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11. MIDWIFERY
Section 23 of the National Health Service Act, 1946, makes it the duty of the Council
to ensure that there are sufficient certified midwives in its area to deliver women in
their homes, and for this purpose the Council operates a domiciliary midwifery
service in Ealing and Southall. Home confinements in the Acton area are conducted
on behalf of the Borough by midwives from Queen Charlotte's Hospital under a
long-standing agreement with the Board of Governors of that Hospital. A further
duty of the Council under the Midwives Act, 1951, makes it the Council's responsibility
to supervise all midwives practising in its area.
The Council's midwifery staff consists of the Chief Nursing Officer (Midwifery
and Home Nursing), Deputy Chief Nursing Officer (Midwifery), and 21 full-time
and two part-time midwives. The Principal Medical Officer (Maternal and Child
Health) is the Medical Supervisor of Midwives and the Chief Nursing Officer the
Non-Medical Supervisor. The midwives are grouped in pairs, are allocated districts
based on the health clinics and conduct weekly ante-natal sessions. They work
closely with the general practitioners and three of them attend ante-natal sessions
held at the general practitioners' surgeries.
For a home confinement case the midwife, in conjunction with the family doctor,
carries out the ante-natal care, conducts the delivery and attends each mother for
10 days after delivery. She then hands over the follow-up care to the health visitor.
Maternity packs containing sufficient equipment and dressings for labour and for a
period of 10 days afterwards are issued without charge to all patients having a home
confinement.
TEACHING
Twelve of the midwives are recognized as teaching midwives by the Central
Midwives Board, and during the year trained pupil midwives taking their Part II
Midwifery at Hillingdon Hospital. All midwives attend lunch-time staff meetings
held weekly at Perivale Maternity Hospital whenever possible.
48-HOUR DISCHARGE SCHEME
The Council operates a planned 48-hour discharge scheme for maternity cases in
conjunction with neighbouring hospitals and with some of the London teaching
hospitals. Provided the home circumstances are adequate, and this is carefully
assessed by the midwife during the ante-natal period, maternity patients are discharged
home after delivery and two days in hospital to the care of three of the Council's
midwives who are specially recruited to provide this service. This arrangement
helps to overcome the effects of the shortage of obstetric beds in the area, in that
high risk patients are admitted to hospital for delivery and discharged home within
a few days. The essential support of the Home Help Service has been readily
available throughout the year and has functioned smoothly and well. The Brentford
and Chiswick parts of the Hounslow Borough are also covered by Ealing midwives
for this service, for which the Council is reimbursed.
RECRUITMENT
Recruitment of midwives presents problems. The Council has therefore taken
a series of steps to make working conditions in the Borough as attractive as possible.
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