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62
ANTE-NATAL CLINIC.
Compared with 192 and 208 respectively during 1923, the
total attendances made by new cases were 325, while re-attendances
numbered 434 during 1924. The average number of casei
attending per session and re-attendances per patient amounted
respectively to 14.8 and 2.3.
It is mainly, if not entirely, through the ante-natal clinic that
a further reduction of infantile mortality, especially the neonatal
or that occurring during the first month of life, which is again
closely connected with the question of maternal death, still-birth
and abortion, is to be looked for, and where, unlike the infantile
mortality as a whole, very little reduction has taken place in the
country during the past 25 years. It is therefore expedient that
every expectant mother, not under the care of a medical practitioner,
should realise the importance of placing herself under
adequate ante-natal supervision throughout pregnancy, a fact
all important in first pregnancies, and little less so in any subsequent
pregnancy which may occur. As already mentioned, an
important lead in this connection has now been taken by the
local staff of the Plaistow Maternity Charity in the co-operation
established between their district midwives and the ante-natal
clinic of the Council, a lead which it is hoped will be followed in
the near future by the remaining midwives of the district.
The post-natal care of cases attended by midwives or confined
in the Maternity Ward cannot be undertaken as a routine measure
at ordinary infant welfare meetings, and such work consequently
comes to form an important item in the extended duties of the
ante-natal clinic. It is impossible from the post-natal aspect to
over-estimate the significance of child birth as a factor in the
causation of gynaecological morbidity, in fact such conditions as
arise unconnected with the puerperal state are comparatively few,
emphasising accordingly the need for more attention being paid
to the early diagnosis and rectification of post-natal defects while
in the majority of cases they are in an early and more remediable
condition soon after labour.