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70
Consultant Ante-natal Clinic.
The consultant ante-natal clinic was held fortnightly at the
Broadway Clinic throughout the year. Patients are mostly referred
from the local ante-natal clinics, at least one visit of all primiparae
even though apparently normal, being encouraged. Cases are also
referred direct by the general medical practitioners in the area and
post-natal cases are also seen. During the year 127 women made
181 attendances.
In exceptional circumstances, the consultant may now be
summoned to an ante-natal case in the patient's home.
Consideration was given to the question of the type of case for
which the Council would accept responsibility for the payment of the
consultants' fees, and the following decision was made: that subject
to the same being reported to the sub-committee at the subsequent
meeting the Medical Officer of Health be authorised to sanction the
services of the consultant gynaecologist in respect of ante-natal
cases, cases of difficult labour and puerperal infection to patients
whose income is not in excess of that which would render them
eligible for panel treatment and that in other cases the decision of
the sub-committee be obtained.
General Practitioner Ante-natal Scheme.
The same arrangements by which pregnant women can receive
ante-natal supervision by their own medical attendants were continued
last year. A very limited use was made of the scheme, only
40 women attending 15 practitioners. Of this number, 14 were
insured patients. 27 women had normal confinements at home.
Three, because of abnormal ante-natal findings, namely, albuminuria,
a damaged heart and small pelvic measurements, were admitted
to hospital where their confinements were normal. Forceps were
applied in six instances to the women who were confined in their
own homes, mostly because of a delayed second stage. One confinement
resulted in a stillbirth, another in premature twins of
whom both died, and in another case the assistance of the practitioner
was summoned by the midwife on account of a prolapse of
the cervix.
Only four women attended for post-natal examination,
The percentage of total notified births (live and still) represented
by the total number of expectant mothers ante-natally
examined at the clinics was 43 and examined under the General
Practitioners' Ante-natal Scheme, 1.5, or a total of 44.5 under the
provisions made by the Council.
ARRANGEMENTS MADE FOR THE CONFINEMENT.
At Home.
There was no alteration during the year made in the forms
of assistance to those who have their confinements at home.