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89 attended first in their fourth month, 70 in the third, 31 in the
eighth and 30 in the second month.
A clinic for gynaecological cases for women over 40 was
commenced in July. These patients attend with the ordinary
ante-natal patients until such time as the numbers justify a special
clinic being held for them.
The total number of attendances of gynaecological cases from
July to December was 21. The numbers now attending this clinic
do not yet warrant the holding of a special clinic for dealing with
these cases.
Hospital Cases: Of the 152 cases referred to hospital, 110
were assisted under the Maternity and Child Welfare Scheme, 71
of which were admitted on other than medical grounds. The
commonest sole reason for this was unsuitable domestic circumstances
which accounted for 34, followed by 21 sent in because it
was their first pregnancy, and 16 were admitted on economic
grounds. In the remaining cases, more than one factor operated,
domestic circumstances being the part reason in 19, first pregnancy
in another 17, and 12 on economic grounds.
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 cases
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, any
Patients referred to him by them.