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The most striking feature of this list is the younger age of parents of microcephalics and the
greater age of the parents of the mongols, 54 per cent. of the mothers of the mongols were over 35 years
of age, and in many cases it was noted that the fathers were younger than the mothers.
Midwives Acts.
The number of midwives with London addresses whose names appear on the Roll of Midwives
exceeds 5,000. Of this number, 648 notified their intention to practise during the whole year or for
shorter periods. In addition, notice was received from 10 midwives that they had acted in their professional
capacity on specific occasions within the Administrative County of London.
The 648 midwives who gave notice of intention to practise cannot be taken as the number of midwives
practising at any given time in the County. In some institutions it is the custom for a midwife
to act as assistant for three months or less after she is qualified, and her place is then filled by another
newly qualified assistant, who in her turn gives notice of intention to practise. At any given time it is
probable that some 450 to 500 midwives, or only 9 or 10 per cent. of those on the roll, are in actual
practice in London. The remaining 90 per cent. act for the most part as monthly or general nurses
under medical supervision.
All practising midwives, except those working in hospitals under medical supervision, are subject
to inspection by the Council's officers, to ascertain whether they are complying with the rules of the
Central Midwives Board as to cleanliness, the possession of antiseptics and appliances, the keeping of
registers and case books and the sending of the required notices to the local supervising authority. The
work of inspection is carried out by four women medical inspectors.
In addition to the ordinary routine inspection, special visits are paid to the midwife when any
case of a septic nature or a persistent high temperature occurs in her practice, and in all cases of inflammation
of infants' eyes. The inspectors also advise midwives on any points of difficulty which may arise
in the course of their duties, and in some instances instruct them as to methods of work. On occasion the
midwife is accompanied by the inspector either to a confinement or on a subsequent visit to a patient to
ascertain whether her methods of work are efficient. This is done more particularly where there is reason
to believe that the midwife's work is not up to standard, and also in cases where she has applied to the
Central Midwives Board for approval, to supervise the training of pupils for the Board's examination.
The inspectors paid 2,374 visits during the year to midwives or institutions employing midwives.
In 39 cases there were infringements of the Rules of the Central Midwives Board. Twenty-six
of these were slight, and a verbal caution was deemed sufficient. Nine cases were of a more serious nature,
and were dealt with by a written caution. The remaining four cases were reported to the Central Midwives
Board, who investigated them with the following results:—Two midwives—charges not proved;
one midwife—strictly cautioned ; one midwife—struck off roll. In four other cases involving irregularities,
other than infringements of the rules, it was decided that the practice of the midwives in question
should be kept under close observation. One midwife was suspended from practice in order to prevent
the spread of infection.
The fee a midwife receives, for attending a confinement and the subsequent visiting for 10 days,
varies in different localities from 10s. 6d. per case upwards, but usually a fee of 15s. 6d. to 30s. is expected.
The charities employing midwives pay from 15s. 6d. to 21s. a case, and provide the midwife with registers,
forms, antiseptics, etc.
Certain midwives 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.
From information received under the Notification of Births Act the following figures have been
obtained showing the number of births notified by midwives:—
8 midwives reported over 500 cases in the year.
2 „ „ between 400 and 500 cases in the year.
11 „ „ „ 300 and 400 „ „
13 „ „ „ 250 and 300 „ „
22 „ „ „ 200 and 250 „ „
31 „ „ „ 150 and 200 „ „
53 „ „ „ 100 and 150 „ „
Registration.