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trained midwife. It is the right of every woman to have skilled attend
ance during pregnancy, labour and the puerperium.
6. The present review of the midwifery services . in the different pro
¬ v i n c e s o f I n d i a r e v e a l s a v e r y u n s a t i s f a c t o r y s t a t e o f a f f a i r s , b u t o n e
should not be unduly pessimistic, for it must be remembered it is only
within the last 20 years that comprehensive schemes for the care of the
expectant, parturient and nursing woman have been established in Europe.
In India poverty, ignorance and illiteracy are wellnigh insuperable factors
to be overcome and the task is gigantic but a start has been made and
in practically all the provinces attempts are being made to meet this
national problem.
7.
In Madras the object aimed at consistently has been to replace the
indigenous dai by means of a superior class of midwife and this Presi
¬ d e n c y w a s t h e f i r s t t o p a s s a n A c t f o r t h e r e g i s t r a t i o n o f n u r s e s a n d
midwives which was intended to eliminate the untrained dai. The Madras
Presidency is educationally the most advanced in India and "purdah"
hardly exists, women go to hospital freely for their confinements and
many educated girls have taken up nursing as a profession, so that the
supply of trained midwives is much greater in Madras than in North India.
In 1931 a special section of maternity and child welfare was set up in
the Department of Public Health and a medical woman was appointed as
Assistant Directress of Public Health. Local authorities administer their
own services under the guidance of the Director of Public Health and
under the control of local Health Officers assisted by specially trained
women medical officers. In 1936 there were 140 centres under the various
local bodies (excluding Madras city) and a cadre of 32 medical women,
27 health visitors and 307 midwives. In the Madras Presidency there are
also exceptionally good facilities for institutional treatment. There are
1,168 beds available for urban and 389 for rural areas. The large hospitals
have well run antenatal clinics attached to them.
8. B o m b a y .
—The maternity service in the Bombay Presidency.
where the difficulties of domiciliary service are considered to be excep-
tionally great, because of poverty and unhealthy surroundings, is tending
more and more to be of an institutional type. Maternity Hospitals and
Homes have been opened in considerable numbers. There are 2,436 beds
available in urban centres and 199 beds in mofussil areas. These figures
indicate that only one bed is available for about 54 confinements in the
urban and about 3,130 confinements in rural areas. The Lady Wilson
Maternity Association Dai Scheme was started to train the indigenous
dais practising midwifery in the rural areas and some useful work has
been done, but the supply of efficient help is inadequate to meet the
great need. The Bombay Mofussil Maternity and Child Welfare Council
has recently been inaugurated and has opened Welfare Centres in different
parts of the Presidency, but the mass of the people are not touched.
9. United Provinces.—The maternity service in the United Provinces
is possibly one of the most extensive in India. In addition to the institu-
tional service which is chiefly under the aegis of the Countess of Dufferin's