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142
Midwife, several private midwives, the Salvation Army midwives
and the midwives and medical students of the London Hospital.
For confinement in hospital, there is Bethnal Green Hospital
in the Borough, London Hospital and two Maternity
Hospitals in Stepney, the Mothers' Hospital in Hackney and the
City of London Maternity Hospital in Finsbury, not to mention
others farther away. For cases of Puerperal Fever, prompt
removal to and treatment in the London County Council Special
Hospitals is available.
The standard of midwifery, both in hospital and at home,
has risen. Largely as a result of representations by one of my
predecessors, the London Hospital now send a trained nurse
with their medical students to attend confinements. Hospital
ante-natal clinics have also improved in efficiency, although
much still remains to be done to secure adequate attendance at
them. The Borough Council has a wide range of services (antenatal
clinics, midwife, obstetric consultants, maternity outfits,
home helps, dental treatment, convalescent homes), which are
well used, but as pointed out in my report, they are capable of
considerable extension, especially in the direction of making
them more accessible to expectant mothers.
In spite of the vital importance of adequate ante-natal
supervision, there is an unfortunate lack of precise knowledge
of how much is actually being provided and by whom, so that
while some mothers may be attending a clinic early in pregnancy
and regularly, others may be attending very irregularly or not
at all. I am, therefore, of opinion that there should be closer
co-ordination between the Borough Council's maternity services
and the various agencies providing midwifery.
Tentative proposals with this object were made to some of
the maternity hospitals a few years ago, but they were not then
accepted. It is worth considering whether a further effort
should be made. If we find from our experience that even a
journey of a quarter-of-a-mile deters a mother from attending
a clinic, how much more is this likely to happen when the clinic
is a mile of so away, as is the case with most of the hospitals.
Stress has been laid upon the desirability of the mother receiving
ante-natal supervision from the doctor who is to undertake her
confinement, but in point of fact this rarely happens and in the
case of such large institutions as the London Hospital is virtually
impossible. There would therefore appear to be no reason
why in many cases mothers should not receive ante-natal supervision
at the local Borough Council clinic and the results of the
examination communicated to the midwifery institution concerned.
This would in fact save the mothers many unnecessary journeys
because at present they have to attend the hospital for ante-natal
examination and then make application at the Welfare Centre
for any assistance they may require in the way of maternity