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(1) Cases supervised by the Ante-Natal Clinics for delivery at
home under the care of doctors or midwives.
(2) Cases referred to the Service by doctors because of some
ante-natal abnormality or anticipated difficulty, and supervised
by the Ante-Natal Clinic before delivery in hospital.
These appear in the "Mayday Hospital Booked" list.
(3) Cases who are delivered before 28 weeks.
(4) Cases of venereal disease or other infectious disease.
(5) Cases of special difficulty requiring X-Ray or other investigation
or special medical or surgical treatment by a resident
medical officer.
Cases admitted more than once during the same pregnancy
are counted as one case only, for all statistical purposes.
Twenty-eight weeks is taken as the dividing line between
abortion and labour except when a foetus of less than 28 weeks
breathes. In this case, no matter what the duration of pregnancy
may have been, the delivery is labelled as premature labour.
In the year 1933 the service has continued along the lines pursued
in previous years. The new obstetric officer took up his duties
on 28th April. In the ante-natal clinics, a system of giving each
patient an appointed time to attend has been instituted, thus avoiding
much tedious waiting. In accordance with modern medical views
the blood pressure of each patient is now taken at every visit. In
the latter half of the year, posterior positions of the vertex have
been treated at the 38th week with Buist's pads. This has given
good results and difficult "posterior" labours have been fewer.
The supervision of expectant mothers at the ante-natal clinics is
not yet as detailed as is desirable. This has been due to insufficient
nursing staff. The lady medical officer has been obliged to do work
that a nurse usually does, so that she has not been able to devote
sufficient time to the medical and obstetric part of the examination.
With the additional health visitor to be appointed in 1934, this will
be remedied. The other deficiency in the Ante-Natal work is the
lack of a Mothercraft scheme organised and conducted by a trained
staff to instruct and assist expectant mothers in their preparations.
For this, it is essential to have instructresses who have had special
training in Mothercraft work.