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71
were in institutions. A certain proportion will have attended
the out-patient ante-natal clinic. Also 321 notifications were
received from doctors. There is still a large field not yet touched.
Out of the 1,451 midwives cases, only 141 were referred to the
elinie. Possibly some were referred to local medical practitioners,
but many would have had no ante-natal supervision. The success
of the midwife in persuading her patient to obtain medical supervision
seems to depend more on the midwife herself than on the
patient, as most are dealing with similar persons. Apart from
the advantage of obtaining medical supervision by attending
the clinic, patients are offered other facilities, such as dental
treatment, etc. To make these services known to the expectant
mothers, a leaflet has been prepared comprising a list of the services
provided by the Maternity and Child Welfare Authority. These
have been distributed to the midwives in the hope that they will
hand them to their patients at the time of booking, so that they
will know what help is available for them as expectant mothers,
and also what assistance is provided in connection with the
confinement.
Cases of gross abnormality attending the clinic are provided
for by the arrangements made for admission to hospital, financial
assistance being afforded where circumstances demand. Ihere is
however, the class of patient with some slight abnormality for
whom institutional treatment is not necessary, but in whose case
it is most desirable that a doctor should be in attendance at the
confinement. Such cases should not be allowed to go into labour
without previously being seen by the medical attendant who will
be present at delivery. Those patients whose financial circumstances
permit it, are referred to their own doctors and continue
under their supervision. There are however some patients falling
into this class who will not, on account of expense, go to their
doctors tor the necessary ante-natal supervision, and, in default
ot more desirable arrangements, continue attendance at the clinic.
As previously pointed out, it is most desirable that arrangements
be made for this class by the Local Authority undertaking to pay
the cost of the patient's ante-natal supervision by her own doctor
father than that she should continue to attend the clinic. Apart
from other considerations, it is uneconomic to arrange, in the only
satisfactory alternative manner, namely, institutional treatment,
for the ante-natal care and for the confinements of such patients
when they can be dealt with at their homes. Furthermore,
here are some mothers who will not go to hospital, and for them
the existing arrangements are definitely unsatisfactory.
One of the desirable facilities which is not yet at present
available, is that of the services of a consultant to be called out