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36
scheme which has been built up to combat maternal
mortality and maternal morbidity, the Ante-Natal Service
must be regarded as the keystone of that structure. The
road to safer maternity lies through an efficient Ante-Natal
Service, and this fundamental fact, unfortunately, is not
yet appreciated even by some engaged professionally in
maternity work. Where it is appreciated it is not stressed
with sufficient conviction to encourage the young expectant
mother to seek out a service so vital to her interests.
This problem will, in my view, be solved, when
midwives come under the salaried control of the Local
Authority, and when a comprehensive midwifery scheme
including the general practitioner and the consultant
obstetrician as envisaged in the Midwives Act, 1936, is in
operation.
Natal Services.
Eight hundred and twenty births (live and still) were
known to have occurred in Bromley during 1936, and
were notified as follows:—
By midwives 365
By doctors and parents 455
820
Included in the figure 455 above are 31 "un-notified''
births, which is an unusually high figure (3.8 per cent.
of the total). Investigation was instituted in each case,
and almost without exception it transpired that a doctor
and midwife were attending in each case and the duty of
notifying had, through misunderstanding, broken down
between them.
It is noteworthy that of the 820 births, 507 confinements
took place in hospitals and nursing homes, while
313 were confined in their own homes. By far the greater
proportion of the 507 confinements in institutions occurred
in the Maternity Hospital which dealt with 397 cases, of
whom 257 were Bromley residents and 140 from other
areas.