MATERNAL MORTALITY.

New Zealand Herald, Volume LXVII, Issue 20525, 28 March 1930, Page 16

MATERNAL MORTALITY.

Sir, —Dr. Gordon should be .more accurate. There is nothing in my letter in the Herald of March 17 which justifies Dr. Gordon's .statement that I am advocating concentrating our energies on annexes, instead of supporting the endowment fund for the obstetrics chair. The object of my last letter was to draw attention to the good work done by New Zealand annexes and to point out that of the many remedies proposed for that obstinate blot on our bill of health called maternal mortality, none can compare with the work done by the annexe. My hope is that the obstetrics chair will help the annexe by explaining their advantages to reactionary hospital boards which are lagging behind their neighbours in this reform, and that the annexe will help the professor by providing him with centres to which he can Send his students to learn practical obstetrics after they have absorbed the wisdom of his Lectures. A subsidiary object of my letter was to deprecate the sensational statements which were being made in the campaign for the fund. Four things are necessary for the safe practice of obstetrics: Healthy surroundings free from anxiety and worryin which surgical cleanliness can tfc easily, practised; an experienced obstetrician; a trained nurse; the certainty of being able to obtain promptly the assistance of another medical man when necessary. Only in exceptional cases can these four requisites be obtained outside a hospital annexe and until, they are obtained the result of an obstetrical case, good or bad, will be largely beyond the control, of the obstetrician, and the maternal mortality will not be decreased. the annexe system is adopted they should not be in country districts, but towns where hospitals already exist. In these townsthere would be no difficulty in finding medical men to staff them and the officers of an annexe should be men who are inclined to specialise in that branch of their profession and are not prevented by the calls of a busy practice from giving the time necessary for an obstetric case. There will be no difficulty in transporting country cases by motor ambulance if / ordinary foresight is observed. No sane person will question the necessity for the obstetrics fund and for (he appointment of a professor of obstetrics in Dunedin University to teach the students, but to emphasise so strongly as Dr. Gordon has done the connection between the professor of obstetrics and the reduction of maternal mortality is to court disappointment and ignore the experience of other countries. In England, Scotland and Wales, in spite of many professors of obstetrics, the maternal mortality is much the same as it was 30 vears ago. E. S. Nutting", M.D., Edin. Inglewood, March 23, 1930. 'j