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MIDWIFERY SERVICE
(Section 23)
At the end of the year nine midwives were employed in the Area, two
of whom live and work in Hornsey. Seven of the midwives are approved
teachers and during the year 21 pupil midwives were received for the
district part of their training. As was foreseen there has been a considerable
increase in the number of home confinements and the midwives
each had a heavy case load. They have worked well together and have
done much more than the usual quota of work laid down per midwife.
The number of women delivered in their own homes totalled 698, while
98 women were nursed at home following confinement in hospital. The
tendency is to send mothers home much earlier than previously and most
were sent home on the second day following delivery. A small number
were sent home a few hours after delivery.
In addition to duties in the clinic, ante-natal and other visits, the midwives
undertook work in connection with the National Birthday Trust's
investigations into the causes of perinatal mortality. The survey lasted
over a period of three months, March, April and May. During the first
week in March a detailed and comprehensive questionnaire was completed
for every delivery and for the rest of the period, in the case of
every death or stillbirth. It is significant of the midwives' good relationship
with their patients that no woman refused to complete the form although
much of the required information was of a personal and intimate nature.
This is an important investigation as the neo-natal death rate is causing
concern throughout the country.
The large number of removals into the Area, particularly in Stroud
Green, has caused an increase in the number of late bookings and in the
calls to the midwife of patients in labour who have made no arrangements
at all. These latter cases are causing much concern amongst the midwives
as they have no prior information about the patient's obstetric history
and there is often difficulty in getting a doctor to attend such cases. A
great deal of time is spent on these patients who usually contact every
possible source of help when labour is well advanced and such a case
recently involved the following services—police who visited the patient's
house and the midwife's house, ambulance service who sent an ambulance
to "stand by", an L.C.C. midwife who lived nearby, a midwife from
Tottenham who was sent to the house. Two hospitals were also contacted.
In addition telephone calls were received at a clinic, at three
midwives' houses, at the Area Health Office and at the Supervisor of
Midwives' house. The cost in time and petrol on such a case is considerable
in addition to disrupting the normal work of the services involved.
Transport. With the present extreme shortage of midwives, it is vital
that every midwife who is able to drive should have the use of a car,
primarily because she is able to do more work in less time and also while
working at such pressure to conserve her energy.
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