Midwifery and Nursing.—These services should be organised by the Public Health Authorities, which already supervise midwives. Longer training for midwives should be required, and an adequate salary secured to them by the Public Health Authorities. A charge of 10s. might be made to mothers employing them, to be remitted if the circumstances require it. This is the only method of meeting the present shortage of midwives, which is particularly serious in rural districts. It is also the only way of securing skilled attention for the women at a charge within their reach, and at the same time of securing adequate payment for midwives. Municipal midwives could be employed with a doctor.
The administration of the Treasury grant for nursing should also be placed under the Public Health Authority.
Maternity and Infant Centres.—These centres should be places where expectant and nursing mothers and children up to school age can come for advice and treatment, so that they may be kept well and made well. Their organisation will depend on local circumstances, but it will be found desirable in most cases to open several centres, so that they may be near the people’s homes and serve the different classes of women in different localities.
Advice to expectant mothers might be given either at local maternity centres or at centres at hospitals.
It is important that treatment of a simple nature should be given with advice at maternity centres. Nourishment being often the treatment mothers most need, provision should be made for dinners for expectant and nursing mothers when ordered by the doctor. Simple talks on personal hygiene, infants’ clothing, etc., should be arranged, and saving-clubs organised.
Medical Service.—It is desirable to appoint women doctors as municipal officers of the centres, but local practitioners may in some cases be advantageously worked into a municipal scheme. The provision of a doctor called in under the Midwives Act should be part of the scheme.
Maternity Hospitals or Beds.—The dearth of such hospitals for abnormal cases is calamitous. The need for their existence is also pressing from the point of view of research, and they could be used as training schools for doctors and midwives.
Maternity Homes.—These are required for normal cases. The few voluntary homes in existence in England are most valuable, and the experience of New Zealand shows that municipal homes could be made self-supporting. Private doctors might attend their patients in the homes.
Milk Depots.—The difficulties of securing pure milk make it desirable to establish municipal depots for the supply of milk to expectant and nursing mothers and children. While every precaution should be taken not to undermine the practice of breast-feeding, there are cases where specially prescribed bottles would be useful.