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39
Midwives and Maternity Homes Acts, 1902 to 1926, and Children Act, 1908.
There are over 5,000 duly certified midwives with London addresses, of whom
870 gave notice of intention to practice within the County during the whole or
part of the year, as compared with 868 in 1926. About 17.4 per cent, of the midwives
with London addresses are in actual independent practice in the County, the remainder
acting mostly as general or monthly nurses under medical supervision.
Practising midwives, other than those who work entirely in hospitals or infirmaries,
under medical supervision, are subject to inspection by the Council's officers with
a view to ensuring that a proper standard of efficiency is maintained. With regard
to these, it may be noted that E. 27 of the rules of the Board provides that the rules,
other than rule 22 (2), shall not apply to certificated midwives exercising their calling
in poor law institutions "under the supervision of a duly appointed medical officer,"
interpreted by the Board as a resident medical officer. The attention of poor law
institutions where the medical officer is non-resident has been drawn to this
decision.
The work of inspection is carried out by four women assistant medical officers,
who pay special visits to midwives where cases of a septic nature or persistent high
temperature or inflammation of the eyes occur. The midwives are also given advice
on any point of difficulty that may arise in connection with the work. Every effort
is made to ensure that the educative side of the inspectorial work is maintained.
2,014 visits were paid this year, as compared with 2,145 in 1926.
Midwives.
New rules made by the Central Midwives Board have been approved by the
Ministry of Health and came into operation on 1st January, 1927. The variations
and additions to the old rules deal with :—(1) the standard of efficiency of candidates
for examination as midwives; (2) the placing of names upon, and removal from,
the roll of midwives; (3) ante-natal notes; (4) duties to patients; (5) certain alterations
in the wording of notices to be sent in by midwives; (6) modifications necessary
to bring the rules in line with (a) the Ophthalmia Neonatorum Regulations, 1926;
(6) the Puerperal Fever and Puerperal Pyrexia Regulations, 1926; (c) the Midwives
and Maternity Homes Act, 1926.
C.M.B. Rules
Seventy-seven infringements of the rules of the Central Midwives Board were
reported during the year, as compared with 88 during 1926. Of these, 41 were
slight and dealt with by means of verbal caution; while 29 cases were of a more
serious nature and were dealt with by a written caution. With regard to the remaining
cases, four midwives were interviewed by the Committee,and personally cautioned.
One case was reported to the Central Midwives Board who postponed sentence and
asked for periodical reports on the midwife's conduct and methods of practice.
Infringements
of
C.M B.
rules.
Nineteen midwives were suspended from practice, with a view to the prevention
of the spread of infection, and in 13 cases compensation was authorised. Midwives
are now, under the Midwives Act, 1926, entitled to reasonable compensation for
suspension from practice.
The Midwives Act, 1902 (Section 1 (2)), as amended by the Midwives and
Maternity Homes Act, 1926, makes it an offence for any uncertified person to attend
women in child-birth except under the direction and personal supervision of a
registered medical practitioner, unless the case is one of sudden or urgent necessity.
During the year, eight enquiries were made into such cases, as compared with 11 in
1926. In six cases no further action was taken, and in two cases a verbal or written
caution was administered.
Suspension
of midwives.
The Births and Deaths Registration Act, 1926, came into force on 1st July,
1927, and requires that the birth of every still-born child shall be registered by the
registrar in a register of still-births containing the heads of information prescribed
in the first schedule of the Act. During the year, there were 486 still-births reported
by midwives in their practice, as compared with 720 in 1922, 582 in 1923, 594 in
Still-births.