London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1950
[Report of the Medical Officer of Health for London County Council]
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60
Ante-natal
sessions
Midwives' sessions for booking patients and for ante-natal examinations at maternity and child welfare centres continued to be developed as necessary. A midwives, however, still book and examine their patients at home.
| Confinements attended by | Maternal | Still- | Neo-natal |
|---|---|---|---|
| London County Council midwives | - | 63 | 23 |
| Hospital district midwives | - | 21 | 9 |
| District nursing association midwives | 1 | 29 | 6 |
| Total 1 | 1 | 113 | 38 |
Mortality
Emergency
Obstetric
Service
During the year 74 calls were made to hospitals for the emergency obstetric
service ; 37 of the calls were made by doctors and 37 by midwives.
The time between the call being made and the arrival of the service was:—
| Less than 30 minutes | 36 cases |
| Between 30-45 minutes | 30 cases |
| Over 45 minutes | 8 cases |
| In no case was the delay really serious. | |
| The conditions for which the service was called were as follow :— | |
| Retained placenta | 28 |
| Post-partum haemorrhage (after delivery of placenta) | 31 |
| Malpresentation and/or obstructed labour | 8 |
| Prolapsed cord | 1 |
| Obstetric shock | 3 |
| Failed forceps | 2 |
| Abortion | 1 |
54 of the cases were multigravidae, 15 primigravidae and 5 not known. In
4 cases the mother had had 6 or more previous pregnancies. Two of these had
post-partum haemorrhage and two malpresentations.
The action taken by emergency obstetric service was as follows :—
| Blood transfusion | 44 cases |
| Saline drip | 4 „ |
| Expression of placenta | 4 „ |
| Manual removal of placenta | 8 „ |
| Forceps delivery | 1 case |
| Internal version and delivery | 1 „ |
| Episiotomy | 1 „ |
| Drugs administered | 6 cases |
In the remaining 5 cases no treatment was given before removal to hospital.
38 patients were removed to hospital either after blood transfusion or, if their condition
was satisfactory, without treatment; 36 patients were treated satisfactorily
at home. In all cases to which service was called the mother made a good recovery.
Comments—During the year the emergency obstetric service was mainly called for
true obstetric emergencies, i.e., 59 cases of retained placenta and/or post-partum
haemorrhage. In the majority of cases a transfusion was given in the house and then
the patient was removed to hospital.
On 11 occasions the emergency obstetric service was called for difficult deliveries
either by a doctor unable to deal with the case himself or by a midwife unable to
obtain a doctor.
Pupil
midwives
At the end of 1950, 74 of the Council's domiciliary midwives had been approved
by the Central Midwives Board as district teachers. During the year 140 pupil midwives
from part II midwifery training schools received their district training with