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39
It is by no means unsatisfactory that out of about 1,150 births, somewhat over
800 women attended at your Ante-Natal centres, but in the absence of evidence
that the remaining 350 cases were under adequate supervision, the figure of 825
first attendances must be regarded as one on which to improve.
The number of women attending for the first time at the ante-natal centres was
825, compared to 716 in 1936. This gives an increase of 14 per cent. approximately
of the number of newly confined mothers who attend ante-natal clinics in Barking.
This is a satisfactory figure.
The average number of attendances per expectant mother is 5.1 and this is a
big figure for ante-natal attendances, because a considerable number of the mothers
did not come for the first time until late in pregnancy. In connection with this it
is worth while to note that some mothers are beginning to take advantage of the
ante-natal centres early in pregnancy. This is most noticeable amongst young
mothers expecting their first baby.
At the ante-natal clinics, mothers attending for the first time are seen firstly
by the sister in attendance, who, if the mothers have not made arrangements for the
confinement, gives them information about obtaining the services of a midwife
and about admission to the Upney Hospital.
After a few routine tests every mother is seen by the medical officer in charge
of the clinic, and in the case of mothers attending for the first time a full history is
taken, including any previous illness and the course of any previous pregnancies.
Enquiries are made about the present health of the mother, and then she is examined
and measured. Any abnormality is noted and steps taken to meet the situation.
Abnormalities may vary from a slight physical disability, such as dyspepsia or foot
trouble, to gross pyorrhoea or a gross gynaecological defect.
The minor troubles can be treated at once by medical prescription or by local
application, more severe complaints can be referred to the appropriate clinics, and
where any obstetric or gynaecological complaint is sufficiently severe it can be referred
to the Consultant Gynaecologist and Obstetrician at his special clinic.
Some of the mothers who attend are found to be suffering from a greater or
lesser degree of malnutrition and after enquiry these cases may obtain help from you
in the form of free milk, free dinners, and free tonics.
The ultimate effect of this extra nutrition upon maternal mortality has not been
ascertained clearly, but there is no doubt about the immediate effect it has and the
benefit it gives to the mother.
(b) iStill-births.—In 1926 the Medical Research Council published the results of
close investigation into still-births.