The North Dakota Committee on Maternal Welfare

Abstract

]'HE North Dakota Committee on Welfare is very young. Time will · give it maturity without, I hope, diminishing its enthusiasm. It was conceived by the American Committee on Welfare, Inc., and born by the North D~:tkota State Medical Assodation. We trust that neither parent will have occasion to disown its offspring. We were appointed as one of the regular committees of the North Dakota State Medical Association in November, 1935. Our first major objective was the spon· soring of as many obstetric meetings before the component District Medical So· cieties of the State as time would allow. Every committee member was assigned a topic and everyone accepted his subject and went to work. The purpose was not merely to present obstetric ])rograms in a hit-or-miss manner but to present a symposium on obstetrics, dealing with the major eauses of obstetric deaths. Infec· tions, toxemias, and hemorrhage are the major causes of maternal deaths in North Dakota, just as they are elsewhere. One of our committee took as his subjee.t, Maternal Mortality in North Dakota. With access to the files of the Bureau of Vital Statistics, he was able to present the :fi!,llres for our own state in a convincing manner. I would not have you believe, from this, that North Dakota has a high maternal mortality. On the eontrary, it ranks with the best in the country, but our neighbor, Minnesota, with the best record in the nation, has given us a tangible goal to reach, and we are out to equal or better her record! Emphasizing the importance of the Mortality Triad, we usually pre· sent three papers at each district meeting. Discussion is based on the papers as a symposium after the formal presentation of all of them. We have found that this is by far the best way to provoke discussion. Informal case reports, based on one of the triad, invariably come to light and the discussion is general, active, and helpful. On one occasion it lasted for one hour and in another meeting for one hour and thirty minutes. When obstetric programs can provoke discussions for that length of time, they are fulfilling a very large part of their mission. This plan of district meetings has met with the splendid cooperation of the ofiticers of the various societies contacted. It has been more a question of finding time to put on all the programs requested than of creating a demand for them. Since January, 1936, when the committee first began to put on these programs, we have appeared before five district societies. At the present rate of progress, it will take us more than a year to 1ill all the requests for meetings. It is obvious to us that om State Committee can function best only as a direct· ing agency and as a clearing house and that the most effective work will be done by the district societies. 'l'o further this, we are asking that each district society ap· point a subcommittee on maternal welfare. We recommend that each subcommittee consist of three physicians, at least one of whom shall be a rural practitioner. We expect such subcommittees to: (1) Sponsor obstetric programs in their own soci· eties at stated intervals. (2) Encourage case reports in obstetrics by the society members. (3) Foster educational work among lay organizations such as Federated w·omeu 's Clubs, Parent-Teachers Organizations and Rome-Makers Clubs. Other activities of such committees naturally suggest themselves, but it has seemed wise not to burden these committees with too extensive a program at the