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partum haemorrhage, disproportion and post maturity. 9 eases of
vaginal discharge were seen, 3 of these being due to a fungus and
others to cervicitis. 3 cases of mole were referred to hospital for
emptying of the uterus.
The following is a copy of a report on Ante-natal services
submitted in October to the Maternity and Child Welfare Committee:—
Ante-natal supervision of women is of comparatively recent
date. Its importance at one time was not realised, little attention
being paid to it in the training of doctors and midwives. This
resulted in an almost complete neglect by the previous generation
of practitioners of this class of work. The need being felt, Local
Authorities provided the service which, with the education of the
women as to its importance, is steadily increasing. The presentday
student as compared with his predecessor is impressed in his
teaching with this side of the work, and most practitioners are
now fully competent and willing to carry it out.
It is accepted as a cardinal principle that the ante-natal supervision
should be undertaken by the doctor who is to attend the
confinement. In districts possessing their own maternity homes,
where the resident Medical Officer of the Home conducts the antenatal
clinics, this requirement is satisfied in those cases who arc
admitted. Provided there is sufficient accommodation to take
in all cases which are likely to need the attendance of a doctor, such
an arrangement is satisfactory, and it is anticipated by some that
the future development of the maternity services will be on these
lines, straightforward cases being attended by midwives, possibly
municipal, in their own homes and cases of anticipated complication
being attended in the institution. Such development would, of
course, necessitate a large increase in the number of beds available
for maternity cases. In a district such as this, without its maternity
home, the ante-natal services suffer from the obvious disadvantage
of the patients being attended at confinement by
doctor who did not carry out the ante-natal supervision. As a
detached unit run on these lines, the ante-natal clinic can never
effect those improvements in the conditions of labour that were
hoped would materialise from efficient pre-natal care.
It is premature to decry the utility of the clinic as there arc
some services that in any event it can supply. The ante-natal
service can claim that it" has been responsible for the education
of the women as to the need of supervision at this time,
necessity is probably not even yet appreciated by the bulk of the
women, and Health Visitors are likely to be more successful in
inducing women to attend a clinic at which they would be presen
than in getting them to attend a doctor's surgery. There is, too.