When a nurse finds, upon her first visit to a patient, that she has engaged a physician to attend her at the time of confinement, she gives no advice, but sends to the doctor a form letter, prepared by the Medical Board, offering to nurse that patient according to the routine of the Maternity Centre Association if he wishes, and to report to him upon each nursing visit. A very small percentage of physicians refuse this offer of assistance, the majority accepting it with eagerness. Patients who have engaged their own physician for delivery, naturally, are not asked to go to the Maternity Centre clinics for medical examination or advice, but are invited to go for the nurse’s instructions, and to attend the group conferences that will be described later. If the patient belongs to the third group, having engaged a midwife, the nurse goes in person to see the midwife, as letters are usually of little avail. She asks the midwife to bring her patient to the clinic, explaining that, though midwives are taught to conduct deliveries, they are not taught to make the examinations that are now known to be so important to the future welfare of mothers and babies, but that such examinations can be made at the clinic by the doctor. If the initial examination discloses any abnormality, this fact is explained to the midwife and also that the rules governing her practice forbid her caring for such a patient. The nurse, midwife and patient then plan for adequate care at the time of delivery. In this way the nurses win and retain the confidence and good will of the midwives; and since these women exert a powerful influence over their patients and their families, their co-operation is of considerable value in persuading the patients to accept more skilled care than midwives can offer. If, on the other hand, the initial examination does not disclose any abnormality, the midwife is simply asked to allow the nurse to visit the patient at regular intervals, in a supervisory way, and to have the patient report to the clinic doctor for his periodic observations and advice. The intelligent midwives, who speak English, are usually co-operative, but the others are sometimes suspicious and persuade their patients to refuse the nurse’s supervision. For the patients in the fourth group, those who have made no arrangement for care at the time of delivery, the nurse is even more responsible. The plans for these patients include three fundamental requirements: a complete physical examination; the correction of physical defects, so far as is possible, and a study of the environment and social status of the patient; this in order to adapt the care during pregnancy and at the time of delivery to each individual’s condition and circumstances.