LYING-IN INSTITUTIONS. LONDON: PRINTED BY SPOTTISWOODE AND CO., NEW-STREET SQUARE AND PARLIAMENT STREET INTRODUCTORY NOTES ON LYING-IN INSTITUTIONS. TOGETHER WITH A PROPOSAL FOR ORGANISING AN INSTITUTION FOR TRAINING MIDWIVES AND MIDWIFERY NURSES. BY FLORENCE NIGHTINGALE. LONDON: LONGMANS, GREEN, AND CO. 1871. If I may dedicate, without ‘permission,’ these small ‘Notes’ to the shade of Socrates’ Mother, may I likewise, without presumption, call to my help the questioning shade of her Son, that I who write may have the spirit of questioning aright, and that those who read may learn not of me but of themselves? And, further, has he not said: ‘The midwives are respectable women, and have a character to lose’? PREFACE. In the year 1862 the Committee of the Nightingale Fund, with a view to extending the advantages of their Training Institution, entered into an arrangement with the authorities of St. John’s House, under which wards were fitted up in the new part of King’s College Hospital, opening out of the great staircase and shut up within their own doors, for the reception of Midwifery cases. The wards were under the charge of the (then) Lady Superintendent. Arrangements were made for medical attendance, a skilled midwife was engaged, a certain number of pupil nurses were admitted for training; and hopes were entertained that this new branch of our Training School would confer a great benefit on the poor, especially in country districts, where trained Midwifery nurses are needed. Every precaution had apparently been taken to render the Midwifery Department perfectly safe; and it was not until the school had been upwards of five years in existence, that the attention of the Nightingale Committee was called to the fact that deaths from puerperal diseases had taken place in each of the preceding years. During the period of nearly six years that the wards were in use, the records show that 780 women had been delivered in the institution, and that out of this number twenty-six[1] had died—a mortality of 33·3 per 1,000.