was born in Glasgow, where her father, John McEwan, was well known as ''a real pharmacist who could make things''. In addition to dealing with prescriptions at his shop on Dumbarton Road, he would concoct beauty products like leg-tan lotion and vanishing cream. ''He was something of an entrepreneur but perhaps not as good a businessman as he thought and, indeed, he lost quite a bit of money. But when he died my mother, who had been a legal secretary, continued running the business.''

McEwan has never married and when you ask if she feels her unstinting commitment to medicine precluded having a family of her own, she answers unhesitatingly: ''If you are wanting to get to the top then you have to be prepared to sacrifice something.

''You never regard your social life as a primary life because your patients always come first. Most nights at home you open your briefcase and then get down to the paperwork, so one way or another you spend your life immersed in medicine.'' A past president of Glasgow Obstetrical Society and past chairman of the Scottish Executive of the Royal College of Obstetricians and Gynaecologists, McEwan was the first woman president of Glasgow's Royal Medical Chirurgical Society, and has also been on the advisory board of Women's Health Concern in London.

But in among these distinctions there is a newer experience. For the past couple of years she has spent some of her annual leave travelling to Guyana and living among the Amerindians in a village called Rupununi, where ''smothered in insect repellent'' she joins the locals on fishing and hunting expeditions.

''Then, slung in a hammock under a grass roof, enjoying some rum - really the only thing to drink - well, there's nothing like it. But just observing the simplicity of the life there is tremendously rewarding, and when I come home I'm appalled by the amount of consumer goods we think we need.'' Yet back on her own turf how does she feel she is perceived? ''Occasionally, I suspect some think I'm a bit of a tyrant, and it's true that I do expect people to work hard. But I've been supported by a wonderful team and on the whole I think folk regard me as OK.

''People are kind enough to say: 'You'll be terribly missed.' But I don't know. No-one is indispensable and you simply can't go on forever. And the really important thing now is that we have another beginning for Rottenrow.'' Above all, though, McEwan regards the practice of medicine as an honour. ''It's a great privilege to be present at a birth, something absolutely wonderful no matter how many times you've been there before.''

And now, as she looks towards the winged roof of the steel-grey structure which is growing week by week to become the new maternity hospital, Helen McEwan does so with a clinician's eye. The delivery, she calculates, will be about eight weeks later than planned. Still, what's eight weeks when this particular baby is already more than 20 years overdue?