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applied for a certificate in support of her application to the Central Midwives Board
for the restoration of her name to the Midwives Roll. The Midwives Act, 1902
(section 1 (2)), makes it an offence for any uncertified woman habitually and for
gain to attend women in childbirth except under the direction of a registered medical
practitioner. During the year 15 inquiries were made by the inspectors into such
cases, in 7 of which it was decided to take no further action; 7 were dealt with by a
verbal or written caution, and the case of one woman was referred to the Middlesex
Countv Council.
Still births.
During the year there were 510 still-births reported by midwives in their practice.
The figures for previous years were: 1920, 896; 1921, 684; 1922, 720; 1923, 582;
1924, 594. Of the 510 still-births 286 were males, and 219 females, and 5 not
stated; furthermore, 254 were reported macerated; and 236 not macerated,
and 20 not stated.
Puerperal
fever,
316 cases of puerperal fever were reported during the year, as against 300 the
previous year. 78 cases proved fatal, as compared with 70 the previous year, a case
mortality of about 25 per cent. as against over 23 per cent. the previous year. In
addition the Registrar-General recorded 26 deaths from puerperal sepsis, which
were, however, not notified as puerperal fever. The distribution of the notified
cases was as follows:—
Delivery conducted Ky Cases. Deaths.
(а) Medical practitioners 109 24
(b) Certified midwives 86 17
(c) Medical practitioner and certified midwife 10 4
(d) Hospitals and poor-law institutions 66 19
(e) Medical students 14 2
(f)Cases of miscarriage or abortion where no attendant was engaged 27 7
(g) Uncertified women 4 3
Total 316 76
Medical aid.
In certain emergencies specifically enumerated in the Rules of the Central
Midwives Board a midwife is required to advise in writing that medical aid be
summoned, and must also see that such help is summoned and obtained. The
notice is sent to the doctor, and a copy must be forwarded to the local supervising
authority. During 1925 as many as 7,034 notices were received, as compared with
6,961 in 1924. Assuming that approximately 41,000 confinements were conducted
during the year by midwives in independent practice, it appears that medical aid
was required in about 17.1 per cent. of the cases, about the same percentage as in the
preceding year.
Ophthalmia
neonatorum.
Great stress is laid by the Council on the due observance by midwives of the
Rules of the Central Midwives Board with regard to inflammation of the eyes. However
slight the inflammation may be, it is the duty of the midwife to summon medical
aid, and as soon as the notice is received at this office the case is followed up by one
of the medical inspectors. Notice is also sent to the borough medical officer, so that
the health visitor may continue to keep observation on the child after the midwife
has left the case. Most valuable assistance is also given by the Voluntary Nursing
Associations in cases where domiciliary treatment is necessary.
1,284 notices were received from midwives during the year with regard to
medical aid summoned for inflammation of the eyes of infants, as compared with
1,266 in 1924. In addition, 65 other cases occurred in which either medical help
was not called in by the midwife or she failed to notify the Council that she had done
so. Of these 1,349 cases, 422 proved to be ophthalmia neonatorum, as compared
with 431 in 1924; 281 other cases that did not occur in the practice of midwives
were also notified, making a total for the year of 703 notified cases of this disease.
The percentage occurring in the practice of midwives was 60.0, as against 61.0 in
1924. All the cases that occurred in the practice of midwives were investigated by
the inspectors, and it was found that 398 were reported as completely cured, while