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53
There was one death among women confined at home. The cause of death wa:
obstetric shock and adherent placenta.
The chief development this year was the increased co-operation between th<
midwife, the general practitioner obstetrician, the hospitals and the pathologica
services available. There was also a marked increase in the number of womer
receiving analgesia during childbirth (see below).
Midwives' sessions for booking patients and for ante-natal examinations at the
maternity and child welfare centres was developed. By the end of the year 117 o:
the Council's midwives, compared with 111 at the end of 1948, were regularl}
holding such sessions. A few midwives, however, had to book and examine theii
patients at home.
There was a large increase during the year in the number of mothers receiving
analgesia from midwives: the following table sets out the numbers receiving
analgesia throughout the year and the percentage which they represent of all con
finement cases attended. In addition to the figures quoted, there were some mother
whom the midwives attended as maternity nurses under the direction of doctor:
who themselves administered anaesthesia or analgesia and in respect of which nc
figures are available :—
Maternal
deaths
Developments
in 1949
Ante-natal
sessions
Gas and
air analgesia
Confinements attended by
January
to June
July
to December
Total
London County Council
midwives
2,882 (63%) , 2,597 (65%) 5,479 (64%)
Hospital district midwives 767 (51%) 804 (59%) 1,571 (55%)
District Nursing Association
midwives
1,555 (62%) 1,478 (69%) 3,033 (65%)

There are still mothers who decline analgesia and in others the birth occurs
before the midwife's arrival.
The Council has continued to provide accommodation for domiciliary midwives
as recommended by the Midwives Salaries (Rushcliffe) Committee. On 31st
December, 1949, 75 midwives were housed in 67 houses or flats, of which 43 were
provided by the Council and 24 taken on lease or on licence either from borough
councils or direct from private owners. The regional hospital boards have continued
to co-operate in arranging for the temporary accommodation of midwives in hospital
staff quarters.
Two midwives were supplied with furniture during the year valued at
approximately £241 lis. 2d. in return for a monthly hire charge. The Council
continues to provide water-heating appliances to midwives occupying premises
provided by the Council.
It is recognised that there should be close co-operation with the regional hospital
boards and teaching hospitals. During the year 48 calls were made for emergency
obstetric units which are sent out from the hospitals.
Drugs and dressings from the hospital dispensaries continued to be issued to
the Council's midwives and pupil midwives from Part II training schools receiving
their district training with the midwives employed either by the Council or by the
district nursing associations. Some hospitals which were Part II training schools also
crave their Dunil midwives district experience with their own midwives.
Housing of
midwives
Furniture
and
appliances
Co-operation
with
hospitals