Personal Fulfillment and Professional Excellence: Dorothy Reed Mendenhall, Pathologist and Children’s Bureau Investigator

A. Early and complete birth registration. Births should be registered within 5 to 10 days after delivery. In cities there is no reason why births should not be registered within a week. Dr. Herman N. Bundesen, until recently health commissioner of Chicago, reports that 95% of the births in that city for 1925 were recorded within the 10-day limit required there. In Newark, N.J. 95% of the midwives are reporting births within 24 hours after delivery. The law there requires that births shall be reported within 5 days after delivery. B. Safeguarding the mother and baby through prenatal care. Maternity (prenatal) centers should be available for all women not able to be under the direct supervision of a private physician during their entire pregnancy. An educational campaign should be conducted to induce all pregnant women to place themselves under the care of their physicians or to go to a prenatal clinic early in pregnancy. Prenatal centers should be established in connection with infant-hygiene centers, either publicly or privately supported or in connection with hospitals connected with medical schools. These prenatal centers should have a well-trained, experienced personnel, both medical and nursing, adequate in number. Physicians and nurses who have an interest in the maintenance of such a service should be engaged. A physician’s contact with the mother should be made as early in pregnancy as possible. A complete medical history should be recorded by the physician; and a physical examination given, including weight, pulse, temperature, blood pressure, urinalysis, and if possible a Wasserman test. The outline for the prenatal examination and the subsequent routine care prepared by the obstetrical advisory committee of the Children’s Bureau (see Standards for Prenatal Care; an outline for the use of physicians, U.S. Children’ Bureau Publication No. 153) or that used by the Maternity Center Association of New York or by other successful prenatal clinics should be followed. Each prospective mother should make regular visits to the clinic for examination or advice every month in early pregnancy, and every two weeks or oftener in late pregnancy. Follow-up visits to every mother should be made by the nurse. One home visit for every case is not enough, but it would be a great improvement over the present practice in the District. Women with certain symptoms may need many visits by the nurse to their homes. Uniform and standard records should be kept up to date and in a form easily available. United States Children’s Bureau Publication No. 153 gives a record blank that is widely used.