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166
THE OBSTETRIC SERVICE.
The obstetric scheme in Croydon is perhaps the most
complete of any of the schemes conducted by local authorities. It
aims at, and to a very large extent achieves, the ideal of complete
ante-natal, natal and post-natal medical supervision under the same
whole time medical officer. It has proved its workability and its
public health usefulness. From the mother's first visit to her last
the aim is prevention and where for some reason or other preventive
measures fail, then immediate treatment. The ante-natal clinics,
Mayday Hospital and St. Mary's Maternity Hospital, and the postnatal
clinics are all links in the chain, working with one another
under the clinical guidance of the specialist Assistant Medical
Officer of Health for Obstetrics.
The Ante-Natal Clinics are held in the Centre in Lodge-road
on four mornings a week. There are in attendance one lady assistant
Medical Officer of Health, the lady almoner and one health visitor
who is assisted by a second on two mornings a week. The obstetric
officer attends each session for part of the time to see abnormal
cases. Pupil midwives from Mayday Hospital and from St. Mary's
Maternity Hospital a.ttend for instruction on three mornings a
week.
The expectant mothers are sent to these clinics from a variety
of sources. In 1933, 10% were directed by other departments of
the Public Health Service, 14% were sent by midwives, 8% came
from medical practitioners and the remaining 68% were from other
sources or came on their own initiative. Of this remainder, a large
number of mothers had been cared for by the service in previous
pregnancies.
An income limit is made for those booked to be delivered in
the Council's beds, and this in the case of a couple without other
children or monetary commitments is £300 per annum.
Most of the cases are supervised throughout the ante-natal
period from about the 20th week; the remainder come for one
consultation at the 36th week, a time when an obstetric opinion
can be given and when examination is most informative.
The patients who attend the ante-natal clinics arrange for their
confinements to take place at Mayday Hospital, at St. Mary's
Maternity Hospital, or at their own homes in the care of private
medical practitioners or midwives.