AMAND ROUTH, M.D., P.R.C.P., ON MOTHERHOOD. 67 



It is her duty when thus engaged to enquire into the history of 

 previous confinements, and to discover any indications of abnor- 

 mal conditions which might lead to premature labour or to other 

 compHcations. 



Every midwife should be in touch with a doctor, directly 

 if working privately, or through the health authority if she is 

 a municipal midwife, and if she should recognize anything 

 likely to cause trouble she must at once, by the excellent rules 

 of the C.M.B., whether during pregnancy or the lying-in, 

 seek medical advice. 



The need for efiicient training of the midwife is obvious, 

 especially as she now attends over 70 per cent, of the total 

 confinements in England and Wales, and, at all events after 

 labour has commenced, is not only the accoucheuse, but the nurse 

 of her patient and of the baby. 



The status and the remuneration of the midwife, especially of 

 those who are living in country villages where fees cannot 

 ensure her a Hving wage, must be improved, otherwise the number 

 of practising mid wives will continue to decrease. 



In 1915-16 there were 30,543 trained and certified midwives 

 on the roll of the C.M.B., but only 6754 were practising midwifery, 

 and although the numbers on the roll continue to increase, 

 the proportion of practising midwives continues to diminish. 



The certified midwife, by administrative or State aid, should 

 be guaranteed a minimum remuneration of at least £150 per 

 annum. 



Other Considerations. 



There are many side issues in relation to motherhood which 

 ought to be shortly considered, but I will only touch on three : — 



Adoption. 



Endowment of motherhood. 

 Assured education. 



Adoption. 



Attempts have been made to bring in a Bill in ParHament 

 to legalize the adoption of children, but it is a particularly 

 difficult subject, for it involves medical, social and legal questions 

 of much complexity. 



F % 



