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44
October, 1937. Facilities to attend were granted by the
Local Supervising Authority, and 14 midwives attended
the Course.
Institutional Provision for Mothers and Children.
Infants.
So far as the child is concerned there are no special
institutional services. Acute cases are of course referred
to hospitals, either in Bromley or in London, and certain
young children needing change of environment by means
of convalescent treatment are referred to the Queen's
Reign Commemoration Fund for convalescent home treatment.
We certainly lack in Bromley adequate provision
tor the treatment and observation of the young baby, as
for example, the baby who requires corrective feeding and
who cannot be adequately supervised at home. The provision
of an open-air ward for a limited number of these
cases would overcome many of our difficulties.
Maternity Hospital.
The Bromley and Chislehurst Maternity Hospital has
19 beds and during 1937 accepted '171 cases. The agreement
between this hospital and the Local Authority is for the
reservation of four beds for the patient who cannot with
safety be confined at home. Some of the cases referred to
the Maternity Hospital by us are financially assisted, ten
such cases received financial aid during 1937.
The present day tendency for patients to seek hospital
accommodation for normal confinement is, in my view,
not entirely satisfactory, as many of them could have their
confinements at home without risk. Hospitals should be
restricted for tlie use of abnormal cases, but there is a
growing tendency to depart from this principle. There is
without doubt always the possible danger of a puerperal
infected patient affecting other patients, a fact that would
not be so frequent in cases confined at home. It is for this
reason that domiciliary midwifery is to be encouraged for
the normal patient, provided that facilities exist for
hospital treatment in emergency, or for the early admission
of patients who show signs of abnormality in the antenatal
period. This danger of puerperal infection passing