64 | Hattie Plum Williams 
but artificial feeding is not a factor in the infant mortality of the 
Russian German settlements in Lincoln, for this practice is almost 
unknown among these foreign mothers. This reduces the prob- 
lem of a pure milk supply to a minimum, particularly since many 
of the people keep their own cows which they pasture on the edge 
of the settlement, and which supply themselves and their neigh- 
bors with fresh milk.*° 
The bad effect of midwifery upon the infant mortality rate is 
often alleged, and it is true that the Russian Germans employ 
these women very largely. In 1914, 201 of the 390 births re- 
ported among these foreigners were attended by midwives, and 
only 186 by physicians.*° According to the health records the . 
work of the midwives is increasing, although this is probably only 
apparent, due to the fact that they have not been held strictly to 
account in reporting births until very recently. There are six or 
eight of these Russian German women, all of whom are untrained 
and who have no legal or professional standing in the community. 
Nevertheless the sum total of their work in the foreign settlements 
redounds to the good, rather than to the harm, of their patients. 
They are, as a rule, cleanly in their habits, as is evidenced by the 
fact that puerperal septicaemia practically never results from their 
work. Besides they do not attend infectious. cases as do the 
regular physicians, who not infrequently transmit infection in this 
way. ‘They are more patient and careful than the doctors who 
“treat the people like dogs,” in the words of one of the physicians 
themselves. Their fees are low, averaging from $5 to $8 a case 
and, in addition to the technical services they perform, they nurse 
45 Several years ago an attempt was made to check the infant mortality 
in the settlements by the establishment of a pure milk station in the ward 
school building. During two months’ existence only one call was received 
(and that largely from curiosity) although milk from the University 
Experiment Station was furnished at less than cost. The plan failed, not 
because the people were too stubborn, or too ignorant, or too heartless 
regarding their children to receive the proffered help, but because it did 
not meet the need in solving their problem. 
46 From 30 to 85 per cent. of the deliveries of infants in large cities are 
in the hands of these women. Newmayer, “The Warfare against Infant 
Mortality,’ in The Public Health Movement, Annals of the American 
Academy of Political and Social Science, XXXVII, number 2, 295. 
190 
