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 1952
[Report of the Medical Officer of Health for London County Council]
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| Confinements attended by | 1948 | 1949 | 1950 | 1951 | 1952 | |
|---|---|---|---|---|---|---|
| London County Council midwives | Number | 3,447 | 5,479 | 5,027 | 5,338 | 4,588 |
| Percentage | (34) | (64) | (68) | (75.8) | (75.8) | |
| Hospital district midwives | Number | 1,838 | 1,571 | 2,783 | 2,323 | 2,310 |
| Percentage | (35) | (55) | (69) | (72.5) | (75.9) | |
| Association midwives | Number | 903 | 3,033 | 1,400 | 1,443 | 1,401 |
| Percentage | (28) | (65) | (57) | (68) | (72.3) | |
Pethidine
Statutory Instrument No. 380, issued under the dangerous drugs regulations, came
into operation on 1st April, 1950, and authorised certified midwives who had notified
intention to practise to the local supervising authority to be in possession of and to
administer medicinal opium, tincture of opium and pethidine so far as is necessary for
the practise of their profession of employment as midwives. Conditions were laid down
which provided that midwives could only obtain supplies of these dangerous drugs by
production of a drug book and their personal registers of cases. Records of supplies and
administration of the drugs have to be kept in the drug books. To ensure that all
practising domiciliary midwives in London were qualified to administer pethidine,
lectures on the subject were arranged. The number of administrations of pethidine by
midwives was :
| Administered by | As midwives | As maternity nurses | ||
|---|---|---|---|---|
| 1951 | 1952 | 1951 | 1952 | |
| London County Council midwives | 1,442 | 1,287 | 175 | 194 |
| Hospital district midwives | 158 | 638 | 43 | 53 |
| Association midwives | 205 | 316 | 52 | 26 |
Trilene
For many years the use of trilene by midwives in domiciliary practice has been under
discussion. At the request of the Ministry of Health, the Council's domiciliary midwifery
service is participating in a trial of trilene inhalers organised by the Joint SubCommittee
of the Medical Research Council and the Royal College of Obstetricians
and Gynaecologists. To enable the domiciliary midwives to participate in this trial,
lectures and demonstrations on the types of inhalers to be used were attended by all the
Council's midwives and by midwives employed by the district nursing associations.
The trial is in progress at present and special reports on the cases selected for inclusion
are being sent to the Medical Research Council who will assess the result.
Maternity beds in hospitals
On 1st November, 1950, the Minister of Health received a deputation from the Council
with regard to the domiciliary midwifery service and was asked to make a policy
decision regarding the provision by hospitals of maternity beds. At the Minister's
suggestion, a conference was held in January, 1951, between officers of the Council,
the four Metropolitan Regional Hospital Boards and Boards of Governors of the
14 teaching hospitals in London to discuss policy regarding the provision of maternity
beds in relation to the domiciliary midwifery service. The Minister of Health was
informed of the results of the conference and asked to indicate his policy with regard to
what the ratio should be of maternity beds to the estimated number of births. As a
result of these representations, the Minister of Health addressed a circular (LHAL. 1 /51)
and memorandum to all local health and hospital authorities on the subject of the
selection of maternity patients for admission to hospital. On the issue of this circular,
divisional medical officers arranged to co-operate with the hospitals on the lines
suggested.