DR. BARBARA SUTHERLAND'S PAPER 401 



information as to how the receiving of the maternity 

 benefit under the Insurance Act affects the welfare 

 of the mothers and infants concerned is especially 

 interesting. 



The choice of cases for visiting depends on the 

 Notification of Births Act. All cases notified by mid- 

 wives, or institution nurses acting as district midwives, 

 are first visited by the female sanitary inspectors. 

 " First Visit " cards are then filled, and from the 

 information entered on these a decision is made as 

 to the need of subsequent visiting by one of the 

 official health visitors, who are nurses with midwifery 

 and general training. 



Effect of Act on Notifications. Since the maternity 

 benefit came into force in January there has been a 

 marked difference in the notifications of births viz., 

 a decrease of notifications by the Maternity Hospital 

 staff, and a corresponding increase in notifications by 

 doctors in private practice and by midwives. Many 

 " handy-women " and midwives in past days have 

 apparently returned to their old duties after some 

 years of comparative leisure, and naturally, serious 

 evils are expected to result ; but, up to the present 

 time, we have not been able to prove that there has 

 been any disastrous effect by this. In many cases, 

 too, midwives are so anxious to secure more cases 

 than formerly, now that the prospect of their payment 

 is comparatively secure, that they cease attending 

 about the sixth or seventh day of the puerperium 

 and pass on to new cases. 



The marked decrease in the number of cases 

 attended by the Maternity Hospital nurses is difficult 

 to explain wholly, as the hospital staff has always been 

 instructed to ask donations from patients attended, 

 and at no time is attendance refused on the ground 

 that the person is able to pay for other attendance. 

 At present, the hospital authorities try to visit (in so 

 far as compulsion lies within their province) on a 



