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subsequent confinements. The knowledge that such suffering
frequently follows childbirth is bound to add materially to
the natural anxiety with which most women regard an
approaching confinement. It should be the aim of those
responsible for maternity and child welfare services to relieve
the prospective mother of unnecessary anxiety and to reduce
the risk incurred.
Various suggestions for the prevention and remedy of the
present high rate of maternal mortality are set out in the
Report mentioned above, many of which are already in
operation, though often only in partial degree. Special
reference may be made to the following matters :—
Ante-natal supervision.—The most important desideratum
of a maternity scheme is to secure the adequate professional
care of the expectant mother, but this cannot be done unless
(a) medical practitioners and midwives are willing to undertake
thie duty as an essential part of the treatment of every
midwifery case which they are engaged to attend, and (b)
every mother is willing to accept and follow the guidance of
her professional attendant. Ante-natal supervision is
required primarily to detect and provide timely treatment
for abnormal conditions, but it has an almost equally
important function, namely, the education of the expectant
mother in the care of her own health and in the proper
management of her baby when it is born.
Ante-natal supervision may be given partly through the
doctor or midwife engaged by the patient but also by means
of Maternity Centres established by the Local Authority. The
number of such centres has gradually increased and there
are now in this country some 560 ante-natal centres organised
either independently or in connection with an infant welfare
centre or maternity hospital. But there is a need for many
more such centres if every expectant mother is to have opportunities
for advice. The functions of a Maternity Centre
provided by a Local Authority under the Maternity and
Child Welfare Act, 1918, are limited. It is not set up to
provide advice and treatment for all diseases of women. The
staff of such a Centre are concerned only with the expectant
mother and the mother who has been confined recently and
requires post-natal advice. They should offer advice as to the
hygiene of pregnancy and as to the remedy of the various
minor ailments which may arise during this period; they
should ascertain the condition and probable course of the
pregnancy and whenever necessary refer necessitous patients
for specialist advice and treatment. As regard other gynaecological
ailments not directly associated with the pregnancy,
the woman should be advised where to go, whom to consult,
and how best she may obtain such special treatment as may
be needed.