H.—3l.

Table II.—St. Helens Hospitals Statistics—continued.

Ante-natal Clinics. Table 111 gives the returns from 50 free ante-natal clinics, 4 of which are connected to St. Helens Hospitals, 31 with other public maternity hospitals, 10 conducted by nurses of the Plunket Society, and 5_ by licensees of the large private hospitals. The system of attendance at these clinics in most cases is that all normal cases are examined twice during pregnancy by a medical officer and monthly, or more often if necessary, by the nurses in charge of the clinic, most of whom are specially experienced m this work. Ail cases of abnormality suspected or diagnosed by the nurses are referred for medical examination, either by the medical officers of the hospital or, in the case of Plunket or private clinic s, by their own medical attendants. There has been difficulty in some of the hospitals in ensuring that the patients shall all receive medical attention, irrespective of whether they show abnormalities or not. Arrangements that this should be done have been made in most cases. From every point of view this is necessary, particularly in those cases where the patient is attended during labour by a midwife only, who is authorized to administer araesthetics to the obstetrical degree. It is obviously necessary that no patient should have an anaesthetic so administered who has not been examined by a doctor and certified as fit for it. Such an act by a nurse is a breach of the Nurses and Midwives Regulations. Ihe majority of patients receive ante-natal attention from their own doctors, with or without the additional service given by clinics. This service is part of the usual medical service in relation to maternity benefits under the Social Security Act, and may or may not be supplemented by attendance at the clinics. It is hoped that complete co-operation between the clinics and the private practitioners will be obtained. Such a combination should provide an ideal service.

Table III.—Ante-natal Clinics.

36

i i | i ill | | I § Totals. jj£g O S3 .2 © O »-~H rj © M t> S-l O ±_ & a_ ___ A. Intern Department—continued. Infant statistics—continued. Full term— live •• •• .. .. 694 510 361 269 1,834 93-38 Dead— Recent .. .. .. .. 12 10 2 2 26 1-32 Macerated .. .. .. 8 .. 6 2 16 0-81 Putrid Children born alive who died in hospital .. 8 12 12 1 33 1-68 Total born dead or died in hospital .. 30 28 26 10 94 4-79 B. Extern Department. Total attended .. .. .. .. 38 9 52 n no Primiparso Multiparas .. .. .. .. 38 9 52 11 no 100-00 3 .. 3 2-73 MorbidityMortality C. Ante-natal Clinic. First visits— Primiparsc .. .. .. .. 286 195 113 76 670 Multipara; 548 413 328 221 1,510 Return visits 4,312 2,841 2,662 1,061 10,876 Outside visits .. .. .. .. 125 490 676 3 1 294

Average Year " JggS* New Cases. Keturn Visits. A J n tLs. ES&£Returns. per Patient. 1925 .. .. .. 16 2,289 7,816 10,105 4-41 20 3,238 12,554 15,792 4-88 20 3,919 15,406 19,325 4-93 1928 21 5,050 20,740 25,790 5-11 1929 24 5,177 17,555 22,732 4-39 1930 25 6,027 22,078 28,105 4-66 1931 •• .. .. 29 6,306 22,869 29,175 4-63 1932 .. .. .. 31 5,882 22,594 28,476 4-84 1933 33 5,978 25,794 29,772 4-98 ;934 .. .. 34 6,191 24,929 31,120 5-03 •• •• 37 6,725 26,662 33,389 4-96 1936 . ; . .. .. 39 7,069 29,103 36,272 5-13 193? 38 6,746 28,769 35,515 5-28 938 .. .. .. 48 8,221 33,808 42,029 5-11 1939 •• .. .. 50 8,728 34,618 43,400 4-94