View report page

97
Midwives Act, 1902.
The number of midwives giving addresses in London, whose names had been placed upon
the Roll up to the end of 1909, was 3,629, made up as follows:—
(a) 1,824 in virtue of a certificate obtained by examination prior to the Midwives Act,
1902.
(b) 1,620 in virtue of a certificate from the Central Midwives Board.
(c) 185 in virtue of having been in bona fide practice for a year prior to the passing
of the Act.

Many of the midwives who notified their intention to practise were connected with institutions
and did not continue to work in London during the whole year, their places being subsequently filled
by other midwives, who in turn also gave notice of intention to practise.
It may be estimated that at any given time during 1909 some 420 midwives were practising in
London. This represents some 13 per cent. of the midwives said to be resident in London. The remainder
for the most part act as monthly or general nurses under the direction of medical practitioners.
One practising midwife died during the year, 19 gave up practice, and 34 removed from the county.
Of the practising midwives, 32 work entirely within poor law institutions or lying-in hospitals,
and are under medical supervision. Others, living in their own homes, attend patients on behalf of
charitable or poor law institutions, and are paid a fee for each case allotted to them. The rest
practise independently or work for lying-in institutions not under the direction of qualified medical
practitioners.
Inspection.—All practising midwives (except those who claim exemption by reason of working
in connection with hospitals and poor-law infirmaries 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 requisite apparatus
and antiseptics, the keeping of registers and case books, and the sending of the various notices to
the local supervising authority. The work of inspection was carried out by Miss I. R. Shields, M.B., B.S.,
and Miss E. Macrory, M.B., Ch.B., L.M., D.P.H.
In addition to the ordinary routine inspection, special inquiries are made into all cases of a
septic nature, in cases of death of mother or child, and cases in which medical help has been advised
on account of inflammation of the eyes. The inspectors also advise midwives on points of difficulty
arising in the course of their duties. In some instances midwives have been accompanied to confinements
or to the subsequent visits to patients in order to ascertain whether their methods of work
are satisfactory. In cases where a midwife applies to the Central Midwives Board for approval to
supervise the practical work of pupils training for examination, the inspectors make special inquiry
to ensure that the applicants possess a requisite standard of efficiency, and the result of such
inquiry is reported to the Board.
During the year 1,562 visits were paid by the inspectors, including visits in special cases. In
904 instances the reports were satisfactory, in 108 instances unsatisfactory; in 494 the midwife was
not seen owing to being away from home when the inspector called; and in the remaining 56
instances it was found that the midwife had removed or was not practising.
The 108 reports where unsatisfactory conditions were found related to 83 midwives; 62 were
reported to be unsatisfactory on one occasion, 18 on two occasions, 2 on three occasions, and 1 on
four occasions. Most of the unsatisfactory reports above mentioned were cases in which
some slight infringement of the rules had occurred, and the midwife's attention was drawn to
the matter, and at a subsequent visit the inspector was able to report favourably. In cases of a
serious nature or where there was persistent neglect to observe the rules, the case was reported to
the Midwives Act Committee of the Council, and a letter of caution was sent to the midwife. This
course was adopted in 15 cases for the following reasons:—
Not advising medical assistance at once in cases of inflammation of eyes 4
Not advising medical assistance at once to mothers as required by rules 5
Not advising medical assistance at once to infants as required by rules 2
Failure to take and record patient's temperature 2
Neglect of mother or child 2
15