View report page

54
Suspension of
midwives.
The Midwives Act, 1926, requires that, in the case of midwives suspended from
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; 26 midwives were suspended from practice during the year
in order to prevent the spread of infection, and in 13 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 7 enquiries were made into such cases, compared with 3 in 1932.
In 2 cases a caution was administered; in 5 cases no further action was considered
necessary.
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 316 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, 363 in 1931, and 324 in 1932. Of the
cases reported this year 165 were male and 151 female; 169 were reported as macerated,
146 not macerated, and in 1 the condition was not stated.
Puerperal
fever.
During the year 259 cases of puerperal fever were investigated, compared with
219 in 1932. Of these cases 41 proved fatal, compared with 35 in 1932, a case
mortality of 15.8 per cent., compared with 16.0 per cent. in 1932. In addition
the Registrar-General recorded 31 deaths from puerperal sepsis, which were not certified
as fever, compared with 26 the previous year. The distribution of notified cases,
with the mode of delivery, was as follows, deaths being shown in brackets:—
Medical practitioners 53 (7); certified midwives 68 (16); medical practitioners
and certified midwives 4 (1); hospitals and poor-law institutions 93 (14); medical
students 10 (0); cases of miscarriage or abortion where no attendant was engaged
31 (3).—Total, 259 (41).
Puerperal
pyrexia.
In July, 1926, the Ministry of Health made regulations requiring the notification
of puerperal pyrexia, which is defined by the regulations to be "any febrile condition
(other than a condition which is required to be notified as puerperal fever under
the Infectious Diseases (Notification) Acts) occurring in a woman within 21 days
after child-birth or miscarriage in which a temperature of 100.4° Fahrenheit (38°
Centigrade) or more has been sustained during a period of 24 hours or has recurred
during that period."
The regulations were amended in 1928 and now require a medical practitioner
to notify any such case on the approved form and transmit the notification to the
medical officer of health of the district in which the patient is actually living at
the time of notification. In addition any notification of a case in a London hospital
must specify the place from which and the date on which the patient was brought to
the hospital and must be sent to the medical officer of health of the district in which
the said place is situated. The number of notifications of puerperal pyrexia investigated
during 1933 was 851, compared with 783 in 1932. The cases were distributed
as follows, the deaths being shown in brackets:—Medical practitioners
92 (7); certified midwives 115 (4); medical practitioners and certified midwives
5 (0); hospitals and poor-law institutions 569 (19); medical students 18 (1); cases
of miscarriage or abortion where no attendant was engaged 52 (5)—Total 851 (36).
Thirty-one of the cases, with 7 deaths, were subsequently notified as puerperal fever,
and are therefore shown in both tables.
Medical aid.
The Rules of the Central Midwives Board indicate the emergencies for which
a midwife must advise in writing that medical aid be obtained, and for which such
help must be secured. A notice in the approved form is sent to the doctor, and to
the Council. In the year now under review 5,405 such notices were received, compared