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It will be seen from these figures that less than 8 per cent, of the enrolled midwives are "uncertificated,"
The proportion of these uncertificated midwives among practising midwives is however much
larger, for it must be borne in mind that the vast majority of enrolled midwives are not practising;
many of them act as monthly nurses and many more are on the nursing staffs of hospitals. During
the year 490 midwives (or 21 per cent, of the number enrolled) gave notice of their intention to practise
within the county and this number includes a large proportion of the 184 uncertificated midwives.
Four midwives died, eight gave up practice, and forty-five removed from the county during the year.
There have been many changes of address within the county, and instances of removal of midwives
from one district to another, An uncertificated midwife on changing her address rarely leaves a district
where she is known.
Inspection.—All practising midwives are subject to inspection to ascertain whether they are
observing the Rules of the Central Midwives Board as to cleanliness, the possession of the required apparatus
and antiseptics, the keeping of case books and registers, and the sending of the required notices to the
Local Supervising Authority. Miss V. E. M. Bennett, M.B., B.S., was appointed inspector for the
purpose of the Act in 1905. There was found, subsequently, need for an additional inspector, and in
October, 1906, Miss L. S. Greig, M.B., L.M., D.P.H., was appointed. In November Miss Bennett
resigned her appointment and the vacancy thus caused was not filled until after the end of the year,
when Miss Ida Shields, M.B., B.S., was appointed. In addition to the routine inspection the inspector
has given assistance to midwives by instruction and advice on any difficulties arising in their practice.
During the year 1,092 inspections were made ; in 626 cases satisfactory reports were made; in 210
cases the reports were unsatisfactory or some special question was raised; in 177 cases the midwife
was away from home at the time of the inspector's visit, and 79 visits were paid to midwives who had
removed or ceased to practise. Under the new rules of the Central Midwives Board it is the duty of
a midwife to report to the Local Supervising Authority any change in her address, and by this
means a number of fruitless visits will be saved. In most of the cases where unsatisfactory conditions
were found the inspector drew the attention of the midwife to the matter and on a subsequent
inspection was able to make a satisfactory report. In cases of persistent neglect to observe the rules
the matter was reported to the Midwives Act Committee and a cautionary letter was sent.

One woman was suspended from practice for not possessing the required antiseptics and apparatus
and the suspension was removed when these had been obtained. Four women were summoned to attend
before the Committee and were cautioned, and seven cases were reported to the Central Midwives Board
as prima facie cases of negligence, malpractice or misconduct, as follows :
Nature of charge.
Action taken by Central Midwives Board.
Refusing to send required notices
» » )• >» •••
Placing out an infant to nurse before ten days
old
Malpractice and calling; in unqualified person as
a medical practitioner
Illegal operation ...
Falsifying register of cases
Want of cleanliness
Midwife cautioned.
)) >■
»» ii
Name removed from Roll.
No action. Patient refused to give evidenci
Midwife cautioned.
Name removed from Roll.
In addition to these cases the conviction of a midwife on a charge of theft was reported to the
Board in accordance with section 8 of the Act, and the midwife's name was removed from the roll. In the
first of the cases in the above table where the name was removed from the roll, the midwife appealed
to the High Court of Justice against the decision of the Board, and the decision of the Board was upheld.
Ten midwives were reported to be more or less illiterate, but such midwives either keep notes of their
cases themselves or make use of relations or friends to keep their register of cases. In three instances
breaches of the rules were said to be due to the midwife not being able to read English, and in this
connection it may be stated that some 25 Yiddish midwives practise in East London amongst the
Yiddish population, and two Italians practise in the Hatton Garden district.
Uncertified Women.—In addition to the 39 uncertified women practising as midwives and referred to
in my report for 1905, 36 others were brought to notice during the year. In the majority of these