ANTE-NATAL HYGIENE : DISCUSSION 367 



DISCUSSION. 



Dr. SMITH (York) said the subject of pre-natal hygiene 

 was specially interesting in connection with stillbirths, 

 and in his own city they had for some years checked 

 the notification of stillbirths by a voluntary arrange- 

 ment with the Registrar of their cemetery, by which 

 the Registrar every week sent him a statement of the 

 stillbirths which had been buried, and furnished him 

 with the names of those who had given the certificate 

 of burial. They were able to check this along with 

 their notification of stillbirths under the Notification of 

 Births Act. They found that a very useful means of 

 checking the stillbirths received under the Midwives Act 

 also. A certain number of the stillbirths either notified 

 under the Midwives Act or under the Notification of Births 

 Act, or by the Registrar of the cemetery, were selected, and 

 his health visitors visited the midwives who had attended 

 the cases, and made close inquiries as to whether in the 

 first place they had seen the child born. That was suggested 

 by a case where a midwife gave a certificate of birth and 

 had not seen the child born she was called in after the 

 birth. They also inquired as to the condition of the child 

 at birth, and also what efforts were made to resuscitate 

 life. They had found this very useful indeed, and the talks 

 which the health visitors had had with the midwives in con- 

 nection with these cases resulted in a considerable amount 

 of education of the untrained midwife. Another valuable 

 thing in towns was to form an association of the certified 

 midwives and link it up with one of the National Midwives 

 Associations. In his town they had meetings every two or 

 three months, and papers were given sometimes by himself, 

 and sometimes by one or other of the medical practitioners, 

 or by some of the more advanced certificated midwives. It 

 was a mutual improvement society as well as a sort of trade 

 union amongst the midwives themselves, and it had a very 

 great educational influence which he found was of help in 

 the prevention of infantile mortality. There were so many 

 different institutions and associations working in the direc- 

 tion of preventing infantile mortality that they tended to 

 tumble over each other in the course of their work. There 

 was a very great need at this time, now that they had got 

 so far in this great work, for a linking up of all these 

 various agencies under some representative committee or 

 some such thing as a Guild of Help. He thought it was 

 becoming very Vital, for there were schools for mothers, 

 restaurants for poor mothers, infant consultations, the work 

 of the official corporation health visitors, and all the other 



