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The corresponding rates for domiciliary confinements for England and Wales in the
year 1958 (the latest available) were for prematurity, 4.5 per cent., and for still-births,
10.9 per 1,000 total births.
The still-birth rate in the domiciliary midwifery service compares favourably with the
rate for domiciliary confinements in England and Wales as a whole. This is to be expected as
although obstetric and medical abnormalities in pregnancy are admitted to hospital for
confinement in both cases the proportion of hospital confinements in London is 81 per cent.
compared with 64 per cent. in England and Wales; nevertheless it is an encouraging
indication of the effect of good ante-natal care.

Each of the Council's midwives had been equipped with a portable trilene inhaler by the
end of 1957. A marked reduction has resulted in the use of the more cumbersome gas and
air apparatus which, nevertheless, is still delivered by the London Ambulance Service on a
midwife's request for use when in her, or a doctor's, clinical judgment it is required.
Midwives Act, 1951
Notifications received of intention to practise:
1955 1956 1957 1958 1959
As midwives 1,193 1,164 1,193 1,160 1,285
As maternity nurses .. .. .. 150 144 137 121 110
In accordance with Section G.l of Rules of the Central Midwives Board, 136 midwives
in the county attended a refresher course during the year.
Fees to medical practitioners called in by midwives in emergency:
1955 1956 1957 1958 1959
Number of claims .. .. .. 2,682 2,554 2,479 2,626 2,653