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91
Report of the Medical Officer of Health.
Enquiries were made into all cases in which it came to the knowledge of the Council that a deliveryhad
been conducted by an uncertified woman, and in six instances there was evidence that the woman
had been engaged beforehand and had received fees for two or more confinements. Proceedings were
instituted and fines in four cases amounting to £3 12s. with £4 10s. costs were imposed. In one case
the woman was convicted and bound over for 12 months in the sum of £2, and in one case the
summons was dismissed.
Most of the other women reported as having conducted cases were found on enquiry to have acted
in emergency, or else they had only conducted one case and could not be described as practising habitually;
these women were informed of the provisions of the Act, and in some cases cautioned by letter.
The rules of the Central Midwives Board provide that in certain circumstances a midwife must Medical
decline to attend alone and must advise in writing that the case is one requiring medical help. The help,
form on which this written advice is given is sent to a medical practitioner, and a copy is forwarded to the
local supervising authority. During the year 3,026 of these notices were received. The figures for the
previous years were : 1905, 1,113 ; 1906, 2,320 ; 1907, 2,533 ; 1908, 2,755 ; 1909, 2,894. The rise in the
figures is no doubt due to the fact that midwives realise more fully the importance of complying
with this rule of the Board. Notices were received from 337 midwives. Midwives in infirmaries
and hospitals under the direction of a qualified medical practitioner are not required to comply with
this rule.
1 midwife reported advising medical help 149 times during the year.
5 midwives „ „ „ 40 to 60 times during the year.
32 „ „ „ „ 20 to 40
64 „ „ „ „ 10 to 20 „
235 „ „ „ „ less than 10 times during the year.
The reasons assigned by the midwife for giving the advice were as follows :—
Pregnancy—
Abortion or miscarriage 44
Deformed pelvis 11
Varicose veins .. .. .. .. .. .. 24
Ante partum hæmorrhage 100
General unhealthy conditions 70
249
Labour—
Pregnaney,
Presentations—
Unable to make out 31
Difficult breech 49
Face 23
Funis 7
Transverse 57
Difficult twins 15
Persistent occipito posterior 35
Hand 15
Placenta previa 18
Prolonged labour (uterine inertia, contracted pelvis, etc.) 511
Laceration of perineum 267
Prolapse of uterus 2
Haemorrhage during labour 15
Retained or adherent placenta 210
Exhaustion or collapse 48
Dyspnoea 1
Hysteria 1
Excessive liquor amnii 2
Uterus not contracting 2
1,329
Lying-in—
Rise of temperature 194
Post partum hæmorrhage 104
Pain or swelling in leg 14
Abdominal pain or swelling 15
Pain or swelling of breast 9
Quick pulse 7
Eclampsia, convulsions 20
Puerperal mania 7
Offensive lochia 4
Sub-involution of uterus 2
Other illness 49
425
5716 G 2