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59
Early Discharge of Maternity Patients
In suitable cases mothers are booked for hospital confinement
on the basis that, with the agreement of the doctor and the midwife,
they may if they wish be discharged 48 hours after delivery. This
scheme is very popular with the mothers and with the co-operation
of the hospitals concerned works extremely well. Unfortunately,
these planned early discharges sometimes have an upsetting effect
on the other mothers in the ward, some of whom occasionally take
their own discharge against medical advice ; they are then, naturally,
given all necessary medical and nursing care but it is not a happy
situation.
Domiciliary Midwifery Service
The number of home confinements continues to decline and
some consequential reorganisation of the domiciliary midwifery
services has been necessary.
Two midwives retired during the year and it was not found
necessary to replace them. The area allocated to each midwife has
been enlarged and for relief purposes the midwives now work in
two groups instead of three, with the result that each midwife may
have to travel considerably increased distances to cover her work.
The midwives have now been classed as essential car-users and
all except four are using cars; two of the four will be retiring
shortly. Two midwives are buying their cars with the help of loans
from the Corporation.
Entenox (gas and oxygen) apparatus has been ordered for all
midwives who are car drivers, since this up-to-date type of anaesthetic
apparatus is too heavy to carry on a bicycle. Three of the
new anaesthetic outfits have been in use for some time.
All midwives undertake the care of mothers discharged under
the booked early-discharge scheme and for the assessment of caseloads
two early discharges rank as one home delivery. On this
basis each midwife undertook an average of 40.5 cases during the
year. Of the 490 early discharges 159 were unbooked and of these
59 were against medical advice. All cases receive adequate care
on discharge but many unbooked cases come home to unsuitable
conditions.
Two general practitioner obstetricians now attend their own
ante-natal patients in Council clinics and six midwives attend antenatal
clinics in general practitioners' surgeries.
Mothers attended in their own homes during the year were as
follows :—
Home confinements 725
Booked early discharges 331
Unbooked early discharges 159