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MATERNAL AND CHILD HEALTH
DOMICILIARY MIDWIFERY
Joan M. Goodman, S.R.N., S.C.M., M.T.D., Q.N.Cert., Nursing Officer
(Midwifery and District Nursing)
The lowering of the birth rate together with an increase in the obstetric beds available
has been evident to some extent in the Borough in 1967. This has resulted in a decrease
in the number of domiciliary confinements (1,180) although the length of time
spent in hospital by lying-in mothers becomes less and less. The overlap of work
between the domiciliary midwife and her hospital counterpart is greater, and her role
changing as she participates more in the total care of the mother who is booked for
either a home or hospital confinement or a planned early discharge which has the
benefit of both schemes.
The full-time midwifery staff of the Borough is now 24. three part-time midwives
are also employed.
Pupil Midwife Training
Eighteen midwives are approved by the Central Midwives Board and train pupil
midwives for the district experience which is required in the last three months of their
year's training.
During 1967, 58 pupils completed their district training. During this period pupil
midwives must live in approved accommodation. This is sometimes at home, sometimes
with a Council midwife, but more frequently in lodgings. Finding suitable
landladies who will not object to the pupil midwives' irregular hours of work and
meals, is sometimes difficult. The hospital as the employing authority advertises, and
inspection of premises is made jointly by Matron of Lewisham Hospital and the
Supervisor of Midwives of the Borough.
Staff Training
Five midwives attended one of the Post Certificate Courses which are statutory under
the Rules of the Central Midwives Board for all practising midwives.
Three midwives attended study days organised by the London Boroughs Training
Committee and four others attended the inservice course in "Aspects of Mental Illness."
All midwives have attended a two-day course in the psychoprophylaxis method of
preparing women for childbirth. Instruction in this method is greatly in demand by
expectant mothers and three midwives are holding well-attended classes.
Patient Care
Out of 1,590 patients who were booked for home delivery only 1,180 were eventually
delivered there. 249 were admitted to hospital for various reasons, the three largest
groups being for Toxaemia, Post Maturity and delay in labour.
A scheme whereby the midwives continued to care for mothers and babies for a
longer period than usual has been tried out in the Forest Hill/Sydenham area since
September, 1966.
The essence of the scheme was flexibility, the mother and baby being discharged
to the care of the health visitor when the mother expressed her readiness to attend
the Child Health Clinic. In the first year out of 450 patients, 309 were looked after by
midwives for a longer period than 10 days.
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