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Safer Obstetric Care
Circular L.H.A.L. 19/67 issued by the Ministry of Health referred to the
publication of a booklet entitled Safer Obstetric Care and prepared by the Operational
Research Unit, Oxford Regional Hospital Board. This booklet summarised
the reports on the confidential enquiries into maternal deaths in England and Wales
during the period 1952 to 1963, gave an analysis of the causes of death, and listed
the avoidable factors contributing to these maternal deaths.
At the request of the Standing Maternity and Midwifery Advisory Committee,
a copy of this informative booklet, together with a copy of a letter from the
Ministry of Health's Chief Medical Officer, was distributed to general medical
practitioners, hospital and local authority medical officers, midwives and health
visitors.
Episiotomies and Local Anaesthesia
The Central Midwives Board issued a statement of policy on the performance
of episiotomy by midwives and arrangements were made for domiciliary midwives
to attend a lecture on the subject given by a consultant obstetrician and gynaecologist
at a local hospital.
Medical Aid Fees
In Circular 12/67 the Ministry of Health advised local authorities that the
scale of fees payable to general practitioners called in to the assistance of midwives
in cases of emergency, and the conditions subject to which these are payable, had
been revised, and that the responsibility for the payment of such fees in nearly all
cases had been transferred from local authorities to executive councils.
Planned Early Discharge of Maternity Patients
Planned early discharge schemes for suitable patients are in operation in conjunction
with North Middlesex and Chase Farm Hospitals in order to ensure, in
the present shortage of maternity beds, a maximum number of admissions to
hospitals for those who require hospital delivery on medical or social grounds.
Cases were also accepted from other hospitals within our quota of planned early
discharges. Patients who are discharged home early under this scheme are usually
cared for by the part-time midwives.
Care of Premature Infants
The number of babies notified during the year who weighed lb. or less at
birth (the accepted criterion for prematurity) was 295, of which 55 were born at
home. Midwives cared for 43 of these babies at home for the full statutory period
of 28 days. Forty-two of the children survived.
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