View report page

99
Medical help.—The rules of the Central Midwives Board provide that in certain circumstances
which are set out in detail a midwife must decline to attend alone and must advise in writing that
the case is one requiring medical help. The form on which this advice is given is sent to the medical
man, and a copy of it is forwarded to the local supervising authority. The number of instances in
which the Council received these notices was 2,894. The figures in previous years were:—1905,1,113;
1906, 2,320; 1907, 2,533 ; 1908, 2,755. The increase in the figures is probably due to the fact that
midwives are realising the importance of securing medical assistance in compliance with the rules
of the Central Midwives Board.
Notices were thus sent in by 327 midwives. Midwives in infirmaries and hospitals under the
direction of a medical practitioner are not required to comply with this rule.
1 midwife reported advising medical help, 159 times.
1„ „ „ „ „ 90 „
1 „ „ „ „ „ 84 „
3 midwives „ „ „ „ between 60 and 80 times.
7 „ „ „ „ „ „ 40 and 60
18 „ „ „ „ „ „ 20 and 40
53 „ „ „ „ „ „ 10 and 20
243 „ „ „ „ „ less than 10 times.
The reasons assigned by the midwife for advising medical help were as follows:—
Pregnancy— Lying-in—
Abortion or miscarriage 52 Abdominal swelling or tenderness 13
Deformed pelvis 7 Excessive sickness 5
Varicose veins 17 Offensive lochia 8
General health of patient 10 Rigor 5
Ante partum haemorrhage 110 Rise of temperature 173
196 Swelling of breasts 12
Post partum haemorrhage 84
Pains in leg 13
Convulsions or eclampsia 15
Labour— Collapse and exhaustion 34
Presentations— Mania 5
Unable to make out 18 Other illness 124
Abnormal vertex 32 491
Difficult breech 43 Child—
Knee 2 Injury at birth 6
Face 35 Asphyxia 69
Funis 41 Malformation or deformity 85
Transverse 73 Inflammation of eyes 162
Placenta prævia 28 Jaundice 15
Twin birth 1 Cyanosis 11
Triple birth 1 Dangerous feebleness 380
Quadruple birth 2 Convulsions 33
Prolapse of vagina or uterus 14 Eruptions on skin 26
Prolonged labour (uterine inertia, Bleeding from cord 9
contracted pelvis, etc.) 523 Death of child 36
Laceration of perineum or injury Still-birth 34
to soft parts 214 Other conditions in child 72
Retained or adherent placenta 207 938
Haemorrhage during labour 19 Infectious disease in patient's house 9
No reason stated 7
1253
2,894
Assuming that some 30,000 births are attended annually by midwives, the above figures show
that midwives have advised medical assistance in 9-6 per cent, of the cases they attended; in 6"5
per cent, on account of the mother, and 31 per cent, on account of the child.
Still-births.—During the year 221 midwives reported still-births in their practice, the number
of still-born children being 676. The numbers in previous years were:—1906,574; 1907,740; 1908, 666.
1 midwife reported 19 still-births 19
1 „ ,, 16 „ 16
3 midwives reported 11 still-births each 33
6 „ „ 9 „ „ 54
5 „ „ 8 „ „ 40
8 „ „ 7 56
6 „ „ 6 „ „ 36
14 „ „ 5 „ „ 70
25 ,, ,, 4 „ „ 100
27 „ „ 3 „ „ 81
46 „ „ 2 „ „ 92
79 „ „ 1 „ „ 79
221 676
The above figures, when compared with the estimate of 30,000 births, show that in 2*2 per cent,
of the births the infant was still-born.