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54
Practising midwives, other than those who work entirely under medical supervision
in hospitals approved by the Central Midwives Board 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; 2,978 visits were paid this
year compared with 2,590 in 1935.
Infringements of the Rules of the Central Midwives Board to the number of 28
were reported during the year, compared with 26 in 1935. Of these, 23 were slight,
and an oral caution by the inspector was deemed to be sufficient; 4 cases of a more
serious nature were dealt with by a written caution, and one midwife was interviewed
and cautioned by the Medical Officer.
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; 26 midwives were suspended from practice during the year
in order to prevent the spread of infection, and 9 claimed and received compensation.

Uncertified
persons.
The Midwives 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 5 enquiries were made into cases of alleged contraventions of the Act, the same
number as in the previous year. In 1 case a caution was administered ; in 4 cases
no further action was considered necessary.
Still-births.
During the year there were 211 still-births reported to the Council by midwives
in their practice, compared with 249 in 1935. Of the cases reported this year 110
were male and 101 female ; 129 were reported as macerated, and 80 not macerated ;
2 not described.
Puerperal
fever.
During the year 170 cases of notified puerperal fever were investigated, compared
with 242 in 1935. Of these cases 11 proved fatal, compared with 23 in 1935,
a case mortality of 6-47 per cent., compared with 9-5 per cent, in 1935. The case
mortality in 1934 was 12-8. The distribution of notified cases, with the mode of
delivery, was as follows, deaths being shown in brackets : medical practitioners
45 (2); certified midwives 25 (0); hospitals and certified midwives 1 (1);
hospitals 81 (7); medical students 7 (0); cases of miscarriage or abortion where no
attendant was engaged 11 (1)—total 170 (11).