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69
About 40 per cent. of the women attended on the recommendation
of the health visitor that they should obtain ante-natal supervision,
and about 20 per cent. on the recommendation of a midwife.
40 were referred by medical practitioners and 43 by hospitals.
35 per cent. of those attending were pregnant for the first time
and nearly an equal number for the second time, 14 per cent. were
pregnant for the third and nearly 20 per cent. for the fourth or more
than the fourth time, 5 per cent. being over the fifth time. Only a
few were mothers of very large families, one attending for her 13th
pregnancy, one her 12th, three their 9th, one her 8th, three their
7th and 8 their 6th.
The sixth month was the most frequent date at which the first
visit was paid to the clinic, though the attendances for each of the
two months on each side of this were only slightly lower. Only
about 10 per cent. attended before the fourth month.
Half of the mothers attended more than five times, approximately
equal numbers attending once to five times.
Of the 706 confinements of which particulars are available,
614 were normal, the criterion being that there was a straightforward
labour and spontaneous delivery. Of the 92 abnormal deliveries,
25 necessitated the application of forceps, 26 resulted in a stillbirth
or miscarriage, 8 were induced, in 8 labour was prolonged, in 6 there
was an ante-partum haemorrhage mostly due to placenta praevia,
and in one a post-partum haemorrhage. Twins were born at three
confinements, while 3 patients suffered from puerperal pyrexia and
two infants died within twenty-four hours of birth. In some of the
47 abnormal deliveries where the abnormality occurred during the
confinement the interference was deliberate to prevent trouble
anticipated as a result of the ante-natal findings.
The local County Hospital to which maternity cases are
admitted is Redhill Hospital which is not accessible to a great part
of this district, so frequent ante-natal visits to the hospital prove a
real burden. For this reason it was suggested that the ante-natal
supervision of normal cases to be admitted to the hospital be undertaken
at the local clinics, subject, of course, to an examination
being made by the hospital staff at about the thirty-sixth week of
pregnancy. This suggestion was agreed to and the arrangements
are now in force.
Compensation of Midwives.
The same arrangements continued in force by which compensation
is paid to a midwife whose case is lost to her by reason of the
medical officer exercising ante-natal care of the patient referring
her on medical grounds to hospital for her confinement. During
the year compensation was paid in respect of six cases.