View report page

84
Only three women attended for post-natal examination.
In general examinations are recommended at the 16th, 32nd
and 36th weeks of pregnancy and one post-natal examination is
advised. It was decided during the year that the Council would
not ordinarily be prepared to pay for ante-natal and post-natal
examinations of uninsured women over a maximum of four, but
that in cases where an application setting out the circumstances
is made the medical officer of health is authorised, if satisfied that
such a course is necessary, to sanction a further examination or
examinations at the expense of the Council.
By those who favour the clinic method of ante-natal supervision,
it has been maintained that quite apart from the benefits of medical
supervision the patient has the advantage of consulting the health
visitors whose duty it is to discuss with the expectant mother all
points in connection with her state of pregnancy and the full
arrangements with regard to the confinement, whether this is to
occur at home or in an institution. Those who obtain their antenatal
supervision at a hospital clinic where the considerations are
wholly medical, or from their practitioners, are largely deprived of
this side of ante-natal care. On the other hand one can look forward
to the day when the midwife is sufficiently acquainted with the full
work in the clinic and of the social services that she takes her rightful
place there, displacing the health visitor. When that time comes
the argument of those who favour the clinic because of these nonmedical
aspects will largely fall to the ground, as the patient will
be seen by the midwife who will attend her at her confinement and
a doctor who will not. In these circumstances it is rational to
anticipate the replacement of the combination of the midwife and
the clinic doctor by the midwife and the patient's own doctor, who
would be the one who would be called in to the confinement if the
presence of a doctor were found necessary. If to the supervision
which the midwife herself undertakes for the patient could be
entrusted to her the responsibility of reading of blood pressures so
that the frequent attendances in the later stages of pregnancy
could be to the midwife, there would in the normal case—and the
vast majority of cases are normal—be no necessity for more than
the three suggested medical examinations, for the carrying out of
which the practitioner would probably be able to afford the time.
ARRANGEMENTS MADE FOR THE CONFINEMENT.
At Home.
1,589 confinements took place in the patients' own homes. Of
these 872 were attended by midwives acting in their capacity as
midwives and 444 by local midwives who had given notice of their
intention to practise, acting as maternity nurses.
Up to the time when the Council's midwives, appointed under
the Midwives Act, 1936, took up duties, the same forms of assistance
were given to those who had their confinements at home as formerly.