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Maternity in great Britain
602
BOOK
REVIEWS
Am. J. Obst. & Gynoc. September,
1941
his
treatment of heart lesions, preferring delivery from below. The chapter on cesarean strongly emphasizes the reasons for the low incidence of cesarean section in this Georgia clinic. This personal exposition on obstetric practice is directed toward those physicians and obstetricians who do the bulk of obstetrics in the United States. Torpin offers for them techniques which, for most conditions, can be used in the home. In this book they will find much valuable and practical information. PIIIl.11~ F. ~‘;ILLIANR. sectlon
The proceedings of the Conference of the Committee on Human Reproduction of the National Research Council, held in New Pork City in January, 1948, on The Normal and Pathological PhYsiologY of Pregnancys appear in bound form after earlier journal publication. This monograph is the sixth in a series on problems of reproduction. One conference session dealt with the subject of nutrition in pregnancy, in which Warkany discussed his recent experimental production of deformities. Darby and his co-workers demonstrated how the nutritional status during pregnancy could be assayed by biochemical methods, while Burke and Dieckmann discussed their clinical studies in the Lying-in Hospitals of Boston and Chicago, with observations and results somewhat dissimilar. Four papers were devoted to the physiology of the toxemias of pregnancy. Page brought up to date recent research on placental dysfunction as an etiological factor. Munnell reviewed the subject of liver function in pregnancy, both normal and abnormal, while Kellogg, and Cosgrove and Chesley described certain findings in the toxemias, Kellogg from the standpoint of hemorrhagic lesions, and the latter authors more as to the clinical management. Reynolds and his associates, in their paper on patterns of uterine contractility, give the results obtained by use of a multichannel tokodynamometer. With this method they have analyzed contractions in various types of inertia, regional retraction rings, nondilatation of the cervix, and false and normal labor. Their study shows reasons for various types of alterations in labor mechanisms, with suggestions as to how such alterations might be treated. Peters and his co-workers suggest the determination of serum iodine as 3. more appropriate measurement of infertility, habitual miscarriages, or the toxemias of pregnancy. This paper is interestingly correlated by the study of Delfs and Jones on endocrine patterns in abortion. Venning discusses the mode of excretion of hormone metabolites in normal pregnancy, and Dobriner and his associates discuss the excretion of ketosteroids in normal and abnormal pregnancies. These are outstanding contributions on the physiology of pregnancy and represent the latest word regarding intensive investigation at present being pursued in many laboratories and clinics. Only slightly less important than the material presented in the papers are the excellent discussions by other investigators following each paper. This monograph deserves reading and study by all who are interested in the problems of reproduction for although the material is on a high scientific level there is much of YHiLn? I!‘. wlI~LIabts. practical significance in this text. This book, Maternity in Cireat Britain,7 presents the results of an inquiry into preg nancy and childbirth made in England in 1946, the basic material being 14,000 women who gave birth to a child in a certain specified week of that year. The inquiry was under the sponsorship of a joint committee of the Royal College of Obstetricians and Gynaecologists and the Population Investigation Committee. Briefly, the investigation has attempted to answer the following questions: What services are available to women bearing childrenT How far are they used and what are Pregnancy, Psoceedings of the Conterenre NatRoaat Research Co~aeil, on Rebeif of the New Horlc Oity, January, 11348. 176 pages The Wflliams & Wilkins Company. Baltimore, 1948. with many illustrations and tables. 5Uatemity In Great Britain, A Snrveg cd Stiel and Eaw~mlc AapPscta of Pregnancy sad ChIldbirth Undertsken by B Joint O~mmlt)as ai the Rer& U&e$fe et TRhetriM aid R%%#eeologists and the Peaulation Inve&is~~&b C~Mtt%e. 220 p&gee and 2 appendices. Geoffrey of the Nrxtional
BThe Normal Ccimmittee Committee
Cumberlege,
Oxford
on
and
Pathological PhysioLegs Human Reproductfen or~the on Maternal Em&h, H&d
University
Press,
London,
of
in
New
York,
Toronto,
1943.
BOOK
REVIEWS
603
as a normal the factors affecting their use? Do they help women to regard childbirth processS How far do they prevent premature birth and infant death and promote the health of mothers and infantsl Finally, what do parents spend on pregnancy and childbirth9 The method used in the inquiry seems to have been sufficiently broad to complete the aims and one can feel that the sample was adequate as to regions, frequency of births, housing, social classes (economic) and in relation to frequency of stillbirths and neonatal deaths. The subject matter of the text develops all of the general problems of maternity, antenatal care, care during confinement, relief of pain, and an extremely interesting chapter on the costs of childbearing. In 1936, the English well-to-do apparently spent an average of $228 for the first baby, while manual workers’ wives spent $144. Less motley was spent for subsequent births, and poorer mothers economized progressively as their families grew in size. There was, of course, a marked difference among women who received care under municipal schemes. A section discusses the provisions of the National Health Service Act for free confinement care which has not removed many of the economic obstacles to childbearing in Great Britain. Such special aspects of the maternity problem as prematurity are brought out. The conclusion is drawn that a reduction in prematurity should be expected from the improvement in the quality of the antenatal service rendered in Great Britain. As to the topic, “Infant Feeding,” it is shown that 43 per cent of the inquiry mothers are wholly bottle feeding their babies at the end of the eighth week, and again the editors of the report feel that antenatal supervision stands out as a more important factor in the maintenance of lactation than any other factor. As to women in industry, it was found that most of the primigravidas employed in gainful occupations during pregnancy terminated their employment in mid-pregnancy and only a few, a small proportion of them, intended, at a date two months after the delivery, to resume such occupation. Home nursing received .attention in the report. Illegitimately pregnant women suffered with respect to antenatal care; as to confinement care, it was about equal with others. In regard to economic circumstances these women were at a great disadvantage as compared to married women. Many became destitute and the assistance available to them in Great Britain was considered most inadequate, The concluding chapter has many sound recommendations for the improvement of the faults brought out in the inquiry. It will be interesting to see a repetition of such an inquiry after the National Medical Service Act has been in operation for a few years. For those who are interested in the social and economic aspects of pregnancy and childbearing, and all physicians should be interested, the book offers a great deal of value. PHILIP F. WILLIAMS. A three-volume Obstetrics-Phyaiolog, Pathology, Operationss by Martius, assisted by Bickenbach, Nordmeyer, and the artist, K&the Droysen, is the first important German contribution submitted to us since World War II. The publisher is the old firm of Georg Thieme, now in Stuttgart. I do not know why the ages and birthplaces of the authors are given-perhaps a military regulation; also the number of copies printed, 4,500. The object is to present a simple, noncontroversial exposition for students and physicians. The illustrations, in the main, are new. %ehrbuch der Geburtschilfe. van Prof. Dr. Med. Heinrich Martius. Direktor versitlits-Frauenklinik GSttingen. Unter Mitarbeit Van Professor Dr. Med. Werner Professor Dr. Med. Kurt Nordmeyer: K&the Droysen als Zeichnerin. Erster Teil: Unvergnderter Neudruck. Yit 539. Zum Teil Farbigen Abbilllungen. 568 pages. Patbologie, UnverXnderter Neudruck, Mit 486, Zum Teil Farbigen Abbildungen.
Georg Thieme Stuttgart.
1948.
- Die Geburtsbilflichen Operatlonen. ftlr Studierende und Gebrauschsbuch fur der Universitllts-Frauenklinik GiSttingen. Georg Thieme. Stuttgart. 1948.
der UniBickenbach; Physiologle,
Zweiter Teil: 605 pages.
Ihre Ausfiihrun und Anwendung. Ein Lehrbuch Prof. %r. Med. Heinrich Martius, Direktor Auflage. Mit 281 Abbildungen. 287 pages.
iirzte. von Sechste
BOOK
REVIEWS
Am. J. Obst. & Gynoc. September,
1941
his
treatment of heart lesions, preferring delivery from below. The chapter on cesarean strongly emphasizes the reasons for the low incidence of cesarean section in this Georgia clinic. This personal exposition on obstetric practice is directed toward those physicians and obstetricians who do the bulk of obstetrics in the United States. Torpin offers for them techniques which, for most conditions, can be used in the home. In this book they will find much valuable and practical information. PIIIl.11~ F. ~‘;ILLIANR. sectlon
The proceedings of the Conference of the Committee on Human Reproduction of the National Research Council, held in New Pork City in January, 1948, on The Normal and Pathological PhYsiologY of Pregnancys appear in bound form after earlier journal publication. This monograph is the sixth in a series on problems of reproduction. One conference session dealt with the subject of nutrition in pregnancy, in which Warkany discussed his recent experimental production of deformities. Darby and his co-workers demonstrated how the nutritional status during pregnancy could be assayed by biochemical methods, while Burke and Dieckmann discussed their clinical studies in the Lying-in Hospitals of Boston and Chicago, with observations and results somewhat dissimilar. Four papers were devoted to the physiology of the toxemias of pregnancy. Page brought up to date recent research on placental dysfunction as an etiological factor. Munnell reviewed the subject of liver function in pregnancy, both normal and abnormal, while Kellogg, and Cosgrove and Chesley described certain findings in the toxemias, Kellogg from the standpoint of hemorrhagic lesions, and the latter authors more as to the clinical management. Reynolds and his associates, in their paper on patterns of uterine contractility, give the results obtained by use of a multichannel tokodynamometer. With this method they have analyzed contractions in various types of inertia, regional retraction rings, nondilatation of the cervix, and false and normal labor. Their study shows reasons for various types of alterations in labor mechanisms, with suggestions as to how such alterations might be treated. Peters and his co-workers suggest the determination of serum iodine as 3. more appropriate measurement of infertility, habitual miscarriages, or the toxemias of pregnancy. This paper is interestingly correlated by the study of Delfs and Jones on endocrine patterns in abortion. Venning discusses the mode of excretion of hormone metabolites in normal pregnancy, and Dobriner and his associates discuss the excretion of ketosteroids in normal and abnormal pregnancies. These are outstanding contributions on the physiology of pregnancy and represent the latest word regarding intensive investigation at present being pursued in many laboratories and clinics. Only slightly less important than the material presented in the papers are the excellent discussions by other investigators following each paper. This monograph deserves reading and study by all who are interested in the problems of reproduction for although the material is on a high scientific level there is much of YHiLn? I!‘. wlI~LIabts. practical significance in this text. This book, Maternity in Cireat Britain,7 presents the results of an inquiry into preg nancy and childbirth made in England in 1946, the basic material being 14,000 women who gave birth to a child in a certain specified week of that year. The inquiry was under the sponsorship of a joint committee of the Royal College of Obstetricians and Gynaecologists and the Population Investigation Committee. Briefly, the investigation has attempted to answer the following questions: What services are available to women bearing childrenT How far are they used and what are Pregnancy, Psoceedings of the Conterenre NatRoaat Research Co~aeil, on Rebeif of the New Horlc Oity, January, 11348. 176 pages The Wflliams & Wilkins Company. Baltimore, 1948. with many illustrations and tables. 5Uatemity In Great Britain, A Snrveg cd Stiel and Eaw~mlc AapPscta of Pregnancy sad ChIldbirth Undertsken by B Joint O~mmlt)as ai the Rer& U&e$fe et TRhetriM aid R%%#eeologists and the Peaulation Inve&is~~&b C~Mtt%e. 220 p&gee and 2 appendices. Geoffrey of the Nrxtional
BThe Normal Ccimmittee Committee
Cumberlege,
Oxford
on
and
Pathological PhysioLegs Human Reproductfen or~the on Maternal Em&h, H&d
University
Press,
London,
of
in
New
York,
Toronto,
1943.
BOOK
REVIEWS
603
as a normal the factors affecting their use? Do they help women to regard childbirth processS How far do they prevent premature birth and infant death and promote the health of mothers and infantsl Finally, what do parents spend on pregnancy and childbirth9 The method used in the inquiry seems to have been sufficiently broad to complete the aims and one can feel that the sample was adequate as to regions, frequency of births, housing, social classes (economic) and in relation to frequency of stillbirths and neonatal deaths. The subject matter of the text develops all of the general problems of maternity, antenatal care, care during confinement, relief of pain, and an extremely interesting chapter on the costs of childbearing. In 1936, the English well-to-do apparently spent an average of $228 for the first baby, while manual workers’ wives spent $144. Less motley was spent for subsequent births, and poorer mothers economized progressively as their families grew in size. There was, of course, a marked difference among women who received care under municipal schemes. A section discusses the provisions of the National Health Service Act for free confinement care which has not removed many of the economic obstacles to childbearing in Great Britain. Such special aspects of the maternity problem as prematurity are brought out. The conclusion is drawn that a reduction in prematurity should be expected from the improvement in the quality of the antenatal service rendered in Great Britain. As to the topic, “Infant Feeding,” it is shown that 43 per cent of the inquiry mothers are wholly bottle feeding their babies at the end of the eighth week, and again the editors of the report feel that antenatal supervision stands out as a more important factor in the maintenance of lactation than any other factor. As to women in industry, it was found that most of the primigravidas employed in gainful occupations during pregnancy terminated their employment in mid-pregnancy and only a few, a small proportion of them, intended, at a date two months after the delivery, to resume such occupation. Home nursing received .attention in the report. Illegitimately pregnant women suffered with respect to antenatal care; as to confinement care, it was about equal with others. In regard to economic circumstances these women were at a great disadvantage as compared to married women. Many became destitute and the assistance available to them in Great Britain was considered most inadequate, The concluding chapter has many sound recommendations for the improvement of the faults brought out in the inquiry. It will be interesting to see a repetition of such an inquiry after the National Medical Service Act has been in operation for a few years. For those who are interested in the social and economic aspects of pregnancy and childbearing, and all physicians should be interested, the book offers a great deal of value. PHILIP F. WILLIAMS. A three-volume Obstetrics-Phyaiolog, Pathology, Operationss by Martius, assisted by Bickenbach, Nordmeyer, and the artist, K&the Droysen, is the first important German contribution submitted to us since World War II. The publisher is the old firm of Georg Thieme, now in Stuttgart. I do not know why the ages and birthplaces of the authors are given-perhaps a military regulation; also the number of copies printed, 4,500. The object is to present a simple, noncontroversial exposition for students and physicians. The illustrations, in the main, are new. %ehrbuch der Geburtschilfe. van Prof. Dr. Med. Heinrich Martius. Direktor versitlits-Frauenklinik GSttingen. Unter Mitarbeit Van Professor Dr. Med. Werner Professor Dr. Med. Kurt Nordmeyer: K&the Droysen als Zeichnerin. Erster Teil: Unvergnderter Neudruck. Yit 539. Zum Teil Farbigen Abbilllungen. 568 pages. Patbologie, UnverXnderter Neudruck, Mit 486, Zum Teil Farbigen Abbildungen.
Georg Thieme Stuttgart.
1948.
- Die Geburtsbilflichen Operatlonen. ftlr Studierende und Gebrauschsbuch fur der Universitllts-Frauenklinik GiSttingen. Georg Thieme. Stuttgart. 1948.
der UniBickenbach; Physiologle,
Zweiter Teil: 605 pages.
Ihre Ausfiihrun und Anwendung. Ein Lehrbuch Prof. %r. Med. Heinrich Martius, Direktor Auflage. Mit 281 Abbildungen. 287 pages.
iirzte. von Sechste