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Infringements of the Rules of the Central Midwives Board to the number of 26
were reported during the year, compared with 42 in 1934. Of these 20 wcc slight,
and an oral caution was deemed to be sufficient; 5 cases of a more serious nature
were dealt with by a written caution, and one midwife was interviewed and cautioned
by the Committee.
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 the 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; 25 midwives were suspended from practice during the year
in order to prevent the spread of infection, and 12 claimed and received compensation.
The Midwives Act, 1926, amended section 1 (2) of the Midwives Act, 1902, so
us 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 5 enquiries were made into cases of alleged contravention of the Act, compared
with 6 in 1934. In 1 case a caution was administered ; in 4 cases no further action
was considered necessary.
Section 1 (1) of the Midwives Act, 1902, makes it an offence for any woman not
certified under the Act to take any title or description implying that she is certified.
During the year one woman was summoned for falsely describing herself as a " midwife
" on a maternity benefit claim certificate. The magistrate dismissed the
summons under the Probation of Offenders Act and allowed two guineas costs to the
Council. Another uncertified woman has been kept under observation, following
reports that she had been bound over for unlawfully using the initials " R.R.C."
and " S.R.N." on her doorplate. The doorplate which had been alleged to contain
also the initials " C.M.B." had been removed.
IStill-births
During the year there were 249 still-births reported to the Council by midwives
in their practice, compared with 510 in 1925, 513 in 1926, 486 in 1927, 473 in 1928,
413 in 1929, 408 in 1930, 363 in 1931, 324 in 1932, 316 in 1933 and 274 in 1934.
Of the cases reported this year 128 were male and 121 female ; 141 were reported
as macerated, and 107 not macerated; 1 not described.
Puerperal
fever.
During the year 242 cases of puerperal fever were investigated, compared with
257 in 1934. Of these cases 23 proved fatal, compared with 33 in 1934, a case
mortality of 9.5 per cent., compared with 12.8 per cent. in 1934. The distribution
of notified cases, with the mode of delivery, was as follows, deaths being shown in
brackets : medical practitioners 52 (7); certified midwives 50 (4); hospitals and
certified midwives 1 (0); hospitals 102 (10); medical students 3 (0); cases of miscarriage
or abortion where no attendant was engaged 34 (2)—total 242 (23).
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 being attended at
the time of notification ; but 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 1935 was 694, compared with 746 in 1934. The cases were distributed
as follows, the deaths being shown in brackets : medical practitioners 87 (5);
certified midwives 82 (1); hospitals and certified midwives 2 (0); hospitals 474 (15);
Uncertified
persons.