WHAT THE OBSTETRICIAN CAN DO TO PREVENT 

 INFANTILE MORTALITY 



By J. WHITRIDGE WILLIAMS, Professor of Obstetrics, 

 Johns Hopkins University, Baltimore 



As obstetrics deals with the care of the mother and her infant 

 during pregnancy, labor and the puerperium, it follows that the 

 duties of the obstetrician are not limited merely to the conduct 

 of labor, and to the care of the mother and child for the few 

 weeks immediately following it ; but, likewise, include supervision 

 during the entire pregnancy, as well as fbr so long a period after 

 delivery as may be necessary for the patient to regain her usual 

 health, and to leave the genitalia in such condition as will give 

 reasonable assurance of normal pregnancies in the future. 



We must learn to regard the occur ranee of abortion or pre- 

 mature labor, as well as the death of the normal child at the time 

 of delivery, or its loss from preventable causes at a later period, 

 as an unnecessary economic, physical and biological waste, not 

 to mention the personal grief or blasted hopes which may be 

 associated with it. 



Moreover, we must recognize that advice as to the prevention 

 of conception may become a medical duty, for under certain ab- 

 normal conditions it is better for a woman not to become pregnant 

 than to go through a series of abortions or premature labors dep- 

 pendent upon them. Thus, it is preferable for a syphilitic woman 

 to remain sterile, rather than to give birth to a series of dead-born 

 premature children or to puny offspring, which will be seriously 

 handicapped in later life. The same holds good for women suffer- 

 ing from tuberculosis or advanced heart disease, in the hope of 

 avoiding the induction of therapeutic abortion, which may later 

 become necessary. I do not wish to be misunderstood in this 

 regard, as I hold that one is not justified in giving such advice 

 merely for the convenience of the patient, but should do so only 

 in the presence of some pressing indication. 



We must also learn that the birth of a puny or damaged child 

 is a great misfortune, as its chances of reaching maturity are 

 greatly diminished, not to speak of the additional expense to 

 the individual or the state entailed in rearing it. Thus, it would 

 seem that the obstetrician may aid in the prevention of infantile 

 mortality, not only by his conduct at the time of labor and by 

 the care of the child during the first few weeks of its life, but 

 even more so by the institution of certain prophylactic measures 



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