To insure effective care of Maternity and Infancy, it would be
necessary to combine the administration of benefits under the Insurance
Act with the services organised by the Public Health Authority.
_Maternity and Pregnancy Sickness Benefits._--These should be taken
out of the Insurance Act, extended to all women (under the income-tax
limit), and increased in amount. In addition to the 30s. maternity
benefit, every mother should receive £3 10s. in weekly payments of 10s.
for three weeks before and four weeks after confinement (or for longer
periods if she prefers smaller weekly payments). During pregnancy she
should be entitled to benefit varying according to her condition, from
2s. 6d. to 7s. 6d. a week, if her health requires it, subject to the
recommendation of a maternity centre or a doctor.
Public Health Authorities should be empowered to administer these
benefits through women health officers and maternity centres.
_Notification of Births._--Notification of births and still-births
is now compulsory throughout the country, and in order to make it
effective, an adequate number of Health Visitors should be appointed in
every area.
_Women Health Officers._--The status of Health Visitors should be
raised, their salaries being increased, and three qualifications being
required--_i.e._, midwifery, sanitary, and nursing certificates.
_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.
_Household Helps._--The need for help in the home before, at, and after
confinement is urgent, but in order to prevent untrained women doing
midwifery work, careful supervision and an organised service under the
public health authority are necessary. The experiments made by relief
committees show the value of such a service.
_Women as Councillors._--Working women should be elected on to councils
and serve on public health committees.
_Public Health Maternity Sub-Committees._--These committees should
be largely composed of representatives of the women concerned.
Such representation should be secured whenever possible through the
following industrial women’s organisations: the Women’s Co-operative
Guild, Women’s Trade Unions, the Women’s Labour League, and the Railway
Women’s Guild.
Any parts of this scheme not at first taken over by Public Health
Committees--_e.g._, Dinners, Household Helps--might be organised
experimentally by the sub-committees with a view to ultimate inclusion
in a municipal scheme.
_Ministry of Health._--In the future it will probably be advantageous
to establish a Ministry of Health, with a Maternity and Infant Life
Department, partly staffed by women.
* * * * *
It is essential that Government departments and Public Health
Committees should be in constant communication with organised
working-women, and be ready to welcome their co-operation, so that
their needs and wishes may be freely consulted. It is by a partnership
between the women who are themselves concerned, the medical profession,
and the State that the best results of democratic government can be
secured for the mothers and infants of the country.
* * * * *
To be obtained from the Women’s Co-operative Guild, 28, Church Row,
Hampstead, London, N.W.:
_The National Care of Maternity_ (leaflets for town and country),
1/2d. each, or 3s. a hundred.
_Hints to Expectant Mothers_, by Dr. J. W. Ballantyne, price 1d., or
6s. a hundred.
_Household Helps_, 1/2d. each, or 3s. a hundred.