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99
Of the three patients referred to hospital during the year, one
has had a repair operation for prolapse ; one has had a cervical
dilatation and insufflation of the fallopian tubes for sterility ; and
the third is now having medical treatment at Queen Mary's Hospital.
General Observations. The maternal mortality rate is
accurately known. Maternal morbidity is often vague and illdefined
; its full effect may not develop until years later. It is,
therefore, difficult to assess its prevalence or degree. In the
latest Ministry of Health Report on Maternal Mortality it is stated
that it had been hoped to consider maternal morbidity, but that
the necessary data could not be found. The onty records available
were the reports from the gynaecological departments of several
large hospitals and they deal only with women who were ill enough
to seek advice. Much minor disability, which is preventable or
curable if the patient is seen soon enough, goes undetected.
A post-natal clinic has two purposes:—
1. To diagnose and arrange treatment for disabilities arising
from childbirth in their early and more readily curable
stages.
2. To collect information about the nature and frequency of
maternal morbidity which will enable measures to be
taken for its prevention.
Disability arising from childbirth may be:—
1. Gynaecological—a local lesion due to trauma or infection.
2. General—the general health may be affected by the stress
and strain of labour, by loss of blood or by some complication
of pregnancy such as albuminuria.
3. These two forms of disability often exist together, e.g.,
a severely anæmic woman may have a prolapse.
Much good can be done by even one post-natal examination,
but in many cases it is necessary to give continued observation
and treatment over a period of time. It is often quite as important
to treat the general as the local condition. A knowledge of the
home circumstances in individual patients is a great help, e.g.,
one patient may need extra nourishment more than medicine ;
the recuperation of another may be retarded because she is worrying
about her ailing child. The maximum value can be obtained only