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1925
39
The most important instrument within our reach to
reduce maternal mortality is ante-natal care.
No one who has an intimate knowledge of maternity and Child
Welfare Work, has any doubt of the importance of ante-natal work.
In the report submitted by Dame Janet Campbell to the
Ministry of Health, the paramount importance of ante-natal work
was emphasised, and at all recent conferences where Maternity Work
or Maternal Mortality is discussed, one cannot but be struck by
the insistence with which ante-natal care is stressed as a sine qua
non. The young practitioners, most of them fresh from the
teaching and practise of the big hospital ante-natal departments.
are imbued with this idea The young midwife trom an up-todate
teaching school starts her district work determined to visit
and examine all her patients ante-natally.
With the knowledge and experience gained by all workers
in the field of obstetrics at the present time, there should be no
weak links in the chain of preventive work. It should be clearly
established that every expectant mother should be carefully and
fully overhauled by a competent obstetrician at least once before
every confinement, and that well before the seventh month.
Why is this not always done ? It is sometimes said that
the expectant mothers do not like it. This is certainly not
our experience here. Practical experience in dealing with expectant
mothers soon teaches one that no one is more appreciative of
proper medical supervision and expert and encouraging advice,
than is the expectant mother if dealt with on proper lines.
The real difficulty, the real hindrance to ante-natal care,
lies, not in the objection of the patient, but in the want of realisation
of old-fashioned practitioners in midwifery—doctors or
midwives—of the necessity for preventive work and the want
of the most elementary knowledge in its routine application.
The Ministry of Health have taken the lead in so far as they
were able in these matters. The report on Maternal Mortality
by Dame Janet Campbell is permeated with the teaching that
ante-natal work is the keystone of midwifery. The Central Midwives
Board recommend, though they do not yet make it compulsory.
that all mid-wives engaged for a confinement, should keep
a record of their bookings and of their ante-natal visits.