New Hampshire co-operating with the Federal Government receives each year from the Government $12,988.31. and from the State of New Hampshire $7,988.31. PROGRAM The program of the Division of Maternity, Infancy and Child Hygiene of the State Board of Health varied in the past two years to the extent that we rearranged our districts and are now giving to every section of the State an all year round nursing service. The special charge of the Division is the expectant mother, the infant and the preschool child. The types of work carried on are: Prenatal Infant Welfare Child Welfare Health Education Along Every Phase of Child Life More universal and intensive prenatal work has been carried on, more educational work through our Hygiene and Maternity and Infancy classes, with a continuation and expansion of our diphtheria immunization for the preschool child. There is no question in the public mind regarding the value of the Maternity and Infancy work. This has been proven conclusively by the splendid support of every women's organization in the State, and by the great majority of citizens, men and women. The physicians of the State have given of their time and effort freely. A splendid letter was recently issued to the Medical Profession of the State by the President of the New Hampshire Medical Society, in which he says: "As President of the New Hampshire Medical Society, I wish to call your attention to the very important effort which is being made to reduce the maternal and infant mortality of our State. Much good work has already been accomplished through our State Board of Health in helping to educate the public concerning prenatal and maternal care." We have given and received co-operation from every other health agency in the State, official and non-official. NURSING SERVICE The nursing staff consists of five full-time nurses. Each nurse carries approximately two counties. Our nursing service is undoubtedly the most important of our activities. It is a well known fact that the success or failure of any public health program depends upon the personality and knowledge of the nurses employed to carry on the work. Our nurses are mature women of fine training and experience. The majority have had special training at Maternity Center Association, New York City. PRENATAL Our prenatal program is planned with the view of giving to every expectant mother in New Hampshire the opportunity of knowing the value of prenatal care, good obstetrics. and good postnatal care. Any program of economy that does not take into consideration the conservation of maternal life is not fundamentally sound. The home is the foundation of society and the mother is the heart of the home. We cannot afford to lose our New Hampshire mothers. To our home visiting and educational work has this year been added a very fine series of prenatal letters which are available on application to the office. That we are getting results is shown in the following table quoting the mortality rates for the past 6 years. MATERNAL MORTALITY RATES Rates per 1000 Living and Stillbirths. MATERNAL MORTALITY STUDY Co-operating with the Children's Bureau, Washington, D. C., the New Hampshire State Board of Health, Division of Maternity, Infancy and Child Hygiene, with the approval of the New Hampshire Medical Society, is to conduct a maternal mortality study in New Hampshire. The United States prides herself on her advancement in many lines, especially science and medicine, but in prenatal and obstetrical care she stands low in the list of civilized countries. This fact is, and always has been, a challenge with the result that a maternal mortality study is to be made in a cross section of the country, with a view to obtaining accurate information for future guidance of medical men and health authorities. The study material has been prepared by the Consulting Obstetrical Committee of the Chil'dren's Bureau. The study is to be conducted by a physician especially trained and adapted for this type of work, the expense to be borne entirely by the Children's Bureau. The death certificate of the mother and the birth certificate of the baby will be obtained from the Bureau of Vital Statistics at Concord. Visits will be made only to physicians who have signed the death certificate of the mother, or who have given prenatal or hospital care. It is hoped in this way to obtain a complete history of each case for the current year, with a continuation of the work during the coming year. Compilation and summary will be made by competent statisticians, and valuable information gained. One fact we are now sure of-probably 50 per cent of these cases receive little or practically no prenatal care. With actual information of conditions in our own state, it will surely bring about more interest in prenatal care and, in childbirth, with a subsequent improvement in our standards. The States having had, or now having, the study are: Rhode Island, Virginia, Washington, Wisconsin, Alabama, Kentucky, Maryland, Michigan and Minnesota. INFANT WELFARE In our work with the expectant mother, we stress the value to herself and to her baby of breast feeding. There are between eight and nine thousand babies born in New Hampshire each year, and in a recent survey made of infant feeding we obtained the following figures on breast feeding: Pediatricians tell us that with only 5 per cent of mothers is nursing a physical impossibility. Why are not more of our babies breast fed? A breast fed baby has a much better chance of living during the first few months of life than a bottle fed one. We contact the home of all new babies through letters, books, diet slips, pamphlets on child training, child management, protection against communicable disease, etc., from the time the birth certificate is received until the child enters school. The reduction in our infant mortality clearly shows that our educational campaign for parents has brought about results. Through our infant and preschool health conferences, we try to teach the value of frequent examinations for physical defects and disease. Properly planned and carried out, the conference cannot fail to arouse the interest of the parents and the citizens in general in community health work. Health is life's most precious possession, and the value of good health, especially child health and the prevention of disease, is a subject of increasing interest and thought to the great majority of people. The examinations at our conferences are carried on by the local physicians. We are fortunate in having two child. health specialists, and many other physicians intensely in |