The kitchen should be well placed, conveniently near, yet sufficiently
cut off from the main corridor by a neck of passage and intermediate
offices.
_SITE._
The site of a lying-in institution must be open, airy, surrounded with
its own grounds, not adjoining or near to any other building, still less
to any hospital or any nuisance or source of miasm. But it must be in
the immediate vicinity of any large centre of population from which the
lying-in women come.
And this involves the question of receiving-rooms.
Should there be a receiving-room, as well as a waiting-room?
The lying-in woman’s name is put down for admission some time
beforehand.
Lying-in hospitals differ as to their rules whether or no to admit women
any time before labour is imminent. If they are not so admitted, they
often have to be sent back again home.
It is now believed to be the soundest principle that the fewer days a
lying-in woman spends in a lying-in institution, beyond the time she is
actually under treatment, the better; and this involves that she should
not be admitted till labour is imminent—even at the risk of the infant
being born in cab or lift (which _has_ happened).
Lying-in institutions must (unfortunately) be, therefore, in the
immediate neighbourhood of great towns or centres of population.
[Even those London Boards which are building their excellent new
workhouse infirmaries in the country, are forced to keep their lying-in
wards in the old workhouses in the town.]
The difference, however, as has been shown by our statistics, is not so
great between the mortality of women lying-in at home in the country and
in the town as should make us pronounce against lying-in institutions in
great centres of population—provided they have a large and entirely
isolated area completely to themselves, perhaps a proportion of two
acres to fifty beds.
But this involves another question.
A large proportion, alas! of workhouse lying-in women (we have seen
two-thirds at Liverpool[21]) are unmarried. Of these many have no home.
It is difficult to send these women back again, even if labour is not
actually imminent. And it is impossible to send them out after delivery,
till recovery is fairly confirmed.
In workhouses the question is solved by women being admitted into the
body of the house during pregnancy, and discharged into the body of the
house, if not to their own homes, when quite convalescent.
In Liverpool Workhouse fourteen days after labour the lying-in women are
thus discharged. Fourteen, eighteen, twenty-one days, are the average of
a woman’s stay in the lying-in division in London workhouses.
A soldiers’ wives’ hospital takes in no unmarried women to lie-in.
Civil lying-in institutions almost invariably have to make exceptions
and take in unmarried women.
In workhouses they are not the exception, they are the rule. Married
women are the exception.
It is to be observed that married women will rarely come in an hour
before, or stay an hour after it is necessary, in any lying-in
institution.
Ten to twelve days is ‘the average period of hospital treatment’ in
Colchester, Woolwich, and other soldiers’ wives’ lying-in hospitals.
‘Women of this station of life cannot, as a rule, be prevailed upon to
submit to longer detention,’ it is added.
The average number of days in King’s College Hospital lying-in ward was
sixteen. None were permitted to leave under fourteen days. Twenty-one
days were _allowed_, in ordinary cases. It is feared this might be too
long; but so very many weakly, half-starved women sought admission, that
to send some away sooner was ‘to ensure a breakdown,’ it is stated.
In a civil lying-in institution it would not be by any means desirable
absolutely to exclude single young women _primiparæ_; it would be
grievous to some of these poor things to be sent among the (often
hardened) wretched women of the workhouse. The whole question of these
poor young women—unmarried mothers of a first child—is full of
difficulty. It would never do, morally, to make special provision for
them. And for this very reason we seem bound to receive such,
conditionally, into well regulated lying-in institutions, and afford
some kindly care to prevent, at the very least, their sinking lower. But
it would not be right to leave any admissions for single women in the
hands of any young assistant, or morally inexperienced person.
The principle appears to be that, if pregnant women are to be received
some time before and kept some time after delivery, the excess of time
should not be passed in the lying-in wards, but in separate
accommodation.