London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1932

[Report of the Medical Officer of Health for London County Council]

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41
Midwives Acts, 1902 to 1926, Nursing Homes Registration Act, 1927, Children Act,
1908, and Adoption of Children Act, 1926.
The Midwives Acts, 1902-1926, and the Rules of the Central Midwives Board Midwives.
regulating the practice of midwives provide for:—
(a) Prevention of the practice of midwifery by unauthorised persons.
(b) Training of midwives. (The Council's scheme of training includes
(i) lectures to pupil midwives; (ii) post-certificate lectures to certified midwives;
(iii) grants for special instruction of midwives and midwife-teachers.)
(c) Supervision of the practice of midwives.
(d) Suspension of midwives from practice on grounds of the possibility
of spreading infection, and compensation for loss of practice resulting from
such suspension.
(e) Payment of fees to doctors called by midwives to attend patients in
cases of abnormality or emergency.
(f) Payment of proportion of any annual deficit incurred by Central Midwives
Board.
Certified midwives to the number of 909 gave notice of intention to practise
within the county during the year, compared with 934 in 1931. Practising midwives,
other than those who work entirely in hospitals approved by the Central Midwives
Board under medical supervision, are subject to inspection by the Council's inspectors
of midwives with a view to ensuring that a proper standard of efficiency is maintained.
The work of inspection is carried out by four women assistant medical officers, who
supervise the work of the midwives generally, give advice in regard to any difficulties
that may arise in connection with their work and pay special visits where cases of a
septic nature or persistent high temperature, inflammation of the eyes or blisters on
the child occur; 2,398 visits were paid this year compared with 2,471 in 1931.
Infringements of the Rules of the Central Midwives Board to the number of 53
were reported during the year, compared with 64 in 1931. Of these 41 were slight,
and a verbal caution was deemed to be sufficient; 11 cases of a more serious nature
were dealt with by a written caution, and 1 midwife was interviewed and
caution by the Committee
Suspension of
midwives.
The Midwives Act, 1926, requires that, in the case ol midwives suspended rrom
practice in order to prevent the spread of infection, the local supervising authority
must compensate such midwife for loss of practice by the payment of such amount
as is reasonable in the circumstances of the case, provided that the midwife was not
herself in default; 42 midwives were suspended from practice during the year
in order to prevent the spread of infection, and in 21 cases compensation was
authorised.
Uncertified
persons.
The Midwives and Maternity Homes Act, 1926, amended section 1 (2) of the
Midwives Act, 1902, so as to make it an offence for any uncertified person to attend
women in childbirth, except under the direction and personal supervision of a
registered medical practitioner, unless the case was one of sudden or urgent necessity.
During the year 3 enquiries were made into such cases, compared with 7 in 1931.
In all 3 cases a caution was administered.
Still-births.
The Births and Deaths Registration Act, 1926, 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 by the first schedule of the Act. During
the year there were 324 still-births reported to the Council by midwives in their
practice, compared with 582 in 1923, 594 in 1924, 510 in 1925, 513 in 1926, 486 in
1927, 473 in 1928, 413 in 1929, 408 in 1930, and 363 in 1931. Of the cases reported
this year 175 were male and 146 female, while in 3 cases the sex was not stated;
174 were reported as macerated, 148 not macerated, and in 2 the condition was not
stated.
Puerneral
During the year 219 cases of puerperal fever were investigated, compared with
283 in 1931. Of these cases 35 proved fatal, compared with 59 in 1931, a case
mortality of nearly 16.4 per cent., compared with 20.8 per cent, in 1931. In addition