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PERSONAL HEALTH SERVICES
DOMICILIARY MIDWIFERY
The changing pattern in maternity services generally was evident to a small degree in
Lewisham as shown by an increase in the number of patients delivered in hospital and
discharged early to be cared for in the community. In 1965 domiciliary midwives
delivered 1,498 mothers at home and cared for 951 who were discharged early.
In 1966 the numbers were 1,337 and 1,100 respectively. The Central Midwives
Board in their most recent report, emphasise the importance of regarding the maternity
service as a whole, from the point of view of midwifery practice and training.
Staff
With the withdrawal of midwifery services on an agency basis by the Nursing
Sisters of St. John the Divine, and the Salvation Army it became necessary for the
Council to assume responsibility for domiciliary services in the part of Deptford and
South London formerly covered by this association. The arrangement took effect
from 1st April 1966.
Parting with such long established and efficient services was a matter for great
regret and it is a matter for congratulation that the Borough midwifery staff
shouldered the additional responsibility without any lessening of services given.
The full time midwifery staff of the Borough is now 26, 6 part-time midwives are
also employed.
Training
Fourteen midwives are approved by the Central Midwives Board as district teaching
midwives, and train pupil midwives for three months district experience that is required
in the second period of their training. During the year 37 pupil midwives
completed their district training and a further 14 were in training at the end of the
year. Only one, who was herself pregnant, failed her examination. An inspection
of pupil midwife training carried out on behalf of the Central Midwives Board
during the year showed that the local arrangements were commendable.
Liaison with the General Practitioner Service
The arrangements whereby 18 General Practitioners attend midwives ante-natal
clinics continued. A total of 15,172 clinic attendances were made at the fourteen
weekly ante-natal sessions. A further 9,607 ante-natal home visits and 26,848
post-natal visits were made by midwives.
Liaison with the Hospital Services
Domiciliary midwives paid 1958 visits to expectant mothers to assess whether on
social grounds a hospital confinement was necessary, or whether a planned early
discharge was possible. Out of the 1,100 early discharges nursed by domiciliary
midwives, 298 were at some period originally booked for a home delivery, 501 were
planned discharges and the remainder came home for some reason.
The Emergency Obstetric Unit from Lewisham Hospital was called out 16 times
during the year. This service is obtained by either doctor or midwife telephoning the
Headquarters Control of the Greater London Council Ambulance Serv'ce who,
having contacted the nearest hospital providing such a service, send an ambulance
there to collect the team. The Emergency Obstetric Unit is used for all grave emergencies
of pregnancy labour, and the post-natal period. This includes cases of
threatened abortion where the family doctor may be called to deal with a sudden
emergency.
The premature baby unit is sent out from Lewisham Hospital when required.
46 premature babies, i.e. those weighing 5i lbs or less, were born at home, of those,
10 were admitted to hospital.
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