View report page

74 Annual Report of the London County Council, 1911.

There is a gradual improvement in the work of midwives generally, and, as the number of untrained
midwives diminishes year by year, the number of instances of disregard of the rules as to cleanliness
and of failure through ignorance to recognise serious conditions has diminished. The Council's
inspectors have paid special attention to the untrained midwives and instructed them as to the use of
antiseptics and the reading of the clinical thermometer.
There are some five midwives who are illiterate, but other members of their family enter up their
registers for them. A copy of the rules of the Board translated into Yiddish by the Jewish Board of
Guardians at the request of the Council was supplied to the Jewish women in East London who have
difficulty in understanding English. There are some 12 or 13 Jewish midwives and two Italian
midwives in practice in London.
Fees charged The fee a midwife receives for attending a confinement and the subsequent visiting for 10 days
by Midwives. varies different localities from 5s. per case upwards, but usually a fee of 7s. 6d. to 10s. is expected.
The charities employing midwives pay 5s. or 6s. a case, and provide the midwife with registers, forms,
antiseptics, etc. It is apparent from the number of cases taken by midwives and the small fees paid
that very few can rely solely on their practice as a means of livelihood. Many of them are married women
who do not trouble to obtain a large practice, a few keep lying-in homes; others, especially those with
a fairly large practice, are approved by the Central Midwives Board to give practical instruction to
pupils preparing for the Board's examination. The pupil resides with the midwife and goes with her
to cases. The fees for pupils are usually about £1 1s. per week, which includes board and lodging
in addition to the practical instruction given by the midwife.
Maternity
charity.
Births
notified by
midwives.
Many midwives are employed in Poor Law Infirmaries, and a large proportion of the 3,000
confinements in infirmaries are conducted by midwives, and many of the infirmaries are approved
as training schools for pupil midwives. Over 5,000 cases are taken annualty into the maternity
hospitals, and some 18,000 to 20,000 are delivered in their own homes by midwives working for
maternity hospitals or in connection with one or other of the free maternity charities.
From information received under the Notification of Births Act the following figures have been
obtained showing the number of births notified by midwives :—
8 midwives reported over 500 cases in the year.
3 „ „ between 400 and 500 cases in the year.
11 „ „ „ 300 and 400 „ „
9 „ „ „ 250 and 300 „ „
20 „ „ „ 200 and 250 „ „
28 „ „ „ 150 and 200 „ „
36 „ „ „ 100 and 150 „ „
90 „ „ „ 50 and 100 „ „
86 „ „ „ 20 and 50 „ „
Uncertified
women.
Most of the midwives who had 300 cases and upwards have qualified assistants, and many are
approved by the Central Midwives Board to supervise the work of pupils. From information received
under the Notification of Births Act, it is computed that some 30,000, or 25 per cent, of the total births
in London, are attended by midwives, excluding the cases attended by midwives in infirmaries.
Since March, 1910, by Section 1 (2) of the Act, no woman, unless she be certified under the Act
may habitually and for gain attend women in childbirth except under the direction of a registered
medical practitioner.
Enquiries were made into all cases in which it came to the knowledge of the Council that a delivery
had been conducted by an uncertified woman, and in 17 instances there was evidence that the woman
had been engaged beforehand and had received fees for three or more confinements. Proceedings were
instituted and fines in fourteen cases amounting to £23 lis., with £11 7s. costs were imposed In three
cases the woman was convicted and bound over for 12 months. In one instance an uncertified woman
was tried on a charge of manslaughter and was sentenced to four months' imprisonment.
Most of the other women reported as having conducted cases were found on enquiry to have acted
in emergency, or else they had only conducted one case and could not be described as practising habitually;
these women were informed of the provisions of the Act, and in some cases cautioned by letter.