68o SCIENCE PROGRESS 



by voluntary workers for Infant Welfare. The development of midwifery in 

 this country is carefully traced and there is a reliable presentation of midwifery 

 practice in England and Wales as existing at the present time. After a short 

 section on Midwifery in other European countries Dr. Campbell sets forth a series 

 of valuable suggestions for raising the standard of midwifery. A section is 

 devoted to a consideration of midwifery in rural areas — a problem which urgently 

 needs fullest consideration. There is also a study of Maternity Homes. We 

 venture to reproduce Dr. Campbell's general summary : 



" Three main conclusions emerge : first, that a large proportion of midwifery 

 practice is, and is likely to remain, in the hands of midwives ; secondly, that the 

 midwives as a whole are not sufficiently well educated and trained to do justice 

 to the heavy responsibilities which devolve upon them ; and, thirdly, that the 

 midwives are not properly distributed in urban and rural districts. This position 

 is clearly unsatisfactory, and is inevitably prejudicial to the health and well-being 

 of numerous mothers and infants. For many reasons it is neither desirable nor 

 practicable to attempt to dispense with the services of midwives ; thus the only 

 alternative available would seem to be so to improve their technical capacity that 

 they may become of true economic value to the State. For this it is necessary : 

 (a) To attract well-educated women to the study and practice of midwifery ; (b) to 

 provide a training which is sufficiently prolonged, thorough, and comprehensive 

 to fit them to carry out their subsequent work with due skill and judgment ; and 

 (c) with the assistance of Local Authorities to secure for them a position consistent 

 with the dignity to which their profession should entitle them, and a wage 

 commensurate with the exacting and arduous mode of life which they are called 

 upon to follow. The end cannot be attained immediately, nor can it be secured 

 without the co-operation of the midwives themselves, but it seems of vital 

 importance that the claims of the midwives, and thus indirectly the needs of 

 their patients, should not be forgotten or disregarded by those responsible for 

 the initiation or administration of schemes for the promotion of infant and 

 maternal welfare." 



The section on Play Centres and Playgrounds deserves the study of all 

 interested in the medico-educational study of Childhood. Vol. II. also contains a 

 most instructive series of illustrations of day nurseries and other new forms of 

 enterprise making for child betterment. 



Vol. IV. is devoted to a consideration of maternal and child-welfare problems 

 in Ireland and is issued under the name of Dr. E. Coey Bigger, Medical Com- 

 missioner of the Local Government Board of Ireland, and Crown Representative 

 for Ireland on the General Medical Council. In the preparation of this Report 

 Dr. Bigger has been assisted by his son, Dr. Joseph W. Bigger of Sheffield 

 University, and by various inspectors and other officials of the Local Government 

 Board in Ireland. Mrs. Dickie, LL.D., Insurance Commissioner, has dealt with 

 matters relating to maternity benefit. Four medical women have also provided 

 memoranda : Dr. Ella Webb on work in Dublin ; Dr. Marion Andrews on enter- 

 prises in Belfast ; Dr. Alice Barry on measures in Cork ; there is also a short 

 communication from Dr. Prudence E. Gaffikin. Ireland requires men, and yet 

 of every ioo children born 9 die before they reach the age of twelve months. 

 The death rate and damage rate are high. In 191 5 95,583 infants were born in 

 Ireland, and 8,753 died under one year of age — that is, at the rate of 92 deaths 

 per 1,000 infants born alive. In England in the same year the rate was no, and 

 in Scotland 126. Since the beginning of the century England's rate has been 

 rapidly and steadily declining, while Ireland's rate in the same period has also 

 declined, but to a less degree than that of England. The reduction in the rate 

 for England has been 24 percent. Ireland's reduction has been just one-third of 



