Evening star., 1938-01-02

Whatever ILLS eApSIlIIleIlI Will mean
to the maternal and infant death rate
OF the Nation-and there are signs
that it will mean lot-in Washing
ton County it means healthy. happy
babies and smiling, confident mothers.
Follow Maternity Nurse.
Follow Ruby Brouillette, dark
haired maternity nurse. over the icy
roads of the county to farm house
near Wellman, Iowa, and you may see
for yourself
Miss Brouillette, in her blve uni
form with white collar and cuffs, is
welcomed at the back door by Mrs.
John Hartsock.
Mrs. Hartsock is the grandmother
OF that fat little cherub in the crib,
born five days ago. The babys
mother-Mrs. Hartsock's daughter
is propped up on one elbow in bed,
eagerly greeting the MUSE.
Miss Brouillette was present when
the baby. Carolyn Ann Speas, was
born. She prepared the way for the
baby. eased the mothers pains, as
sisted the doctor at the delivery. Now
she has come to help Mrs. Speas to
recover as quickly as possible-and to
give the new baby good start in life.
Practical Demonstration.
Miss Brouillette, her sleeves rolled
up. pathes the baby. shows exactly
how each step in child care is done
offers friendly criticism and makes
suggestions both to help the baby and
to make things easier for the mother.
When Miss Brouillette leaves. the
grandmother follows her to the door
My" says Mrs. Hartsock, Its sure
nice to have you come out. / raised
four children myself, but they do
things lot different noWadays-and
better I wish some one like you
had helped me-"
Grandmother Hartsock, comment
ing on the maternal health service in
Washington County, pointed out the
reason for it.
In 1885 maternal deaths and deaths
Of babies in the United States equaled
the population of Des Moines. Ac-
cording to some surveys. approx
imately two-thirds of these deaths
were unnecessary
One day. perhaps, those deaths could
not have been avoided. but times7-as
Grandmother Hartsock pointed out
have changed.
Problem Is to Reach Mothers.
The best medical practice can
avoid many Of these deaths. The
problem is to reach more mothers and
more babies with the best medical
practice.
The Social Security Act passed by
Congress appropriated funds to pro-
vide services for promoting the
health Of mothers and children, espe-
cially in rural areas. ="
Under this act, the Federal Gov
ernment, in cooperation with the
Iowa State Health Department. chose
washington County in which to prove
that maternal and child deaths could
be avoided. So far this is the only
experiment Of its kind in the State,
although there are several In other
States. If it works in Washington
County, it is hoped other Iowa COM
munities will adopt the plan.
Washington County was chosen be-
cause it has a progressive, well-or-
ganized medical profession, good fa-
cilities for medical care and because
the maternal death rate-despite
these advantages-Was highest of all
but IA counties in the State, using 4
medlan figure over a f1ve-year period.
Death Rate Declines.
Although the experiment has not
been in progress long enough for tab
ulation accurately of results, the State
Health Department recently has COM
pleted survey from December l,
1885, until December /, 1897, which
shows that out of 316 babies born in
the county. the maternal health pro-
gram reached 229 of them
In sharp contrast with the rela-
lively high maternal death figure for
the five-year period-there were 10
maternal deaths at all during the
last year. Deaths of infants were
well below the State average, also.
To achieve this result, several
things were done-although DR.. Wal
ter l.. Bierring, State health commits
sioner. says the practicing physicians
OF the county are chiefly responsible.
Two full-time public health nurses
were employed and paid a salary of
$1,000 each and either supplied with
q car or allowed mileage fees The
nurses visit each expectant mother as
early IN pregnancy as the case is dis
covered, and they constantly try to
discover cases cas- early as possible.
During pregnancy. the nurse sees
that the women visit their doctors
Tor periodic examinations, gives them
pamphlets furnished by the State
health department and Federal Gov
eminent, and instructs them on pre-
natal care, as well as on child care.
Nurse Assists at Delivery.
IT the expectant mother is unable
to pay for nurse during delivery
II it Is to be home delivery-the
public health nurse assists.
After the baby is born the nurse visits
the home again to see that the baby
gets of to a good start and that the
mother RECEIVERS.
In addition, the Federal Government.
through the State health department,
furnishes packets, prepared by these
same two nurses and used in virtually
all home deliveries in the county.
The packets, sterilized at the county
hospital, contain all the necessary
sterile equipment for home delivery
instead Of leaving it to the hit-or-
miss sterlizing method of boiling In
the home.
There have been no cases of child
bed fever in the county since the pro-
gram was begun, year and a half
ago.
AS . third measure, the physicians
m the county are paid bonuses for CIV
ing prenatal care early in pregnancy,
in cases where the patient is unable
to pay. A physician is allowed IS
for the first examination if it is made
under the fifth month, and 81 If
Ia