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52
medical aid was necessary in about 22.5 per cent. of the cases, compared with 22.8
per cent. during 1929.
Ophthalmia
neonatorum.
In 1926, regulations came into force rendering it no longer necessary for a midwife
to notify a case of this disease to the local sanitary authority, this duty being assigned
to the medical practitioner only. This, however, did not relieve the midwife of the
necessity of sending a copy of her medical aid notice in all such cases to the Council.
The Ministry of Health issued a memorandum in connection with the regulations,
suggesting that the Council should consider whether it should not refrain from
exercising the power of recovery from the patient of the fee paid to a medical practitioner
summoned by a midwife in a case of inflammation of the eyes, and the Council
decided that parents should not be asked to reimburse the Council for fees paid
for such medical attendance. The number of these cases during the year was 789
and the amount paid to medical practitioners in respect of the cases was £716.
Inflammation
of the
eyes.
Notices.
During the year 1,346 notices were received indicating that medical aid had
been summoned for inflammation of the eyes of infants, compared with 1,333 in 1929;
23 other cases arose in which either medical aid was not called in by the midwife
or she failed to notify the Council that she had done so. Of these 1,369 cases, 321
proved to be ophthalmia neonatorum, compared with 415 in 1929; 293 other cases
that did not occur in midwives' practices were also notified, making a grand total
of 614 such cases during the year, the percentage occurring in the practice of midwives
being 52.3 per cent., compared with 56.7 per cent. in 1929. All the midwives' cases
were investigated, and it was found that 316 were completed cured, 2 were left with
impaired vision one with both eyes affected and one with one eye only affected, 2 died
of inter-current disease, and 1 could not be traced owing to the removal of the parents.
Thirty-eight cases became in-patients at St. Margaret's Hospital, compared with 47
during 1929. Special provision is made by the Council at this hospital to deal with
cases of this disease, including the admission of mothers with breast-fed children, and
the results are most encouraging. Every effort is made to persuade parents of babies
with serious ophthalmia to take advantage of this provision.
Instruction
of midwives.
As in past years, courses of demonstrations and lectures by obstetrical specialists
at convenient centres were provided for the post graduate instruction of midwives
practising in London or Middlesex, the cost being shared by the two county councils
in proportion to the the numbers of London and Middlesex midwives attending.
Occasional special instruction by approved teachers was also arranged for the benefit
of selected midwives.
In April of this year the Central Midwives Board suggested that lectures to
pupil midwives on the Rules of the Central Midwives Board and the relationship
of the midwife to the various health authorities should be given by the medical
officer of health of the local supervising authority.
The Board approved the arrangements made by the Council for providing a
course of two lectures by two of the Council's medical officers particularly associated
with the supervision of midwives. Pupil midwives in training at the Council's hospitals
and other institutions in London are admitted to the courses, the first of which was
held in June, 1930, at the London Day Training College and was attended by 346
pupil midwives. The second course, given at the end of September, was attended
by 178 pupils. A certificate of the attendance of a pupil at the course is signed by the
Council's medical officer and furnished to the Central Midwives Board.
This course of lectures is to be provided four times a year for the instruction
of fresh pupils before each examination of the Central Midwives Board for candidates
for admission to the Midwives Roll.
Pemphigus
neonatorum.
During the year 79 cases of pemphigus neonatorum were reported, the same
number as in the previous year.
Maternal
mortality.
The arrangement made at the suggestion of the Ministry of Health whereby
confidential reports are made on maternal deaths by medical officers of the Council