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62
The Conclusions and Recommendations of the Departmental
Committee's Report are comprehensive and relate, of course, to the
country as a whole. The conclusions fall into two categories, (1)
Clinical and (II) Administrative, and important among the Recommendations
are the two following statements:—
"Every pregnant woman should have a routine medical
examination by a doctor during the early months of pregnancy.
More hospital accommodation should be provided for the treatment
of cases of heart disease, tuberculosis and nephritis associated
with pregnancy. Where it appears that further child-birth
will endanger life, medical advice should be given as to the prevention
of pregnancy. More vigorous efforts should be made to
apply effectively and widely the new knowledge now available
for the prevention of rickets,"and,
"The Committee desire to see confidential inquiries into the
circumstances of maternal deaths continued by the Public Health
Authorities, but deprecate the institution of a system of inquiry
by a Coroner into every maternal death as a matter of routine."
It is interesting to note that the Committee state that they are
"convinced that the primary essential for the reduction of a high
maternal mortality is sound midwifery, before, during and after
child-birth,"and that "this does not chiefly depend upon administrative
arrangements or the expenditure of public money."The
Report also states:—
"False hopes would be raised if it were suggested that all
maternal deaths are preventable. Changes in social life necessary
to raise the standard of health and physical development
of the women of the nation can come only with time; great
advances in medical knowledge must be made before many of
the risks of child-birth can be eliminated; even then the factor
of human fallibility will remain. Nevertheless, we are confirmed
in the opinion expressed in our Interim Report that at least half
the deaths which have come under review could have been prevented
had due forethought been exercised by the expectant
mother and her attendant, a reasonable degree of skill been
brought to bear upon the management of the case, and adequate
facilities for treatment been provided and utilised."