Environment and Childbearing

Professor Baird: The great importance attached to a thorough training of doctors and nurses wishing to practise midwifery has possibly exaggerated the importance of the part they play in pregnancy and labour.For example, the impression is created that they play an active and essential part in normal parturition when, in fact, most women deliver their babies almost unaided and the outcome of pregnancy depends more on the physiological efficiency of the mother than on the standard of medical and nursing care.The healthier and more efficient the population, the less elaborate need the maternity services be, so that money and resources spent on education and social services and on preventive medicine should result in saving in expenditure on curative medicine.It seems reasonable to suppose that those reared in a good environment will show better results in childbearing than those brought up in poor circumstances.In the past, this has not been at all clear from mortality statistics, since maternal mortality was just as high in Social Class I as in Class V, and although there was a social gradient in the case of stillbirths the difference between the rates in Social Classes I and V was slight compared with that for inifant mortality.