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violent, such as accidents and drug taking. On the other hand,
death of the infant during or shortly after uterine life may be due
to causes in the foetus as distinct from the mother, such as inherited
weakness or disease of unknown cause.
"The next question is, can this wastage of life be prevented or
reduced? Reduced it certainly can be, but there will always be a
certain amount beyond the reach of medical skill. As the question
is a very large one I can only indicate the lines on which it has been
recommended, that sanitary authorities might do much good. As
we have seen that the greatest amount of wastage is ante-natal and
natal, the remedy which immediately suggests itself is to endeavour
to get all mothers under some sort of medical supervision during this
period; but this can only be done by teaching women the great
importance of proper advice during pregnancy. The medical
officer of the Local Government Board does not think anything is
to be gained by compulsory notification of pregnancy, and most
people will agree with him, but the prospective mother should know
where she can go to for sound advice, and it is here, in my opinion,
that judicious and tactful advice from health visitors will accomplish
much good. If the district which a health visitor supervises is not
too large she soon gets to know the prospective mothers, for if she
is known to be tactful and sympathetic she will never have to force
her advice on the young married woman, but it will be eagerly
sought by them, and they will make her a confident of their various
troubles and difficulties. If the case seems to demand it the health
visitor would advise her to consult her medical attendant or, failing
this, to seek advice at a maternity centre or ante-natal clinic. Such
a centre may be established by the sanitary authority in districts
where special hospitals do not exist, or if in a city like London,
similar use should be made of the many excellently equipped general
or special hospitals for women. In this way only will it be possible
to deal with this problem in its first stage. If this succeeds the rest
follows easily, for once the women of the district have gained confidence
in her advice they will engage proper help during labour, and
when the child is born will naturally turn to the same source when
the many difficulties connected with rearing which beset the young