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33
Domiciliary Midwifery
The number of home confinements during the year under review
was less than in 1963. This was due to a deliberate emphasis on
careful selection for admission to hospital. The risk to women
who have borne four or more children is considerable, and all
recommendations about safer midwifery stress the need for these
mothers to be confined in hospital. For obvious reasons they are
often most reluctant to leave home, but they can usually be persuaded
to enter hospital for the delivery of the child, on the
understanding that early discharge for subsequent home care will
be arranged. That for the third year running there was not a
single death in childbirth in Croydon indicates the value of
this policy. It did result in 1.173 mothers booked for hospital
confinement being referred for subsequent domiciliary care. A
small rise on the figure for 1963. The recruitment of midwives
to fill vacancies remained difficult, and it was not possible at
all times to maintain the permitted establishment.
For detailed figures see Appendices, pages 99 - 102
Midwives Acts 1902-51
The number of midwives who notified their intention to practice
as midwives within the Borough (including those in hospitals)
and who were practising at the end of the year was 91.
All held the certificate of the Central Midwives' Board. The
Medical Supervisor of Midwives visits midwives in private
practice and nursing homes, and the Superintendent Municipal
Midwife carries out these duties for the domiciliary midwives.
Child Welfare Centres
There was a considerable rise in the number of attendances.
Toddler clinics and Health Education facilities were steadily
augmented during the year. Stress was laid upon the diagnosis of
remediable defects at as early an age as possible.
For other detailed figures see Appendix, page 105