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Domiciliary Midwifery
To meet the needs of mothers wishing to have a home confinement 11 domiciliary
midwives were employed by the Council; in addition three midwives from the General
Lying-in Hospital covered a selected area in the Borough. The midwives visit the expectant
mother to assess the suitability of the home for domiciliary confinement, or its suitability
for the mother and baby to return home to the care of the midwife 48 hours after
confinement in one of the local hospitals. This year 577 mothers were able to enjoy the
facilities of the early discharge scheme.
To supplement clinic attendance each mother booked for home confinement
received at least three home visits so that the midwife could advise on the preparation of
the home and ante-natal care. In two centres, classes in the psycho-prophylactic method
of relaxation were held to which ante-natal mothers who had booked either for hospital
or domiciliary confinement were invited. All midwives have attended a course of
instruction to enable them to assist mothers in this form of relaxation during labour. As
mentioned elsewhere in this report the Guthrie test for phenylketonuria was introduced
during the latter part of the year.
There were 415 domiciliary confinements during the year. Of these 24 were
premature births; one was stillborn.
Eight of the Council's midwives are approved teachers under the Central Midwives
Board second period Training Scheme. During the year 28 pupils completed three months
district training. Student Nurses from Guy's Hospital doing the obstetric training course
also made visits of observation to an ante-natal clinic and accompanied the midwives on
home visits.
We have continued the joint arrangement with the London Boroughs of Lambeth
and Wandsworth of providing two non-medical supervisors to co-ordinate, on a rota basis,
a 24 hour control of the midwifery services throughout the three boroughs (APPENDIX
C).
Maternal Deaths
Two deaths assigned to maternal causes or associated therewith were investigated
on behalf of the Department of Health and Social Security during 1969. One of these
was due to abortion.
District Nursing
Section 25 of the National Health Services Act, 1946, as amended, imposes a duty
on local health authorities to make provision, either directly or through a voluntary body,
for the attendance of nurses on patients who require nursing in their own homes or
elsewhere.
The district nursing service in Southwark is provided directly by the Council. This
service is provided only on the recommendation of the patient's general practitioner with
whom the nurse works in close co-operation (see also page 21 "Attachment of Staff to
General Practitioner"). Nursing auxiliaries were employed to work under the direction of
and to carry out duties not requiring the skills of a trained nurse.
The psychiatric liaison scheme with St. Olave's Hospital and the geriatric liaison
schemes with New Cross and St. Francis Hospitals continue. The success of this closer
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