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39
ANTE-NATAL AND POST-NATAL CLINICS.
Administrative arrangements under the National Health
Servic Act are complex because there is a variety of interests
involved. The essential requirements are that an expectant mother
shall receive her ante-natal care from those who will be responsible
for the confinement and shall have freely available to her
all the obstetric facilities she may require. Some of the steps
taken in Croydon to achieve this objective, include a Group
Maternity Advisory Committee to discuss technicalities of major
questions of policy in regard to obstetrics, and the Consultant
Obstetrician to Mayday and St. Mary's Hospital acting as the
clinical adviser on obstetrics to the Local Health Authority and
being a member of the appropriate Corporation Committee.
Ante-natal and post-natal clinics for hospital-booked cases are
staffed by hospital doctors and midwives and those for domiciliary
confinements by the domiciliary midwives. Almoner and clerical
staffs are common to both clinics and the same form of case
records are kept. These are immediately available for the
hospital obstetricians should a mother, not previously known to
them, be admitted as an emergency case. Every mother has a
blood test for blood group, Rh. factor, W.R. and Kahn tests
and is offered instruction in relaxation exercises, mothercraft and
ante-natal demonstration of the gas/air apparatus.
When mothers booked for home confinement prefer to attend
their own doctor, contact is maintained with the midwife by a
record card exchanged between her and the doctor or by attendance
of the midwife at the doctor's surgery. Nine general practitioner
obstetricians held regular ante-natal sessions at their surgeries
at which the domiciliary midwives attended. A mother
receiving ante-natal care from her own doctor is welcomed at
the Ante-Natal Clinics for any of the ancillary services for which
her doctor may refer her. A mobile Obstetric Emergency Unit,
staffed from the Maternity Hospital, is available at all times and
if a midwife cannot readily obtain the services of a doctor, she
may summon the Unit direct. General practitioners who applied
for admission to the list of general practitioner obstetricians and
who have insufficient post-graduate experience are offered training
facilities in local ante-natal clinics and hospital maternity units.
During the year 4,420 cases were seen at the Ante-Natal
Clinics, of which 3,569 were new cases. A total of 28,221 attendances
was recorded, and 1,676 cases were seen at the Post-Natal
Clinics (1,589 new cases) and 1,785 attendances recorded.