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on five mornings a week, the conduct of one morning and one
afternoon session of the post-natal clinic, and operations at Mayday
Hospital on three afternoons a week. He directs the Puerperal
Infection unit at the Borough Hospital and visits maternity cases
in other institutions of the Council. As Borough Consulting
Obstetrician, he is called into consultation by practitioners whose
patients are unable to pay for the services of a specialist. This
scheme approaches very nearly the requirements of a complete
obstetric service. It works smoothly and well and ensures a continuity
of supervision which influences mothers to use it to their
full advantage. The disinclination of many mothers to avail themselves
of expert guidance before and after confinement is one of the
chief factors in the persistence of a high maternal mortality and
morbidity.
In the following report, an effort is made to indicate the
relation of the Obstetric service to the obstetric activity of the whole
borough. The form of the report is that recommended by the Committee
of the Section of Obstetrics and Gynaecology of the Royal
Society of Medicine for the Unification of Clinical Reports of
Maternity Hospitals (1928). This is intended to facilitate the
compilation of aggregate statistics which include all the hospitals,
and to compare the results obtained by hospitals situated in different
parts of the country and dealing with populations working under
different industrial conditions.
The small number of abnormalities diminishes the intrinsic
value of the tables and percentages, but the method of setting out
the results brings out many striking facts ; and as the same tables
will be repeated over a period of years, valuable statistics will be
obtained. Some of the tables are probably of interest only to the
medical and nursing professions. One salient feature is that the
cases are divided into "Booked" and "Emergency" groups. A case
that attends the ante-natal clinic more than once is a "Booked"
case. An "Emergency" case is one sent into hospital severely ill
or with some complication, by an outside doctor.
The patients themselves signify whether they wish to book for
Mayday Hospital or for St. Mary's Maternity Hospital. Apart
from this, five special groups of abnormal "Booked" cases are dealt
with only at Mayday Hospital; and if they have already booked
for St. Mary's, they are transferred to the Mayday Hospital list.
These are:—