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8 cases sent in because of a previous poor obstetric history had
normal confinements. The other medical reasons for admitting
cases to hospital included raised blood pressure—three cases,
in one of whom labour was prematurely induced—oedema, debility
and toxaemia. One persistent breech case was admitted, but
was delivered of a stillborn child. One patient was admitted on
account of A.P.H. and one for an ectopic pregnancy.
Amongst the patients who regularly attended the clinic,
there were no maternal deaths, but there were 11 stillbirths.
Consultant Ante-natal Clinic : The 125 women seen by the
Consultant paid a total of 196 visits. The commonest conditions
for which these patients were referred were contracted or flat pelvis,
cardiac abnormality and breech presentation.
The ante-natal service, for those who avail themselves of it,
provides the necessary co-operation between those responsible for
the ante-natal examination and those who carry out the delivery.
In all cases the attendant is informed of the clinic findings. Normal
cases attending the clinic would not be under the care of a medical
attendant, the confinement being undertaken by a midwife.
Arrangements are made for the midwife to report to the clinic
doctor when referring her patient in the first place, the doctor sends
reports to the midwife of her findings, and finally the midwife is
encouraged to send after the confinement an account of it to the
clinic. Further co-operation with the midwives is ensured by
the payment by the Local Authority of compensation to the
midwife for loss of her patient when her condition demands hospital
treatment, and also by the payment of the midwives fees in eases
of necessitous patients.
Abnormal cases are referred to their own medical attendants,
or where the patient desires, and her condition demands, arrangements
are made for her confinement to take place in an institution.
In the latter event, she is transferred to the ante-natal clinic of the
hospital at which she will be - confined. Furthermore, the
Consultant sees on behalf of any local medical practitioner, am
patients referred to him by them.
35 per cent of the women confined last year attended the ante
natal clinic. It is unknown what proportion of women receive
ante-natal care because some will attend their own private doctors
and some are attending hospitals. It will be noted that altoghter
291 confinements took place outside the district, of which most