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8. The midwife should see that the sick room is kept clean. The blinds
should be drawn up by day, unless the patient desires to sleep, or is
unpleasantly affected by the light. The windows should be kept open a
few inches at the top, day and night, unless the weather is severe. At the
same time, care must be taken to protect mother and child from any
draught.
9. Under Section 55 of the Public Health (London) Act, midwives are
responsible for notifying to the Medical Officer of Health the existence of
puerperal fever or other infectious disease from which a patient may be
suffering. Any such disease must be notified immediately.
10. Midwives should summon the aid of a medical man in the following
cases:—
(1). All cases of hoemorrhage before the birth of the child, and any
unusual loss of blood after the delivery.
(2). All cases where the patient shews signs of an attack of any
illness of a serious nature.
(3). All abnormal positions and presentations of the child, and any
case where the presentation is uncertain.
(4). In presenting placenta or placenta-prævia even where there is
no hœmorrhage.
(5). In any case of unaccountable delay in the birtli of the child,
(6). In rupture of the perinseum.
(7). If the placenta be not expelled complete an hour after the birth
of the child, even if no bleeding has occurred.
(8). In twins or multiple births.
(9). In the apparently dead new-born child.
11. Where a doctor is summoned, the midwife should send him a short
written statement of the cause for which medical aid is sought.
SIDNEY DAVIBS, M.D.,
Vestry Offices. Medical Officer of Health.