We frankly admit that as things now stand--apart from the possibility of the maternity benefit being made to help her--midwifery is financially but a poor profession. But to an enthusiastic lover of her kind, who has other means or prospects for her future than the proceeds of her profession, there is much that is attractive in this most useful calling.
Now let us turn to a consideration of the poor mother. Dr Matthews Duncan in 1870 put the puerperal mortality at 1 in 100 for in-patients and 1 in 120 for patients in their own homes--shocking figures for a physiological event! Miss Wilson, a member of the Central Midwives Board, stated in 1907 that the average mortality of English women, from puerperal fever, a preventable disease, is 47 in 10,000 or _1 in 213_, but that in three of the best lying-in hospitals this figure has been reduced to less than _1 in 3,000_. To quote Miss Alice Gregory in her article on this subject in _The Nineteenth Century_ for January 1908: "We feel there is something hopelessly wrong somewhere. It becomes indeed a burning question: By what means have the Maternity Hospitals so marvellously reduced their death rate?"
The answer is not now far to seek in the opinion of the writer, who has worked continuously at Midwifery since 1st May 1884. It is probably wholly contained in the three following points:--
(1) All that makes for scrupulous asepsis in every detail for the surroundings of the mother.
(2) The absence of "Meddlesome Midwifery."
(3) Pre-maternity treatment, a factor which the writer considers to be of great importance, and of which she would like to have much more experience.
By this is meant the building up of the future mother's health by improved hygiene and careful, wise dieting and exercising and bathing during the last three months of pregnancy, which enables many a stumbling-block to be removed out of the way. Hence, the utility of pre-maternity wards wisely used. This is, one knows, a "counsel of perfection"; but every expectant mother should and could be taught how to treat herself wisely at this time.
These three points are all in favour of the well-trained midwife.
(1) _Scrupulous Asepsis_, if intelligently taught, can be learned in six months' training, though one feels bound to add it requires moral "grit" in the character to make one unswervingly faithful in observing it. The midwife, too, should run no risk of carrying infection from others, as a doctor might do.