CHAPTER XX. HOME DELIVERIES AND CARE OF THE YOUNG MOTHER BY VISITING NURSES. Forms and Routines of the Philadelphia Visiting Nurse Society.
CHAPTER XIX
ORGANIZED PRENATAL WORK
The foregoing discussions of prenatal care and the principal complications of pregnancy, and the dangers to which expectant mothers, young mothers and their babies are exposed, bring us sharply face to face with the questions, “What can be done about it?” “What is being done about it?” and, “Is anything more possible?”
We have considered the problem, and the remedy, at very close range; that is, from the standpoint of the individual patient. We are now concerned to know whether or not the remedy, in the shape of care and supervision during pregnancy, may be extended in proportion to the enormous multiplication of the problem, when instead of one patient we must think of millions. In other words, is country-wide prenatal care, with all that it implies, practicable? And if so, by what means or method?
Let us review the problem for a moment, and acknowledge the pathos and tragedy of it.
Child-bearing is so dangerous, under present conditions in this country, that it stands second only to tuberculosis as a cause of death among women between the ages of 15 and 44. The discharge of woman’s supreme function is apparently very hazardous.
Dr. Dublin summarizes as follows the rate at which mothers die throughout the country at large:
1. “More than seven women die from disorders of pregnancy or childbirth out of each 1,000 confinements. This is equivalent to one maternal death out of every 140 confinements. (About 20,000 in 1920.) 2. “Forty-five babies out of every 1,000 births, or one out of every 22, are born dead. (About 112,000 annually.) 3. “Forty babies out of every 1,000 born alive, die before they are one month old. (About 100,000 annually.) “Such are the dangers to mother and infant at the present time.”
And then, as though in answer to our question, “What can be done about it?” he states that, “among women who receive prenatal and maternal care under skilled direction:
1. Only two women instead of seven die out of every 1,000 confinements. 2. Only twelve babies, instead of 45, are still-born in every 1,000 births. 3. Only ten babies, instead of 40 per 1,000 born alive, die before they are one month old.”