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medical students 14 (0) ; cases of miscarriage or abortion where no attendant was
engaged 35 (2)—total 694 (23). Thirty-two of the cases, with 4 deaths, were subsequently
notified as puerperal fever, and are therefore shown in both tables.
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 4,822 such notices were received, compared
with 5,362 in 1934. The estimated number of confinements conducted by midwives
(other than in hospitals approved by the Central Midwives Board under rule E2)
during the year was 17,000. This appears to indicate that medical aid was necessary
in about 28.4 per cent. of the cases, compared with 26.6 per cent. during 1934.
Medical aid.
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 medical attendance on account of a baby's eye affection.
The number of claims for attending cases of eye affection during the year was 507
and the amount paid to medical practitioners in respect of the cases was £534,
compared with £525 in 1934.
Ophthalmia
neonatorum.
During the year, 799 notices were received from midwives indicating that
medical aid had been summoned for inflammation of the eyes of infants, compared with
955 in 1934 ; 15 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 814
cases, 166 proved to be ophthalmia neonatorum, compared with 230 in 1934 ; 211
other cases that did not occur in midwives' practices were also notified, making a
total of 377 cases during the year, the percentage occurring in the practice of midwives
being 44.03 per cent., compared with 48.7 per cent. in 1934. All the midwives'
cases were investigated, and it was found that 160 were completely cured; in one
child the left eye was scarred and sight impaired ; 3 cases could not be traced owing
to the removal of the parents; one child died; one child, progressing satisfactorily,
was still in St. Margaret's hospital at the end of the year. Twenty-eight cases became
in-patients at St. Margaret's hospital, compared with 46 during 1934.
Inflammation
of the
eyes—
Notices.
During the year, 61 cases of pemphigus neonatorum occurred in the practice of
midwives, compared with 24 during the previous year.
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 on the relationship of the
midwife to the various health authorities should be given by the medical officer of
health of the local supervising authority.
Pemphigus
neonatorum.
Instruction
of midwives.
The Board approved the arrangements made by the Council tor 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 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 numbered
811. compared with 755 in 1934.