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65
Infringements of the Rules of the Central Midwives Board to the number of 15
were reported during the year, compared with 28 in 1936. Of these, 12 were slight
and an oral caution by the inspector was deemed to be sufficient; 3 cases of a more
serious nature were dealt with by a written caution.
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 14 claimed and received compensation.
The Midwives Act, 1926, amended section 1 (2) of the Midwives Act, 1902, sc
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 enquiry was made into one case of alleged contravention of the Act, compared
with 5 such enquiries made in 1936. In this case no further action was considered
necessary.
During the year there were 237 still-births reported to the Council by midwives
in their practice, compared with 211 in 1936. Of the cases reported this year 114
were male, 122 female, and one sex not stated ; 117 were reported as macerated,
and 120 not macerated.
During the year 240 cases of notified puerperal fever were investigated, compared
with 170 in 1936. Of these cases 18 proved fatal, compared with 11 in 1936,
a case mortality of 7.5 per cent., compared with 6.47 per cent, in 1936. The case
mortality in 1935 was 9.5. The distribution of notified cases, with the mode of
delivery, was as follows, deaths being shown in brackets : medical practitioners
63 (4); certified midwives 34 (3); hospitals 122 (8); medical students 4 (0); cases
of miscarriage or abortion where no attendant was engaged 17 (3)—total 240 (18).
The number of notifications of puerperal pyrexia investigated during 1937 was
859, compared with 681 in 1936. The cases were distributed as follows, the deaths
being shown in brackets : medical practitioners 108 (3); certified midwives 85 (2);
hospitals 636 (8); medical students 10 (0); cases of miscarriage or abortion where
no attendant was engaged 20 (1)—total 859 (14). Fourteen of the cases, of whom
none died, 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 call in a medical practitioner. A notice in the approved form is
sent to the doctor, and to the Council. In the year now under review 4,269 such
notices were received, compared with 4,726 in 1936. 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 17,800. This appears
to indicate that medical aid was necessary in about 24 per cent, of the cases, compared
with 27 per cent, during 1936.
The number of claims from medical practitioners for attending cases of eye
affection of newly-born children during the year was 547 and the amount paid in
respect of the cases was £544, compared with £516 in 1936.
During the year, 830 notices were received from midwives indicating that
medical aid had been summoned for inflammation of the eyes of infants, compared with
782 in 1936 ; 9 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 the total
839 cases, 144 proved to be ophthalmia neonatorum (.8 per cent, of the 17,800
patients attended by midwives), compared with 158 in 1936 ; 310 other cases that
did not occur in midwives' practices were also notified, making a total of 452 cases
during the year, the percentage occurring in the practice of midwives being 31.42
per cent, of all cases of ophthalmia neonatorum, compared with 33.97 per cent, in
1936.
Suspension of
midwives
Uncertified
persons
Still-births
Puerperal
fever
Puerperal
pyrexia
Medical aid
Ophthalmia
neonatorum
Inflammation
of the
eyes—
notices