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(i) An arrangement with the School Medical Treatment Committee for the
provision of dental treatment to expectant and nursing mothers.
(j) Provision of nursing assistance for young children suffering from ophthalmia
neonatorum and for mothers suffering from puerperal fever or puerperal
pyrexia.
(k) Provision of beds for the institutional treatment of midwifery for 144
cases per annum in the British Hospital for Mothers and Babies, and
for 66 cases in the War Memorial Hospital.
(l) Reservation of beds for ante-natal treatment and emergencies of midwifery
at the War Memorial Hospital, equivalent to 18 weeks' treatment per
annum.
(m) Convalescent Home Treatment for expectant and nursing mothers.
(n) Arrangements for the supply and distribution to expectant and nursing
mothers of milk and food drugs at cost price, half cost or free, according
to economic circumstances.
To-day all authorities regard ante-natal care as the basis of an adequate
maternity service, and in this Borough there are ample ante-natal arrangements.
At four Centres the Council have ante-natal clinics, and there are others in all the
hospitals of this Borough with maternity beds. There is a large excess of midwives
in Woolwich—sixty-one gave notice of their intention to practise. Every one of
these can send her cases to the Council's ante-natal clinics for opinion and advice,
and most of them do so. Their fees can be paid in necessitous cases and compensation
is made to them if it is found that their cases ought to be confined in
hospital. A Consultant is available to assist doctors called in by midwives in
emergencies at home. There are many ancillary services and post-natal examinations
are arranged for. Moreover, there are arrangements whereby cases seen
at the non-hospital clinics can be referred to the hospital clinics for specialist
opinion and if necessary, for treatment, and in this way the ante-natal services
of the Council are fully linked up with hospital practice. The number of maternity
beds in Woolwich hospitals is 84. In brief the local maternity arrangements are
as complete as present day knowledge and practice can make them.
At the present time a Midwives' Bill, providing for a salaried midwife serivce,
is going through Parliament. It seems to me, however, in view of the increased
public demand for maternity beds in London, that there is reason to doubt the
necessity for a domiciliary salaried midwifery service in London. There has been
a great increase in the percentage of women going into hospital for their confinements
since 1919. In that year one birth in fourteen in Woolwich took place in
institutions, to-day three out of every five do so. Many authorities believe that
if sufficient beds were provided very few expectant mothers would refuse to use
them. The hospitals are evidently providing something which the women want
and believe in—whatever the obstetricians may say. The chief argument used
against hospitals is the story of occasional disaster—mostly years ago. In the
development of any other services disaster is the spur to greater development in
safety procedure, and midwifery should be no exception. When the Bill becomes
law it will be interesting to see whether the salaried midwife will change the present