1 heart disease, 1 dropsy.

Footnote 16:

The approximate number of deliveries, 6396, given elsewhere, is rather

under the mark than over, as will be seen by this Table, and is taken

in order to be on the safe side. For, up to the three last years, the

numbers are rather estimated than reckoned from the records. The total

annual average deliveries calculated from different monthly records,

i. e. 10 years of months = 500 in round numbers—1858–1867.

The three years 1868–9–70, for which only there are accurate records,

speak for themselves; and they show that the death-rate is

marvellously low: not higher than in the healthy districts of England.

Footnote 17:

An attempt has been made in certain cases to account for the high

death-rates of lying-in hospitals from the large proportion of

unmarried women admitted. This opinion is directly contradicted by the

experience of Liverpool workhouse, where out of 1,401 deliveries of

women, 936 of whom, or two-thirds, were unmarried, there were only 6

deaths = 4·2 per 1,000 death-rate.

Footnote 18:

In Lambeth and St. Pancras the wards are generally full.

Footnote 19:

These arrangements are commonly the same in civil lying-in

institutions.

Footnote 20:

I call a midwife a woman who has received such a training, scientific

and practical, as that she can undertake all cases of parturition,

normal and abnormal, subject only to consultations, like any other

accoucheur. Such a training could not be given in less than two years.

I call a midwifery nurse a woman who has received such a training as

will enable her to undertake all normal cases of parturition, and to

know when the case is of that abnormal character that she must call in

an accoucheur.

No training of six months could enable a woman to be more than a

midwifery nurse.

Footnote 21:

In some London workhouses it is yet larger.

Footnote 22:

The only difficulty is as to protecting the patient (a lying-in woman)

during the transit in cold or wet weather; but perhaps some cover

might be contrived for the bed or litter on which she is carried,

which would be light, easily removable, and which could be exposed to

the free action of the open air when not in use.

Footnote 23:

For a great part of the foregoing details of management I am indebted

to the valuable experience of her, who, as then Superior of the

nursing at King’s College Hospital, conducted our Training School for

Midwifery Nurses there, so kindly, so wisely, and so well, that its

necessary breaking up was the more to be deplored by all.

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