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nursing duties. The midwife must, of course, retain her function
as an education instructor to the expectant mother. She must also
concentrate to a greater extent on post-natal domiciliary work for
a high proportion of parous women sutler from gynaecological
disorders directly attributable to neglect in the immediate postnatal
period. On the practical side, the home midwife must in some
way be brought into the hospital as well as the home and encouraged
to take her full share in the delivery in hospital of the normal case.
Similarly, general practitioner obstetricians should be encouraged
to use the local maternity hospital as a place where they can deal
with their own cases and work in close association with the consultants.
I am aware that this is happening to some extent locally,
but the practice should be more universal.
As regards our own local authority clinics and domiciliary
services, I am confident that if we move with the times and foster
even closer links with the general practitioner obstetricians and the
hospitals, apart from the mechanics of home midwifery, there are
important duties to perform in the field of education and in relation
to medico-social needs. These matters are already being given the
close attention of the Central Midwives Board. It is with hope and
confidence that this first report on the local authority midwifery
services is presented. Despite the tripartite administration of midwifery
imposed by statute, I believe that it is possible, and indeed
it is already happening, that all three branches can co-operate in
harmony, with hospital care for priority groups and perhaps
eventually hospital general practitioner/midwife beds for the
normal cases preferring hospital delivery, while at the same time
home confinement can be made easily available for those whose
homes are suitable and who are eager and willing to have their
babies at home. It must never be forgotten, however, that whatever
the arrangements, the pre-eminent consideration must be the safety
and the health of future mothers and children.
General
All sessions have continued and attendances have remained
fairly steady throughout the year. A great deal of individual health
education goes on at these sessions and demonstration cabinets and
posters which are always on display are noticed and frequently
discussed by the mothers and by the children.
In addition to the two creches in the Borough, both of which
open one half day weekly, a number of mothers have been enrolled
in accordance with the voluntary child-minders' registration scheme.
In the absence of a Borough day nursery, these mothers are fulfilling
a very necessary function.
During the year, a new purpose-built centre was opened at
Abbey Wood, taking the place of the previously very inadequate