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31
In a summary of their conclusions, the Committee state,
we are convinced that the primary essential for the reduction
of a high maternal mortality is sound midwifery before, during,
and after childbirth, and this does not chiefly depend upon
administration arrangements or the expenditure of public
money.
We are confirmed in the opinion expressed in our Interim
Report that at least half the deaths which have come under
review would have been prevented had due forethought been
exercised by the expectant mother and her attendant, a reasonable
degree of skill been brought to bear upon the management
of the case and adequate facilities for treatment been provided
and utilised.
The recommendations of the Committee cover a wide field of
clinical and administrative work. These include:—
(1) Practical measures for the prevention of sepsis (Puerperal
Infection).
(2) Methods of dealing with toxsemias.
(3) Hemorrhages, and
(4) Pre-existing disease.
(5) Improvement in the education of medical students in
obstetrics, an extension of the facilities for post-graduate
instruction of doctors, improvement in the training and
employment of midwives, the provision of ante-natal
supervision and co-operation between the Clinic and the
Maternity Hospital, the education of the public as to
the need for ante-natal care, and certain recommendations
with regard to Maternity Hospitals.
(6) The development and co-ordination of existing Maternity
services.
(7) The encouragement of specialisation by the establishment
of gynaecological departments in all the larger nonteaching
provincial hospitals, and finally
(8) The continuation of confidential inquiries into the
cumstances of maternal deaths by the Public Health
Authorities.
The Maternity and Child Welfare Committee of this Authority
are giving careful consideration to the whole report with a view of
determining whether there are any deficiencies existing in the
Council's maternity and child welfare scheme, which it is possible
to make good, and whether an improvement of any part of the
machinery is required, in order to secure for the women of Camberwell
a greater measure of safety during childbirth.
Obstetric Complications in Private Practice.
In April, 1931, Mr. Arnold Walker was appointed by the
Council to assist private practitioners in cases of difficult confinement.
During 1932 two cases were dealt with under this scheme.