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43
Two of the mothers in these cases had attended the Borough
Council's Pre-maternity Clinic.
Among the volunteered suggestions made by the general practitioners
were the following:—
(a) "The commonest cause of still-birth is difficult labour, including
mat-presentation, which should be preventable by ante-natal
measurements, though contraction is extraordinarily difficult
to detect."
(b) "It should be a condition of the employment of midwives that,
in all cases attended by them alone, the mother should be seen
by a medical practitioner, or the medical officer of an institution,
at least once, not less than a month prior to the term.
This practice might perhaps afford greater security than exists
at present against abnormalities remaining undetected untit
too late to be dealt with by the most satisfactory methods."
(c) "Ante-natal care and, if possible, anticipating difficult labour
and acting accordingly."
and
(d) "Treatment of specific disease prior to labour."
From a midwife came a suggestion that in any midwife's case
attending the Pre maternity Clinic, it should be a rule that the doctor
in charge should communicate the information direct to the midwife
and not to the patient. In regard to this suggestion, the Committee
were of opinion that it would be far better for the midwife to attend
with her patient and hear what the doctor at the Clinic had to say.
During the Committee's consideration of still-births, it was much
commented upon that such a large number of the still-births were due
to mal-presentation, difficult labour, contracted pelvis, all of which
mean much the same thing, and the Committee were of the opinion
that the cause of the still-births, as revealed by the list, emphasizes
the importance of examining the mothers prior to labour.
They were also of opinion that it would be of considerable help if
skilled obstetrical help was available for any practitioners attending
cases of grave difficulty.