The Association does not usurp nor supplant, but endeavors to give impulse to public and private agencies alike in affording the best possible supervision and care for expectant and parturient mothers and their babies. Thus has the stupendous problem in New York been attacked with courage and with gratifying results. Much might be accomplished in smaller and less complex communities with proportionately less difficulty. But all of the foregoing relates to city dwellers. What about the expectant mothers in isolated and rural communities? I wish we did not have to say. Prenatal care is practically unknown among them and there is scarcely any provision for obstetrical care, either. The nearest physician may live miles away and even though one were near, country women and their husbands do not always feel that the expense of employing a doctor, for mere childbirth, is justifiable. In certain Northern and Western communities, that were considered fairly representative of those sections, conditions have been studied at some length by agents of the Federal Children’s Bureau. They found that about half of the mothers in those communities had no medical attention whatever in childbirth. Untrained women, friends or neighbors, frequently someone’s grandmother, were in attendance. Or husbands or workmen were pressed into service. A few women were entirely alone in their hour of trial. Scarcely a mother among them received prenatal care and instruction worthy of the name. In the Southern states, the proportion of women delivered by physicians seems to be even smaller than in the North and West, and in some of the mountain regions the conditions are distressing. From one such locality we learn that when a woman goes into labor the first passing teamster is hailed, or perhaps a member of the family hurries down the road for the nearest tanner or blacksmith, or any one else, who in total ignorance will fearlessly rush in to meet the great emergency. The results of this practice—dismembered infants and badly injured or dead mothers,—are too sickening to describe, but may be imagined by any nurse who has seen good obstetrical work and appreciates its value. From another mountain region in the South comes the contrast in accounts of the work done by Miss Lydia Holman, founder of the Holman Association, as evidence of what skill and desire may accomplish. Something more than twenty years ago this nurse started volunteer visiting nursing among the mountain people, with no precedent to follow and no Board to direct or advise. But there were sick people all about, people needing care, and Miss Holman was not only trained but eager to nurse them, and after all these qualifications are the chief requisites.