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From these figures it is apparent that only slightly more than 10 per cent. of
mothers can be said to have adequate ante-natal care, whilst in 28.2 per cent. of such
cases ante-natal care is totally inadequate
It is known that in some parts of London mothers who present themselves for
ante-natal care for the first time during the second trimester of pregnancy are already
too late for a hospital booking. It is clear that hospital maternity units should reserve
a number of beds for late bookings for the high risk categories and the medical
officer of health could provide hospital authorities with an estimate of the number of
beds required. Attempts are made by the staff at the Council's ante-natal clinics to
book hospital beds for women whose homes are unsuitable for confinement, but when
it becomes apparent that a booking is unlikely to be obtained in advance—usually after
10-20 hospitals have been tried—the patient is referred to her family doctor with a
letter requesting him to arrange admission through the Emergency Bed Service when
labour starts. If the family doctor does not agree to this proposal, arrangements are made
for a domiciliary midwife to take necessary action.
This procedure, which has been adopted through necessity, can only be regarded as an
unsatisfactory improvisation. The patient is left in a state of anxiety and uncertainty
and trouble often arises with landlords; delay in admission to hospital is inevitable as
the patient must be visited by the doctor or midwife before the Emergency Bed Service
will act, and these visits are an unnecessary burden on the doctor or midwife. A fee is
also payable to the doctor which better arrangements would avoid.
As has been indicated earlier, it is hoped that the Cranbrook Committee will give
firm advice on the present unsatisfactory situation in which some patients in real need
of hospital confinement are unable to gain admission, yet beds are occupied by those
who have not the same claim. In the meantime, the matter rests in the hands of the
hospital obstetricians who are in the position to decide to what degree preference for a
hospital confinement shall be subordinated to need.
Although the home help service is available to meet the needs that arise at the time
of confinement or when the mother is resting at home or is admitted to hospital antenatally,
the calls on the service are not as great as might be expected. In many cases the
father will take time off from work but in others it is not known whether the small
calls on the service are due to the fact that a charge is made or to the mother's preference
to make other arrangements for the care of her home and family.
Assistance in
the home
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