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The remaining 20 to 30 per cent. of deaths are due to
toxaemias of pregnancy, embolism and extra-uterine pregnancies,
all of which come within the scope of Ante-Natal care.
If we add to these (1) a percentage of those who may be saved
from operative shock by a timely diagnosis of abnormalities
and (2) some of the abortion cases, it is perhaps fair to assume
that about 40 per cent. of maternal deaths may be controlled
by Ante-Natal treatment.
The consideration of the first set of causes mentioned
above, viz., those directly connected with actual childbirth,
does not come within the scope of this report, except to call
attention to the letter from the Minister of Health of the
16th January, reporting on the findings of his Medical Inspector
on the work of Maternity and Child Welfare, that "sterilized
maternity outfits might be provided for patients for whom
either the Doctor or Midwife consider that this provision is
desirable." Also one may emphasise how important it is for a
Local Authority to have sufficient maternity beds at their
disposal for those who need them, and to secure the service
of a skilled obstetrician who can always be called in for special
cases.
In this area plans are maturing for increasing the number
of available maternity beds and a skilled obstetrician was
engaged some years ago.
The chief concern of this Authority is the Ante-Natal
service which, assuming that the calculations mentioned above
are fairly correct, may help to control some 40 per cent. of
maternal deaths.
There are two Ante-Natal centres in the Borough, one in
Brentford and one in Chiswick, and a session is held at each
clinic every week. The extent to which these clinics are used
is indicated by the fact that about 333 expectant mothers
residing in the Borough made 1,839 attendances in a year.
This number of expectant mothers represents 36 per cent. of
the total births notified in the District. Most of these women
come on their own initiative or by the invitation of Health
Visitors, some are sent by midwives and a few by Doctors.
A thorough and systematic examination is made of each
woman and normal cases are invited to attend once a month
until the last month when they attend each week.
Cases showing any complication or abnormality are seen
more frequently and in some cases have been seen daily. Others