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84
for the medical examination to take place, if only one examination
is carried out.
The 7th month of pregnancy was the commonest time for the
first attendances, 120 persons attending at this stage; 96 attended
first in their 8th month and 89 in their 6th; 22 attended before they
were 2 months pregnant. Whilst some of these no doubt came
primarily to determine the fact as to whether or not they were pregnant,
most continued to attend regularly, 15 of them paying six
or more visits. 50 attended in the third month of pregnancy.
74 and 61 in the 4th and 5th months, and 45 in the 9th month.
Confinements at Home. To the women who attended the
ante-natal clinics, an abortion or miscarriage occurred in 31
instances, 342 confinements were normal and in a further 7 cases the
labour was normal, but puerperium complicated by phlebitis,
puerperal pyrexia, etc. In 36 cases there was some abnormality
in the confinement; amongst these cases there was a forceps
delivery in 19 instances, a breech delivery in another 5, and along
labour in a further 7. The fact that forceps were applied does not
of course necessarily indicate the presence of any abnormal condition.
One patient had intrapartum fits ; in another case the infant
died during delivery ; another child died on the 2nd day, and there
were two cases of severe perineal tear.
Hospital Cases. 110 women were referred to hospital for
confinement. In many cases there was more than one reason for
recommendation that confinement should take place in an institution.
Where there was only one reason the commonest was
economic circumstances, 26 being referred solely on this account.
The use of a hospital for confinement for this reason is extravagant.
As it was considered that possibly many of these patients, could
they have afforded it, would have preferred their confinements
at home, alternative arrangements have now been made in that
such cases can now receive financial assistance by payment of the
midwives' fees. The next commonest sole reason for referring
cases to hospital was the patient suffering from a small pelvis or
other obstruction, 20 cases being admitted on this account. Other
medical reasons accounted for the admission of 15 cases, of which
albuminuria was the cause in 6, bad obstetric history in 4, an
raised blood pressure 4. 8 patients were admitted because it was
their first confinement.
Of the 26 cases admitted solely or partly because of anticipated
obstruction, 5 had normal confinements ; 11 were induced
in one of which the infant was stillborn ; 7 had caesarean section,
in one of which the infant died and in one the mother died, and
two the mother was at her own request sterilized, in one case
because of the abnormal size of the pelvis and the other because