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charge of the cases, and the medical staff undertake the treatment of those
requiring operative measures. Several operations of major degree, such
as Cesarean sections, have been performed most successfully. There are
also wards for patients suffering from septic conditions of the puerperium.
Those cases should be handled at home as little as possible. If the case
happens to be one of accident to an early pregnancy there is always
present the risk of sepsis, which sometimes proves fatal. Thorough
treatment is immediately necessary to prevent this risk, and the patient
should be removed to hospital at once.
A further remark about the facilities at St. Stephen's Hospital might
be made. Women may be admitted many days before labour has begun—
in some instances weeks before. This is possible because of the ample
accommodation which the Guardians have provided, and is of immeasurable
benefit to patients when there are organic complications present.
A period of rest before labour lessens the strain of the confinement.
Patients are also kept in the hospital for two or three weeks
afterwards. Most women appreciate this extension of the usual puerperium,
which should certainly diminish any tendencies to subsequent
complications. The following table shows the number of confinements in
Westminster institutions:—
Table VI.
Charing Cross Hospital: 226, of which 63 were Westminster cases.
St. George's Hospital: 260, of which 76 were Westminster cases.
Westminster Hospital: 123, of which 61 were Westminster cases.
St. Stephen's Hospital: 122. Sheffield St. Hospital: 28.
In order to link up the ante-natal work of the centres with the
maternity service provided in hospitals the Council in 1924 entered into an
agreement with St. George's Hospital for the reception of maternity
cases recommended by the Medical Officer of the Ante-natal Clinic : cases
in emergency may also be admitted at the request of the Council's midwife.
This arrangement is in operation for the area in which the Council are
responsible for maternity and child welfare. A grant is payable by the
Council to the hospital for each case admitted on recommendation, and
the number treated in 1925 was ten, and in 1924 ten.
Puerperal Fever and Mortality in Childbirth.—Six cases occurred with
one death. The results of inquiries showed that in one instance fatal
sepsis followed an abortion. Two other patients died who were normally
resident out of the City: they had made inadequate arrangements for
confinement.
Infancy and Early Childhood.—At the four centres in the City 7 weekly
clinics are held for the purpose of giving medical advice. The health