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nal death and injury will not be made. It is the key to success in
any scheme of prevention, and it must be insisted upon in and out of
season until it is no longer ignored or looked upon as a luxury for the
well-to-do woman, but is recognised as a necessary and integral part
of the management of every confinement case.
The special value of ante-natal care, as far as puerperal
sepsis is concerned, is to reduce the number of difficult labours, which
always involve manipulation, and especially emergency operations.
These render patients particularly liable to sepsis, partly from
opportunity of infection, and also from damage to the tissues.
Ante-natal examination also affords an opportunity for treating
before the confinement septic infections from which the woman may
suffer. It is disappointing to find how few patients, even primiparae,
are examined before labour in the course of ordinary practice.
The Council does not possess a maternity home. Some
years ago the Council had an agreement with the authorities in
charge of the Salvation Army lying-in-hospital in Clapton. The
hospital is an excellent one and was very popular with the mothers
who were confined there. Its popularity though, interfered with
its utility, as far as Acton was concerned, on account of the big
waiting list.
Admission of Acton women became almost an impossibility
and the agreement was terminated, or rather, it lapsed because
no mothers were admitted.
The Guardians established a private ward for confinement
cases at Warkworth House, and a charge of two guineas a week was
was made for cases admitted into these wards. For some reason or
other, these private wards have been discontinued.
Chiswick and Haling have a joint maternity hospital established
in what was formerly the Chiswick Fever Hospital. At the
start, outside cases were admitted, and some Acton mothers went
there. This hospital now has a waiting list, and it is most difficult,
if not impossible, for cases outside Chiswick or Ealing to be admitted.
The Infirmary at Isleworth and Queen Charlotte's lyingin-hospital
are the principal public institutions which receive cases
from the district for normal confinements. Occasional confinements
take place in other general and lying-in-hospitals.
Of the measures suggested in the report, the Council has
already adopted a scheme for ante-natal supervision, the provision
of beds for complicated cases and the provision of nursing assistance
in necessitous cases. As necessity arises, this part of the
Council's scheme can be developed.
The ante-natal supervision can be extended, and efforts
made to encourage ante-natal hygiene through the centre. The