MISS ALICE GREGORY'S PAPER 277 



who will be in a position to judge whether the patient 

 can be delivered naturally or with the aid of instru- 

 ments, whether the labour should be induced at the 

 seventh or eighth month, with the natural sequence 

 of a delicate child, or whether Caesarean section should 

 be resorted to at full term, an operation giving a better 

 prognosis for the infant but slightly increasing the 

 risk to the mother. 



All these knotty problems lie outside the midwife's 

 scope, but it will entirely depend on her wisdom and 

 foresight whether they are referred at the right 

 moment to a tribunal really capable of deciding them, 

 or whether the pregnancy is allowed to proceed to 

 full term, the patient eating and drinking heartily 

 meantime until the moment arrives when both nature 

 and science fail to produce a 9 Ib. baby, with a head 

 13 in. in circumference, through a 3 in. conjugate, and 

 the destruction of the child is the only resource avail- 

 able if the terrible alternative of a ruptured uterus is 

 to be avoided. 



Our complacent young graduate, you will remem- 

 ber, made no mention of all this office work, the 

 essential foundation of all true midwifery. She 

 rejoiced to find a child lying across the pelvis a 

 transverse presentation as it is called because it 

 added another to her list of abnormalities, sublimely 

 unconscious of the fact that the number of such 

 presentations which she had known discovered and 

 corrected before labour began would really have been 

 the thing to boast of. It is a comparatively easy 

 process then by external manipulation only ; she could 

 easily do it herself in her own practice, without trans- 

 gressing any of the Central Mid wives Board rules, 

 but one cannot learn everything in three months or 

 even six, and these little facts, on which incidentally 

 the lives of both mother and infant, but especially the 

 infant, may come to hang, have either not been taught 

 her or else have failed to secure her attention, 



