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62
Fifty-five per cent. of the cases were referred to the clinic
by the local midwives, two-thirds of these being sent by the
nurses of the District Nursing Association or the Salvation Army
Curses. The practice of individual midwives varies greatly in
the use they make of the clinic, some referring very lew cases'.
Twenty per cent. of the cases attend on the recommendation of
a previous patient. Another 20 per cent. attended on the
commendation of a Health Visitor or through having seen an
advertisement or having themselves attended previously.
The total number of new leases attending the clinic was 596,
being 25 per cent. of the total number of births registered in the
district. Of these cases, 471 had normal confinements with
living children, compared with 57 with some abnormality. These,
include some 20 pregnant women referred to hospital. Seven
cases were admitted to hospital for induction, mostly on account
of small or flat pelvis, and two for cæsarian section. Two had
lysterectomy performed and two other cardiac cases had normal
habours after a period of stay in hospital; as had one case each
of raised blood pressure and hydramnios. Three other cases
were admitted for conditions associated with pregnancy.
Amongst those who attended the ante-natal clinic 6 gave
rise to premature births, of which 3 died; another 14 were
delivered of stillbirths. Malpresentation occurrcd in three eases
while forceps were applied in another 12. In two instances
manual removal of an adherent placenta was necessitated.
Full benefits of ante-natal attendances cannot be obtained
until the patients have realised its importance. 207 cases paid
only one visit. No doubt a large number of these are cases
referred by the midwives or who came for the comfort of
knowing no abnormality is present at the time—but this condition
of affairs is not satisfactory when it is realised that fully
one-half of these single attendances are made before the
completion of the 6th month of pregnancy. Another onequarter
paid only two visits.
The commonest date of the first attendance was the 6th
month when, some 20 per cent. first attended—closely followed
by the 7th month. About 15 per cent, paid their first visit in
the 5th month and the same in the 8th. 41 persons attended
in whoom the diagnosis of pregnancy was not made. 23 attended
for post-natal examination, of whom 10 were referred either to
their own doctor or to hospital for treatment.
In almost one-third of the cases teeth were good; rather
less were in need of slight treatment, while tin more than onethird
the dental condition was sufficient to cause impairment
of health