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with 5,990 in 1932. The estimated number of confinements conducted by midwives
in independent practice during the year was 20,957. This appears to indicate that
medical aid was necessary in about 25.8 per cent. of the cases, compared with 22.9
per cent. during 1932.
Ophthalmia
neonatorum.
In 1926, regulations came into force rendering it no longer necessary for a midwife
to notify a case of ophthalmia neonatorum 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's representative of the fee
paid to a medical practitioner summoned by a midwife in a case of ophthalmia
neonatorum, and the Council decided that parents should not be asked to reimburse
the Council for fees paid for such medical attendance on account of a baby's eye
affection. The number of claims for attending cases of eye affection during the
year was 629 and the amount paid to medical practitioners in respect of the cases
was £624, compared with £733 in 1932.
Inflammation
of the
eyes—
Notices.
During the year 1,052 notices were received from midwives indicating that
medical aid had been summoned for inflammation of the eyes of infants, compared with
1,155 in 1932; 22 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 1,074
cases, 270 proved to be ophthalmia neonatorum, compared with 333 in 1932; 260
other cases that did not occur in midwives' practices were also notified, making a
grand total of 530 cases during the year, the percentage occurring in the practice of
midwives being 50.9 per cent., compared with 48.8 per cent. in 1932. All the
midwives' cases were investigated, and it was found that 267 were completely cured ;
in 1 case blindness in one eye resulted, 1 case died, 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 36 during 1932.
Pemphigus
neonatorum,
During the year 37 cases of pemphigus neonatorum occurred in the practice of
midwives, compared with 59 during the previous year.
Instruction
of midwives.
As in past years, courses of demonstrations and lectures at convenient centres
were provided for the post graduate instruction of midwives practising in London,
Middlesex, Ealing, Edmonton, Tottenham and Willesden, the cost being shared by
the local supervising authorities in proportion to the numbers of their midwives
attending.
In April, 1930, 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, at
suitable intervals, a course of two lectures by two of the Council's medical officers
particularly associated with the supervision of midwives. This course of lectures is
provided four times a year for the instruction of pupils before each examination
of the Central Midwives Board for candidates for admission to the Midwives Roll.
Pupil midwives in training at the Council's hospitals and other institutions in London
are admitted to the courses, which are held in the conference hall at the County Hall.
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. Pupils attending
during the year 1933 numbered 701, compared with 770 in 1932.
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
and are exchanged with the metropolitan borough medical officers of health as
described in the Annual Report for 1929, was continued during the year.