View report page

38
Ante-natal
sessions at
Maternity
and child
Welfare
Centres
By arrangement with the metropolitan borough councils, thirty-four midwives
held weekly ante-natal sessions at the maternity and child welfare centres at the
beginning of the year and on 1st July, 1948, this number had increased to 62. With
the transfer of the centres to the Council even more rapid progress was made, and by
the end of the year, 111 midwives were regularly attending centres. Wherever possible,
the midwife attends a combined session with a doctor to whom she can refer patients,
when necessary, with the minimum delay. This has the added advantage that doctor
and midwife can hold consultations and exchange reports in regard to each patient.
It also suits the expectant mother as her visit to the midwife can be combined with
the other visits which she must periodically pay to the centre, e.g., for medical
examinations and social services. The other midwives book and examine their
patients at home and will be allocated to centres as soon as suitable premises are
available.
Gas and air
analgesia
The following tables Set out the number of mothers receiving analgesia during
the year and the percentage which they represent of all confinements taken. In
addition, there are the mothers on whom the midwives attend as maternity nurses
under the direction of doctors who themselves give anaesthesia or analgesia and for
whom no figures are available.
An indication of the progress made in 1948 is shown by the half-yearly statistics:—
January to July to Total for
June, 1948 December, 1948 the year
London County Council domiciliary
midwives 1,345 (25%) 2,102 (44%) 3,447 (34%)
Hospital district midwives 787 (27%) 1,051 (44%) 1,838 (35%)
District nursing association
wives 445 (25%) 458 (30%) 903 (28%)
Steady progress was made during the year in the training of midwives to administer
gas and air analgesia. Six courses of training were held and the number trained at
31st December, 1948, was 148 out of a total of 155 midwives, as compared with 94
out of 158 midwives at 31st December, 1947.
For various reasons, the percentage of mothers confined at home who receive
gas and air or similar analgesia will never reach 100 but the aim of the Council is to
provide it whenever the mother desires it and there is no medical contra-indication.
Housing of
midwives
The Council has continued to provide accommodation for domiciliary midwives,
as recommended by the Midwives Salaries (Rushcliffe) Committee. At 31st December,
1948, 74 midwives were housed in 66 houses, of which 43 were provided by the Council
and 23 taken on lease or on licence either from the borough councils or direct from the
owners. The Regional Hospital Boards have co-operated in arranging for the temporary
accommodation of midwives in hospital staff quarters.
Furniture
Seventeen midwives were supplied with furniture, valued at approximately
£950 during the year, in return for a monthly hire charge. Charges for water heating
appliances supplied to midwives occupying premises provided by the Council ceased
on 30th June, 1948, as it was decided that the Council would henceforth provide
these appliances.
Co-operation
with
Hospitals
W hen the Council was a hospital authority, a close system of co-operation was
built up between the maternity hospitals and the domiciliary midwifery service, from
which the latter service derived much benefit and this co-operation has continued
with the Regional Hospital Boards. Its principal features are:—
(i) The doctor or, in his absence, the midwife, may apply in any emergency
affecting either the mother or child, for a hospital bed through the Emergency
Bed Service, and similarly for women who develop puerperal fever or pyrexia, or
for infants who are premature or suffering from ophthalmia neonatorum. Direct
admission to certain hospitals may also be arranged for infants with rhesus
negative condition.