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Four were primigravidæ, one of whom was advised to have her confinement
in hospital because of risk of disproportion. The second made
arrangements herself to go to hospital. The third booked with a general
practitioner and was under his supervision. The fourth ceased attending
the clinic at the most important time (during the last month) and had a
long and difficult labour from which the child died (asphyxia pallida).
One of the multiparæ was a very fat woman who had an instrumental
delivery in her first pregnancy.
With one exception, all the babies survived.
(d) Breech Presentation (6 cases).
Of the six breech deliveries, one was in a primigravida and five in multipara.
Of these six, four (including the primigravida) made only one
attendance at the ante-natal clinic. One booked with a doctor, a second
had her confinement outside the district; and the remaining two were
midwives' patients who failed to keep their appointments for a second
-examination.
Of the two who attended regularly, one had a breech delivery nine
years previously, and a four months' miscarriage in 1930. She was advised
to arrange to have her confinment in hospital, but she preferred to engage
a. doctor and midwife. She was sent to hospital by her doctor and delivered
of a breech with extended legs. In the other ease the breech presentation
was not diagnosed ante-natally. All six children survived.
(e) Miscarriages (6 cases).
Of the six patients whose pregnancy terminated in miscarriage, five
had previous premature births or miscarriages. One had two full-term
children, one premature and three miscarriages. The second had six fullterm
children, two six months pregnancies (children born alive) and one
miscarriage. The third had one full-term child and two premature (one
stillborn). The fourth had four full-term children, three premature and
two miscarriages. The fifth had had one premature seven months' child
(died at 3 days). The sixth, who had five full-term children, was 42 years
of age and appeared to be in very poor condition.
Cases Referred to Hospital.
Fifteen cases were referred to hospital for the following medical
reasons:—
9 threatened disporportion (2 confined in hospital).
2 ante-partum haemorrhage.
1 hyper-thyroidism with glycosuria (admitted for investigation).
1 version.
1 X-ray of chest.
1 for diagnosis.
In addition, 35 cases were referred to hospital for admission because
of lack of accommodation or lack of suitable arrangements in their own
homes.