Aside by Dr Williams’ about obstetrical fees
p. 81 “The laity should also be taught that a well-conducted hospital is the ideal place for delivery, especially in the case of those with limited incomes.
“Moreover, they should learn that the average compensation for obstetric cases is usually quite inadequate; and should realize, … that doctors who are obliged to live on what they earn from their practice cannot reasonably be expected to give much better service than they are paid for.
“I think I may safely state that obstetric fees are generally much too low as those for many gynecologic and surgical operations are absurdly high. I am loath to mention so sordid a matter and I do so at the risk of being misunderstood, but in know … that many well-to-do patients object to paying as much for the conduct of a complicated labor case as
for the simplest operation which involves no responsibility.
Do the Math, Convince the People, Collect the Taxes
In a population of twenty thousand people, there will occur, on the average, about seven hundred births in a year. So the obstetrical needs of such a community as this are by no means insignificant when considered in the aggregate. There is ample material for the patronage of a small hospital, located, let us say, at the county seat, if even a large minority of the women of the community can be induced to patronize it.
….small lying-in hospital, with its average of one or two births per day, will be provided of course with a resident physician and with a staff of nurses competent to give the first doses of the drug [of scopalomine]. So the treatment may be carried out as it is at Freiburg, and a considerable proportion of patients will secure the hoped-for boon of the
“Twilight Sleep.”
Recall that the average annual birthrate is about thirty-five to every thousand inhabitants; that is to say, about one in every six families, and that sooner or later there are children in every normal household. We are dealing, then, with a project that concerns not here and there an exceptional family, but one that concerns each and every family. No project
could more justifiably call for the expenditure of public money, – money raised, if need be, by the issuing of bonds or by the levying of a special tax.
In many places small public or semi-public hospitals already exist. These can be enlarged at relatively small cost, or their existing wards, – which in many cases are now for the most part vacant, – may be utilized as lying-in quarters.
Once the hospital is in operation, it will in many regions be altogether self-supporting, – for, of course, all but the poorest classes will wish to pay for the services received. And even where the funds received are inadequate to meet the necessary outlay, there will be no part of the public service for which the average citizen will more willingly submit to
taxation than for this institution which so manifestly adds to the comfort and well-being of the mothers and wives and daughters of the community.
But even without resort to public funds, there should be no difficulty whatever in any community in securing subscriptions for the erection and maintenance of the lying-in hospital, so soon as the need of it and its manifold beneficences are clearly understood.
The Trump Card – Convincing the Men
Many a man who will give for almost no other object, will make liberal donations when he is convinced that the project is one that will immeasurably decrease the dangers and practically annul the pains of the women of the community in the condition which he has hitherto contemplated with the utmost apprehension as a menace, present or prospective, to the loved ones of his household.
Incidentally, it should be noted that the male population of the community will also benefit directly from the introduction of such lying-in hospitals, because it will be possible to establish in connection with these hospitals, wards or departments of general surgery, for the treatment of various diseases, in many places where it would be impossible to maintain such a hospital service independently, because of insufficient patronage. The patronage of a lying-in hospital is an assured element, assuming good proportions even in districts relatively sparsely settled.
More Distain by “Medical Men” for the Normal Physiological
The need of such a service would long ago have been evident, had it not been for the current conviction that the bearing of children is a physiological function not to be considered seriously; and a function, moreover, that is scarcely to be referred to in general conversation.
Now that the time has arrived when a matter of such vital import can be frankly discussed in public, we may expect to see aroused a growing interest in the betterment of the condition of woman through amelioration of the evils incident to the performance of her supreme function.
