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84
MIDWIVES ACT, 1902.
The number of midwives giving addresses in London whose names have been placed on the roll
was 3,020, made up as follows:—
(a) 1,824 in virtue of a certificate obtained by examination prior to the Midwives Act, 1902.
(b) 1,011 in virtue of a certificate from the Central Midwives Board.
(c) 185 in virtue of having been in practice for a year prior to the passing of the Act.
After correcting for removals and deaths, where such had been reported, the number of certified

Many of the 204 midwives in class (b) who notified their intention to practise were newly qualified
and were working for short periods at the institutions where they were trained, prior to taking up
practice in other parts of England or going abroad.
From the above figures it will be seen that less than 20 per cent, of the midwives residing in
London are practising. The remainder for the most part act as monthly nurses under the direction of
medical practitioners.
Of the practising midwives, some 25 reside at, and work in connection with, lying-in hospitals
or poor-law infirmaries, and are under the supervision of medical practitioners. Others living in their own
homes attend patients on behalf of charitable institutions, which pay them fees for each case allotted
to them, a few taking no other cases, while others are also engaged in independent private practice.
The rest practise independently, or work in lying-in institutions not under direct medical supervision.
Three practising midwives died, 12 gave up practice, and 27 removed from the county during the
year.
Inspection.—All practising midwives (except those working under the direction of a medical
practitioner), are subject to supervision by the Council's officers to ascertain whether they are
observing the rules of the Central Midwives Board as to cleanliness, the possession of the required
apparatus and antiseptics, the keeping of case books and registers, and the sending of the various
notices to the local supervising authority. The work of inspection was carried out by Miss L. S. Greig,
M.B.,L.M., D.P.H., and Miss I. R. Shields, M.B., B.S. In May, Miss Greig resigned her appointment
and the vacancy thus caused was filled in July by the appointment of Miss E. Macrory, M.B., Ch.B.,
L.M., D.P.H. In addition to routine inspection, inquiries are also made into cases of a septic nature,
death of mother or child and inflammation of the eyes of infants. It has also been the practice of
the inspectors to improve the knowledge of midwives required in the course of their work
and to suggest methods for the better performance of their duties. The inspectors have also on several
occasions accompanied midwives to confinements and on subsequent visits to their patients. Much
useful information has thus been obtained as to the actual methods of work of midwives, especially in
the cases of midwives who apply to the Central Midwives Board for approval to supervise the practical
work of pupils intending to present themselves for examination. During the year 1,420 visits of
inspection were made, including visits in special cases. In 779 cases the reports were satisfactory, in
143 cases unsatisfactory, in 421 the midwife was away from home when the inspector called, and in
77 cases the midwife had ceased to practise or had removed to some other address.
The 143 unsatisfactory reports referred to 106 midwives. 78 were reported to be unsatisfactory
on one occasion only, 21 twice, 5 three times, and 2 four times. The improvement in the work
of midwives which has been noted in successive years has continued. In most of the cases where the
report was unfavourable, the midwife's attention was drawn by the inspector to the particular rule
which she had failed to observe, and at a subsequent inspection the inspector was generally able to
report favourably. In cases of a serious character, or of persistent neglect to observe the rules, the
matter was reported to the Midwives Act Committee and a letter of caution was sent to the midwife.
This course was adopted in 14 cases for the following reasons.
Delay in advising medical assistance for inflammation of infant's eyes
4
Delay in advising medical assistance for weakly infant
4
Delay in advising medical assistance for mother, as required by rules
2
Failure to take temperature
3
Attending a patient without being disinfected after attendance upon a case
of puerperal fever
1
14