72 INFANT WELFARE WORK 



cago are attended by midwives and, moreover, that the majority of 

 these women are ignorant and untrained, and consequently incapable 

 of properly discharging the functions they assume. 



The condition of the midwives in Chicago, both as to the character 

 of the women practising and the percentage of the births which they 

 report, is duplicated in the majority of our large cities. It would 

 seem that the last word had not been said in connection with the pre- 

 vention of infant mortality so long as we ignore the fact that about 

 50 per cent, of the babies born in this country are attended by women 

 who, by the consensus of opinion, may be pronounced incompetent. 

 Moreover, since the keynote of many of these discussions of work 

 for the preservation of infant life is the importance of teaching 

 mothers how to care for themselves and for their infants, surely 

 an important feature in this work is being disregarded when so pow- 

 erful an instrument as the midwife is not utilized. Her word is law 

 and gospel to her patients. The logical conclusion is then that if 

 the midwife herself knew something of the rudiments of nursing, of 

 hygiene and of the care and feeding of infants, her influence would 

 be far-reaching toward preventing unnecessary death among infants. 



It is deemed necessary for a doctor in this country to take a long 

 course, both practical and theoretical, and to pass a state board ex- 

 amination, before he may practice obstetrics. A nurse must also 

 be trained before she may assume the nursing care of a mother and 

 infant. It seems criminally unjust, therefore, that a midwife who 

 at the outset is often ignorant and dirty in her habits, may, without 

 training and without supervision, discharge all the functions of both 

 doctor and nurse, in attending nearly half the births in this country. 



We have also to consider the long train of disasters which follow 

 in the wake of the midwife among them being, not alone death of 

 infants, but blindness, mental and physical degeneracy, and invalidism 

 and death of mothers. 



These being the facts, it is indeed unreasonable for us to continue 

 to build and equip hospital wards for mothers, conduct schools for 

 the blind and feeble-minded, while allowing these untrained women 

 to pursue their calling in such a way as steadily to increase the num- 

 ber of inmates of these institutions when, if midwives did careful 

 and clean work, many of their patients would be deflected from these 

 institutions. 



In spite of the damaging evidence against midwives in America, 

 they are after all not the ones at fault. The culpability lies with the 

 American public, in allowing this condition of affairs to exist. So 

 far as we are able to discover, this is the only civilized country in 

 the world in which the lives and health of mothers and infants are 

 not safeguarded by means of the training, supervision and control 

 of midwives. 



In countries other than this the question of preserving infant life 

 is regarded as a grave problem, but a question of equal gravity is 

 preserving the mind and body of the infant intact. Society is not 

 enriched through the addition of lame and halt and blind citizens, 

 whereas the person who is normal both in mind and body is re- 

 garded as one of the state's most valuable assets. 



Evidently the problem of the untrained midwife in America must 

 be faced. Either she should not practice at all, or she should be 

 trained and supervised. 



Mr. Edwin D. Solenberger, Secretary of the Children's Aid So- 

 ciety, Philadelphia: I want to say just a word on the subject of this 

 paper, the relation of infant welfare work to the social movement. 



