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8
Street Infant Welfare Centre; a minority of these did not arrive at
the Ultra Violet Ray Centre, whilst others would break the sequence
of their attendances at the sessions. To a certain extent a small
minority of mothers are feckless, slow to seize upon a good thing.
Some again have other children to think about so cannot attend.
Enquiry should always be made where a mother fails to appear with
the patient; should this really be due to some home difficulty, some
effort should be made to get a neighbour to bring the child to the
Centre. I am bound to say. however, that few cases of this kind occur.
At the Ante-Natal Centre the nurse in charge, Miss Clubbe, gives
valuable talks, and cuts out patterns for the mothers. A sewing class
is needed here. In my reports a description of such classes in other
boroughs will be found. Miss Clubbe makes urine examinations and
generally acts as a fidus Achates to Dr. Hill. Where a mother fails
to come on the day she is due for examination she is duly visited by a
Health Visitor. The reason for absence is usually some simple one
fortunately, but the visit should always be paid. Some day the Health
Visitor may find an absentee expectant mother on the point of a
rapidly developing eclamptic condition. Speaking of this dangerous
ailment there is one delicate point. Suppose that Dr. Hill finds
albumen in the urine of a woman—as happens in threatened eclampsia
is Dr. Hill to advise treatment or send the case to the family doctor
for such ? Accidents will happen in this world ; many people make
light of their symptoms, whatever they portend, and will not go to their
family doctor ; then again, the patient may not carry out her doctor's
instructions, or the doctor may be out. Whatever betide, I know of
one case in which a woman died. I think that, in a case of the kind,
Dr. Hill should undertake at least, the dietetic treatment, as far as may
be necessary. If the Health Visitor concerned is too busy, a district
or Ranyard Nurse should visit daily at the patient's home and report
daily by phone or letter to Dr. Hill. One must be exacting in such
cases; moreover, few of such occur so the expense would be small.
Where some abnormality is found at a routine Ante-Natal examination,
the patient may be sent to her own doctor or direct to Dr. Gilliatt at
King's College Hospital.
We are living in the days of specialists and really, having regard to
our National Maternal Mortality Rate, we cannot send expectant mothers,
labouring under some abnormality, too quickly to such as Dr. Gilliatt.