[Report 1959] / Medical Officer of Health, Somerset County Council.

  • Somerset (England). County Council.
Date:
1959
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1959] / Medical Officer of Health, Somerset County Council. Source: Wellcome Collection.

    15/116 (page 13)
    ANTE-NATAL CARE Ante-natal care in most rural and some uroan areas has for some long time now been a midwife/general practitioner undertaking and their joint clinics have served both hospital and home booked cases. No County premises are used for this purpose but the clinic at the Mary Stan¬ ley Home, Bridgwater, mentioned last year, is working well. The mid¬ wives attendances on twelve doctors do however occupy a great deal of time and this is the chief disadvantage of extending the idea to other large towns. The County ante-natal clinics still operating are very large¬ ly blood taking clinics with medical examination of the occasional patient referred by her general practitioner or, rarely, without a doctor booked. Domiciliary mid wives run clinics at the same or separate times as an alternative to visiting patients booked for home delivery for examinatiorr in their own homes, so the domiciliary midwife gets to know her mothers well The hospital midwife on the other hand is often unlikely to see her patient beforehand since few general practitioner units have an ante-natal clinic although some now invite the expectant mother to call in and see the unit and meet the staff. The use of a record card carried by the patie'^t — agreed in principle in the Bath and Bristol Clinical areas has few disadvantages which cannot be overcome, while its chief value would be in providing a-continuous record of ante-natal progress which is very likely to be available to the attendants at the confinement. It should in¬ cidentally reduce over-examination by two groups working independently and also help in the care of mothers moving about in this period, such as the unmarried mother going to hostel or mother and baby home. Some large maternity hospitals distant from the patient’s home area already insist that every one has a card. Immediate follow-up of defaulters from ante-natal clinics depends on accurate records, and should be simplest in a hospital fully equipped with clerical staff. A letter of reminder, however, while simple and often employed is unrealistic since it assumes the patient was weU and an appointment for the following week may leave a developing toxaemia un¬ diagnosed too long. The obvious course of asking the family doctor r midwife to visit, examine and remind about another appointment is st not generally enough used. In the past year measures introduced foUo ' ing discussions with the staff of St. Martin’s Hospital in Bath has ‘t ^ hooed improved the surveillance of cases booked there so that ante nat suSvisZ at hospital or home is assured. In the domiciliary field there L the same need for co-operation and an agreed frequency of examination y Ictor'and midwife in Lrmal cases so that none escapes supervision. More education of paUents (or their husbands) in the need tor this care is still required.