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MIDWIFERY SERVICE
Section 23
Miss F. E. Curtis, Non-medical Supervisor, reports that two midwives
are now working in Hornsey and all other vacancies have been filled,
bringing the total number of midwives employed to nine by the end of
1957.
Five of these are approved by the Central Midwives Board as District
Teachers. Five pupil midwives were in training in the Area during
the year.
The character of the domiciliary midwife's work is changing with the
now common use of modern analgesia. Patients to whom trilene, pethidine
or nitrous oxide and air is administered cannot be left and it is not unusual
for the midwife to remain 36, 48 hours or even longer with these patients.
This calls for redistribution of work every day in order that those women
already delivered may receive the necessary attention. It may be that some
"shift system" will have to be considered for the future.
There were 555 deliveries attended by the midwives during 1957 and
76 women were discharged from hospitals before the 14th day (usually
the third day following delivery). This work together amounted to 12,971
visits. Most of the patients sent home by hospitals are sent in by the
midwife who has already spent many hours with them before admission.
In addition to deliveries and nursing visits the midwives make visits
to the patients' homes during the ante-natal period, attend ante-natal
clinics and also give instruction in the use of the gas and air and trilene
apparatus.
The present bookings still show an upward trend and the difficulty
of obtaining a hospital bed often results in a home booking having to be
made for the patient who on social circumstances should be delivered in
hospital. These patients sometimes cause very grave anxiety to doctors
and midwives.
In addition, some women, including immigrants to this country,
make no arrangements for their confinements, having been advised by
their friends to telephone for an ambulance when labour begins. Sometimes
they are successful in obtaining an emergency bed, but at other
times it results in the mother having her baby at home as an emergency
with no preparations made for the confinement.