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65
Transport
Transport by ambulance cars continues to be available for the use of midwives in
emergencies, particularly at night-time and when undertaking relief duties.
Housing of
midwives
Accommodation for domiciliary midwives continued to be provided by the Council.
On 31st December, 1953, 53 midwives were housed in 51 houses and flats.
Payment to
district
nursing
associations
and hospitals
Payments to district nursing associations under Section 23 of the National Health
Service Act, 1946, continued to be merged in grants made to them for home nursing
services provided under Section 25 of the Act.
The rate of payment for hospitals providing midwifery services on behalf of the
Council continued at the rate of 10 gns. a patient, except in the cases of the Mothers'
Hospital (Salvation Army) where the rate, because of special circumstances, was £9 15s.
a patient.
Maternity
outfits
Every woman delivered at home under the National Health Service Act is eligible
for a free maternity outfit containing accouchement sheet and dressings required for
the confinement. The Council supplies these outfits to its own midwives and to district
nursing associations and hospitals providing domiciliary midwifery service.
Analgesia
Gas and air
The use of gas and air analgesia by the Council began in 1946. The apparatus is held at
selected ambulance stations throughout the county and delivered by ambulance to the
patient's home on the request of the midwife.
The number of midwives qualified to administer analgesia has steadily increased and
since 1950 all midwives employed by the Council have been so qualified. Progress in
its use has been rapid and its administration shown as a percentage of all domiciliary
confinements has risen from 3 per cent. in 1946 to over 77 per cent. in 1953. A similar
increase in the use of gas and air analgesia has also been effected in confinements attended
by hospital district midwives and district nursing association midwives. Analgesia is
always offered by the Council's midwives. The cases in which it is not used are those
in which the mother refuses or sends too late in labour, is considered medically unfit
to receive it or the doctor giving the maternity medical services himself provides the
analgesia or anaesthetic. The following table shows the number of administrations of
gas and air analgesia:
Confinements attended by
1953
L.C.C. Midwives Number 4,406
Percentage 77.4
Hospital District Midwives Number 2,253
Percentage 78.2
District Nursing Association Midwives Number 1,474
Percentage 78.1
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 practice of their profession or 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 register of cases.
On 1st April, 1953, the Dangerous Drugs Regulations, 1953, came into effect by which
the method of obtaining a supply of pethidine was altered. It has now become necessary
for a midwife to obtain a midwife's supply order, signed by the Supervisor of Midwives,
which she takes to the pharmacist issuing the drugs.
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