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Report of the Medical Officer of Health.
75
The rules of the Central Midwives Board provide that in certain circumstances a midwife must Medical
decline to attend alone and must advise in writing that the case is one requiring medical help. The helpform
on which this written advice is given is sent to a medical practitioner, and a copy is forwarded to the
local supervising authority. During the year 3,477 of these notices were received. The figures for the
previous years were: 1905,1,113; 1906, 2,320; 1907, 2,533; 1908, 2,755; 1909, 2,894; 1910, 3,026.
The rise in the figures is no doubt due to the fact that midwives realise more fully the importance
of complying with this rule of the Board. Notices were received from 353 midwives. Midwives
in infirmaries and hospitals under the direction of a qualified medical practitioner are not required to
comply with this rule.
The number of instances of advising medical help in the practice of midwives during the year
may be summarised as follows :—
1 midwife reported advising medical help 146 times during the year.
1 ,, ,, ,, ,, 100 ,, ,,
1 ,, ,, ,, ,, 81 ,, ,,
5 midwives „ „ „ 40 to 60 times during the year.
36 „ „ „ „ 20 to 40 „ „
66 „ „ „ „ 10 to 20 „ „
243 „ „ „ „ less than 10 times during the year.
The reasons assigned by the midwife for giving the advice were as follows :— Pregnancy.
Pregnancy—
Purulent discharge 3
Abortion or miscarriage 53
Deformed pelvis 8
Varicose veins 20
Ante partum hæmorrhage 119
General unhealthy conditions 80
283
Labour—
Presentations—
Unable to make out 25
Difficult breech 54
Face 26
Funis 46
Transverse 37
Difficult twins 16
„ triplets 2
Persistent occipito posterior 39
Hand 20
Placenta prævia 18
Prolonged labour (uterine inertia, contracted pelvis, etc.) 581
Laceration of perineum 298
Prolapse of uterus 4
Hæmorrhage during labour 9
Retained or adherent placenta 245
Exhaustion or collapse 26
Hysteria or fits 10
Excessive liquor amnii 4
Uterus not contracting 1
—1,461
Lying-in—
Rise of temperature 225
Post partum haemorrhage 133
Pain or swelling in leg 23
Abdominal pain or swelling 21
Pain or swelling of breast 11
Quick pulse 5
Eclampsia, convulsions 15
Collapse 15
Puerperal mania 4
Offensive lochia 6
Sub-involution of uterus 4
Excessive sickness or headache 12
Severe diarrhœa 4
Continued sleeplessness 3
Other illness 37
—518
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