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Recommendations in Previous Reports.
Previous reports are unanimous in expressing the view that a
National Maternity Scheme is urgently required, and there is
agreement also upon tlie following points :—•
That domiciliary midwifery should continue to form the
basis of the maternity service.
That the nursing of every maternity case in which a medical
practitioner is engaged should be conducted by a qualified
midwife.
That the status and remuneration of midwives should be
substantially improved.
That the training of midwives must be lengthened,
improved and standardised.
That compulsory post-certificate courses are essential.
That the general supervision of midwives should be carried
out by senior members of their own profession.
Domiciliary Midwifery.
This Committee concurs with the views expressed in the
reports that, although adequate hospital accommodation lor antenatal
cases and for abnormal labours is essential, normal confinements,
where the conditions are suitable, can be satisfactorily and
safely conducted in the patient's own home.
It should be clearly understood that a reduction in maternal
mortality will not be secured merely by increasing the hospital
provision for normal eases.
Remuneration of Midwives.
The remuneration of individual midwives is entirely inadequate,
and compares most unfavourably even with that of nurses, who, as a
class, are admittedly underpaid. The average salaries of village
liurse-midwives, Queen's nurse-midwives, hospital nurses, and
health visitors all considerably exceed the £80 which the committee
has ascertained to represent the average yearly earnings of a midwife
dependent upon her profession. In certain areas this figure
may sink as low as £50, and out of this meagre sum the midwife is
expected to provide equipment, necessary drugs and disinfectants,
and even in some cases dressings, for her patients. There is evidence
that the low standard of comfort and cleanliness in the houses or
lodgings occupied by midwives in certain areas militates against
the maintenance of a high standard of professional work, particularly
where ante-natal examinations have to be undertaken in