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31
L.C.C. hospitals 196
Voluntary maternity hospitals (district) 210
Voluntary general and special hospitals 107
Borough maternity homes 59
Voluntary nursing associations 129
Total 1,050
The following is a summary of returns wh1ich have been made voluntarily by
the 139 midwives in private practice in London as to the number of patients attended
by them during 1938:—
Number of midwives who attended under 25 cases*90
25 to 50 „ 20
50 to 75 11
75 to 100 11
„ „ „ over 100 7
Total 139
* Of whom 44 took no patients.
Infringements of the Rules of the Central Midwives Board to the number of 14
were reported during the year, compared with 15 in 1937. Eight midwives received
a written caution and four received an oral caution. Of the remaining two cases,
which were of a more serious nature, one was cautioned by the appropriate Committee
of the Council and one by the Central Midwives Board.
The County
of London
(MidwiferyProhibition
of Unqualified
Persons)
Order, 1938.
The County of London (Midwifery—Prohibition of Unqualified Persons) Order,
1938, came into operation on 1st November, 1938. With certain exceptions, an
unqualified person is prohibited from attending patients for gain in the capacity
of a maternity nurse. Up to the end of the year, four persons received either written
or oral cautions.
Still-births
During the year there were 203 still-births reported to the Council by midwives
in their practice, compared with 237 in 1937. Of the cases reported this year 101
were male, 102 female; 104 were reported as macerated, and 98 not macerated,
and in one the condition was not stated.
Puerperal
fever
During the year 201 cases of notified puerperal fever were investigated, compared
with 240 in 1937. Of these cases 7 proved fatal, compared with 18 in 1937,
a case mortality of 3.46 per cent., compared with 7.5 per cent. in 1937. The case
mortality in 1936 was 6.47. The distribution of notified cases, with the mode of
delivery, was as follows, deaths being shown in brackets: medical practitioners
43(1); certified midwives 32 (3); hospitals 102 (2); cases of miscarriage or abortion
where no attendant was engaged 24 (1)—total 201 (7).
Puerperal
pyrexia
The number of notifications of puerperal pyrexia investigated during 1938 was
930, compared with 859 in 1937. The cases were distributed as follows, the deaths
being shown in brackets: medical practitioners 103 (1); certified midwives 111 (3);
hospitals 677 (8); cases of miscarriage or abortion where no attendant was engaged
39 (0)—total 930 (12). Six of the cases, of whom none died, were subsequently
notified as puerperal fever, and are therefore shown in both tables.
Medical aid
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 5,410 such
notices were received, compared with 4,269 in 1937. 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 17,850. Thi,s appears
to indicate that medical aid was necessary in about 30'3 per cent. of the cases, compared
with 24 per cent. during 1937.
Inflammation
of the
eyes—
notices
During the year, 845 notices were received from midwives indicating that
medical aid had been summoned for inflammation of the eyes of infants, compared with
830 in 1937; 11 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