This report constitutes a serious indictment of society, and should goad civic and social conscience to aggressive action. But there are evidences (and, indeed, the existence of the Bureau is one) that the public is beginning to realize the profound importance in our national life of saving the children that are born. * * * * * Perhaps nothing indicates more impressively our contempt for alien customs than the general attitude taken toward the midwife. In other lands she holds a place of respect, but in this country there seems to be a general determination on the part of physicians and departments of health to ignore her existence and leave her free to practice without fit preparation, despite the fact that her services are extensively used in humble homes. In New York City the midwife brings into the world over forty per cent. of all the babies born there, and ninety-eight per cent. of those among the Italians. We had many experiences with them, beginning with poor Ida, the carpenter’s wife, and some that had the salt of humor. Before our first year had passed I wrote to the superintendent of a large relief society operating in our neighborhood, advising that the society discontinue its employment of midwives as a branch of relief, because of their entire lack of standards and their exemption from restraining influence. To force attention to the harmful effect of leaving the midwife without training in midwifery and asepsis free to attend women in childbirth, the Union Settlement in 1905 financed an investigation under the auspices of a committee of which I was chairman. A trained nurse was selected to inquire into and report upon the practice of the midwives. The inquiry disclosed the extent to which habit, tradition, and economic necessity made the midwife practically indispensable, and gave ample proof of the neglect, ignorance, and criminality that prevailed; logical consequences of the policy that had been pursued. The Commissioner of Health and eminent obstetricians now co-operated to improve matters, and legislation was secured making it mandatory for the Department of Health to regulate the practice of midwifery. Five years later the first school for midwives in America was established in connection with Bellevue Hospital. [Illustration] Part of the duty assigned to nurses of the Bureau of Child Hygiene is to inspect the bags of the midwives licensed to practice, and to visit the new-born in the campaign to wipe out _ophthalmia neonatorum_, that tragically frequent and preventable cause of blindness among the new-born.