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90
Annual Report of the London County Council, 1910.
previously, the matter was reported to the Midwives Act Committee of the Council, and a letter of
caution was sent to the midwife. This occurred in seven cases on the following grounds :—
Delay in advising medical assistance for the mother 2
„ „ „ „ feeble child 4
„ „ „ „ inflammation of child's eyes 1
Prima facie cases of negligence or misconduct were found against two midwives, and in one case a
charge of drunkenness made against a midwife was communicated to the Board without investigation
owing to the dismissal of the midwife from the institution at which she was engaged, and the absence
of any knowledge of her address. The name of this woman was removed from the roll subsequently.
I Charge. Result.
I Neglect and incompetence Cautioned by Board.
I Falsifying register and want of cleanliness .. .. .. Name removed from Roll
Drunkenness while on duty Name removed from Roll.
There is a gradual improvement in the work of midwives, and, as the number of untrained
midwives diminishes year by year, the number of instances of disregard of the rules as to cleanliness
and of failure through ignorance to recognise serious conditions has also diminished. The Council's
inspectors have paid special attention to the untrained midwives and instructed them as to the use of
antiseptics and the reading of the clinical thermometer.
There are some five midwives who are illiterate, but other members of their family enter up their
registers for them. A copy of the rules of the Board translated into Yiddish by the Jewish Board of
Guardians at the request of the Council was supplied to the Jewish women in East London who have
difficulty in understanding English. There are some 12 or 13 Jewish midwives and two Italians in
in London.
Fees charged
by Midwives
The fee a midwife receives for attending a confinement and the subsequent visiting for 10 days
varies in different localities from 5s. per case upwards, but usually a fee of 7s. 6d. to 10s. is expected.
The charities employing midwives pay 5s. or 6s. a case, and provide the midwife with registers, forms,
antiseptics, etc. It is apparent from the number of cases taken by midwives and the small fees paid
that very few can rely solely on their practice as a means of livelihood. Many of them are married women
who do not trouble to obtain a large practice, a few keep lying-in homes ; others, especially those with
a fairly large practice, are approved by the Central Midwives Board to give practical instruction to
pupils preparing for the Board's examination. The pupil resides with the midwife and goes with her
to cases. The fees for pupils are usually about £1 1s. per week, which includes board and lodging
in addition to the Practical instruction given by the midwife.
Maternity
charity
In answer to a question in the House of Commons, the President of the Local Government Board
stated that in 1910, 3,125 maternity cases were admitted to the wards of the London workhouses and
infirmaries and 329 midwifery orders were given by the guardians to midwives working outside the
infirmaries. A large proportion of the indoor cases are conducted by midwives, and many of the
infirmaries are approved as training schools for pupil midwives. Over 5,000 cases are taken annually
into the maternity hospitals, and some 18,000 to 20,000 are delivered in their own homes by midwives
working for maternity hospitals or in connection with one or other of the free maternity charities.
From information received under the Notification of Births Act the following figures have been
obtained showing the number of births notified by midwives :—
12 midwives reported over 500 cases in the year.
3 „ ,, between 400 and 500 cases in the year.
8 „ „ „ 300 and 400 „ „
12 „ „ „ 250 and 300 „ „
12 „ ,, 200 and 250 „ „
30 „ „ „ 150 and 200 „ „ 3
45 „ „ „ 100 and 150 „ „
72 „ „ 50 and 100 „ „
64 , „ „ 20 and 50 „ „
Uncertified
women.
Most of the midwives who had 300 cases and upwards have qualified assistants, and many are
approved by the Central Midwives Board to supervise the work of pupils. From information received
under the Notification of Births Act, it is computed that some 30,000, or 25 per cent, of the total births
in London, are attended by midwives, excluding the cases attended by midwives in infirmaries.
After March, 1910, by Section 1 (2) of the Act, no woman, unless she be certified under the Act
may habitually and for gain attend women in childbirth except under the direction of a registered
medical practitioner. The Council had already compiled a list of names of women who were known
to be attending women in childbirth, and a letter was addressed to these women calling their attention
to the provisions of this section. As already mentioned a new rule was framed allowing the Board to
enrol women who might have been enrolled, but who had failed to apply for enrolment prior to March
1905. Several uncertified women made application under the new rule, but were refused by the Board,
who laid down as one of the conditions, the want of certified midwives in the neighbourhood where the
applicant resided.