With a brief nod to the Teaching Medical Center and the middle and upper class, predominantly suburban, private pediatric practice, Tunley takes off on the deficits of American pediatrics. His list begins with antenatal care.

In the field of obstetrics we are an underdeveloped country; we rank sixth in infant mortality; the proportion of women receiving antenatal care is declining; our lowest infant mortality, even in essentially all white states, is above Europe's best.

Our free clinics are "alms" oriented, crowded, inconveniently located, bleak and uninviting, poorly staffed, with rude and thoughtless personnel; in other nations they are convenient, attractive and offer inducements—layettes in Finland, cash bonuses and compensation for loss of income during pregnancy in Sweden.

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