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Unsatisfactory or illegal minding of children continued to give cause for concern.
Health visitors diligently followed up all cases discovered by them or referred by other
agencies. Senior medical and nursing staff visited all applicants for statutory registration
and those who continued their illegal activities against advice. Many women were found to be
minding more children than was permitted under the Nurseries and Child Minders Regulation
Act, 1948, and in unsuitable conditions; but as the children were stated to be relatives legal
action could not be taken. Others were reluctant to disclose the fact that they were minding
children out of fear that their activities would be stopped thus leading to loss of income.
Domiciliary Midwifery Service
The number of domiciliary confinements declined during 1967 although there was a slight
increase in the number of planned early discharges.
The decline in the birth rate, the increase in available hospital beds and planned early
discharge all account for the changing pattern of domiciliary midwifery care.
In addition to the 507 confinements 77 other patients were booked for domiciliary
confinement but subsequently transferred before delivery to the hospital service:-
16 due to complications of pregnancy
20 in premature labour
41 in labour at term.
There were 19 calls for the services of the emergency obstetric unit. The Planned Early
Discharge Scheme from Hospital, continued to maintain its popularity. 542 assessments of
home conditions were made during the year, 71 were found to be unsuitable. 158 remained in
hospital for nursing. Of the 471 patients accepted, 313 were subsequently discharged home.
In addition 166 other mothers who were delivered in hospital were nursed in the district
following unplanned early discharges.
Group attachment of a domiciliary midwife
In March a domiciliary midwife was attached to a group practice of four doctors. During
the nine months 20 domiciliary confinements were booked and subsequently delivered. In
addition 17 planned early discharge patients were given ante and post-natal care. The midwife
attached to the group practice relieved off duty with two colleagues.
Maternal Deaths
Confidential enquiries in accordance with Ministry of Health instructions were initiated
into the deaths of four women who had been Islington residents; in no case has the Council's
staff been concerned in care or treatment given.
Stillbirths
2 domiciliary stillbirths occurred during the year; 1 case had been booked for domiciliary
delivery by a Council midwife and the other was an emergency to which the Council's midwife
was called. In both cases the infant was born before the midwife arrived.
Training
Of the Council's full-time midwives, 11 were approved by the Central Midwives Board as
district teaching midwives to train pupil midwives for the three months district experience
that is required in the second period of their training. The Council accept pupil midwives
from the City of London Maternity and Paddington General Hospitals. During 1967, 36 pupils
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