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112
the return of the birth-rate to a more normal level in 1948 it was possible to
concentrate on training in analgesic methods. The following tables illustrate the
progress made :—
Number of L.C.C. midwives qualified to administer analgesia
At 31-12-46 50 out of 148 in the service
At 31-12-47 94 out of 158 in the service
At 31-12-48 148 out of 155 in the service
Increase in the number of patients receiving analgesia
This is shown for L.C.C. midwives by a comparison of the number of administrations
during the half-yearly periods since analgesia was introduced for their use in
June, 1946:—
Total Percentage of all
Period administrations confinements
1946
June to December (7 months) 260 3%
1947
January to June 406 6%
July to December 729 13%
1948
January to June 1,345 25%
July to December 2,102 44%
The increase has been consistent within the half-yearly periods and culminated
in December, 1948, for which the monthly return of analgesia administrations was:—
Total administrations by L.C.C. midwives in December, 1948.
Total administrations Percentage of all confinements
455 59%
As a footnote to these figures, it may be added that at the time of writing this
report all the Council's midwives are qualified to administer analgesia and every
woman (booked by them) who wishes to have relief in childbirth may have it, provided
she is certified as medically fit.
Transport
Various modes 01 transport are used by the Council s midwives in the performance
of their duty. Bicycles and motor-cars are used by some who receive special
allowances for their use. Travelling expenses are paid for those who have to use
public transport. Midwives are assisted in obtaining new cars by means of a
priority scheme agreed between the Ministry of Health and the manufacturers.
Transport by ambulance vehicle is available in certain circumstances by night and
when no public transport is available, and during the day time if specially required.
Ante-natal
care
Ante-natal care tails into three categories :—(1) medical examination at the
beginning of pregnancy and at or about the 36th week, or more often as required by
the doctor, (ii) intermediate ante-natal examination by the midwife as required by
the rules of the Central Midwives' Board, (iii) associated social and educational
services. Medical examination is undertaken by a doctor at an ante-natal centre or,
if the patient wishes, by her own private doctor ; in either case the midwife receives
reports of these examinations from the doctors. The social and educational services
are also available at the ante-natal centres. The midwife's own examinations have
usually been carried out at her own home where a room was set aside for professional
use or at the patient's own homes, when they could not be done at the midwife's
home. In some boroughs, it has been possible to develop a closer link by arranging
for the midwife to use a room at the borough ante-natal centre and to see her patients
there. As has been explained in the report on the midwifery service for 1948, the
Council's policy under the National Health Service Act has been that wherever possible
the midwives shall use the maternity and child welfare centres to book and examine
their patients with a doctor in attendance to whom patients can be referred by the
midwife.