A National Maternity Service
One grave exception to the general improvement in health and mortality during the last quarter of a century has throughout that period baffled the medical profession. It is in regard to maternal mortality. The creation of a national maternity service, recommended in a report of the Royal College of Obstetricians and Gynaecologists, is one of the matters that should be considered in connection with the new National Health scheme. The committee is convinced that the death-rate among mothers could be considerably diminished if better provision were made for care before, during and after birth. It recommends the division of the country into areas, with key centres fully equipped with clinics, laboratories and research facilities, and, associated with these, divisional maternity centres and smaller local centres. If this proposal is to be linked up with those of the White Paper it may be presumed that the areas would correspond with the regions contemplated by the Government. Lying-in beds would be provided in every area, with ante-natal services and departments for the care of infants, and improvements are also urged for treatment after birth. The committee does not appear to recommend that all expectant mothers should go to maternity centres, but is of the opinion that only practitioners of special experience should practise obstetrics. The question of maternity should not, obviously, be considered in isolation, but in connexion with the new organisation of National Health. An im- provement in mortality rates is likely to be effected not only by treatment at the time of maternity, but by more knowledge of the proper regimen in the months before child-birth.
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