ame is on the register, and thus
the scale of charges remains very low and the profession, as one for
educated women, is thereby greatly injured.

Granted an intelligent woman is willing to give six months' work and
study and L35 to L40 for her training, what chance has she of earning
a decent living? If she could command 15s. or 17s. 6d. per case
afterwards, she could make a decent living, given fairly hard work and
the acceptance of real responsibility. If she had 100 cases a year,
she would earn L75 at 15s. per case, and so on. This rise in the
fees payable to midwives has just been made possible by the National
Insurance Act of 1911, the framers of which appear to have recognised
the necessary result of the Midwives' Act of 1902. As the _bona-fide_
midwife, who has received no training, gradually dies out, it becomes
necessary to provide the means of paying trained midwives, whom the
people are obliged to employ in place of the old ones, but who would
soon be non-existent were the means of paying them not also provided
by the State.

A 30s. maternity benefit is now given for every confinement of an
insured person or the wife of an insured person. As the patient may
have free choice of doctor or midwife, it seems possible, now that it
has been established that the benefit shall go direct to the mother or
her nominee, that hereafter the greater part of it may be paid over to
the person who can supply that most necessary item of the treatment,
i.e., good and intelligent midwifery with nursing care of mother and
child. Therefore, it is the right moment for the careful, well-trained
popular midwife definitely to raise her fees to all "insured"
patients, being still willing to help the poor at a low fee as before.
It should be remembered that in about one-tenth of all her cases,
medical help will be required, but this case could probably be guarded
against by an insurance fund, if properly organised.

We frankly admit that as things now stand--apart from the possibility
of the maternity benefit being made to help her--midwifery is
financially but a poor profession. But to an enthusiastic lover of
her kind, who has other means or prospects for her future than the
proceeds of her profession, there is much that is attractive in this
most useful calling.

Now let us turn to a consideration of the poor mother. Dr Matthews
Duncan in 1870 put the puerperal mortality at 1 in 100 for in-patients
and 1 in 120 for patients in t