View report page

MATERNAL AND CHILD HEALTH
DOMICILIARY MIDWIFERY
Valerie J. Buckingham, S.R.N., R.F.N., S.C.M., M.T.D., N.D.N.Cert.
(Assistant Chief Nursing Officer)
Domiciliary Midwifery Service
Following the publication of the report of the Standing Maternity and Midwifery
Advisory Committee of the Central Health Services Council, there resulted in a
reduction in the number of domiciliary confinements and an increase in the number
of planned early discharge patients.
Whilst total births within the Borough remained stable, 4,495 in 1969 and 4,456
in 1970, domiciliary confinements totalled 404, a decline of 29.5 per cent. on the
previous year.
Owing to adverse factors bookings were changed for 82 other patients.
The Emergency Obstetric Unit was called out on 11 occasions.
Early Discharge Scheme
This scheme was originally intended to facilitate hospital delivery where available
beds were limited. It was also hoped that irregular discharges would not occur but,
although available at patients' request, irregular discharges still occur in a high
proportion, as shown below:—
998 Planned discharges
79 District transfers
278 Irregular discharges.
Ante Natal Care
The number of ante natal home visits, including social assessments, remained
constant at 8,022 visits, but the total attendances of 6,443 at ante natal clinics was
1,500 less than last year. Fewer patients were referred to hospital with toxaemia
of pregnancy.
Attachment of Midwives to General Practitioner Obstetricians
For many years a good liaison has existed between midwives and general practitioner
obstetricians, the latter undertaking ante natal consultations at the health clinics.
It was necessary to reorganise the work of the service to cover practice areas
as opposed to geographical areas; the determining factor being the midwifery content
of each practice. This resulted in the number of doctors to which midwives were
attached varying in different areas but nevertheless a close association existed, to
the benefit of the patients.
Liaison Scheme with Domiciliary Midwives Working with Lewisham Hospital
The scheme commenced in January 1970 for a trial period of one year. It had been
designed to permit adequate ante-natal care, delivery and post-natal care to be
provided in as practical a way as possible whilst contributing to the experience of
domiciliary midwives and Part II pupil midwives working on the district.
Whilst it was envisaged that four patients weekly would be selected for the scheme,
the number subsequently delivered by domiciliary midwives was considerably less.
Overall, the project has been a success. The continuous care was appreciated
by the patients and many expressed disappointment when they were not included
in the scheme.
Owing to sickness and staff shortage in the domiciliary field, it became necessary
to discontinue the scheme in November for a short period, but the staff are keen to
recommence as soon as possible.
19