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relatively common, but in our series of domiciliary cases they are
very rare. Apart from the skill of the attending midwives, I
believe that this is due to the home environment, more natural
than that of hospital, which induces better relaxation by the
mother during labour.
The incidence of uterine and vaginal wall prolapse in our
cases has also been relatively small. This is due to very careful
selection of cases as to suitability for home confinement, with the
result that we had no unduly prolonged labours on the district and
the number of forceps deliveries was extremely small.
The main problem in the post-natal clinic is the treatment of
cervicitis and cervical erosion, the incidence of which appears to
be high. Apart from local antiseptic treatment, we find that the
best results are achieved by specific treatment of the causative
infection with sulphonamides and antibiotics. The number of
patients who have to be referred to hospital for cauterization is
small (four during the period under survey).
These figures show that excellent results can be achieved in
domiciliary midwifery by good team work. The clinic doctor
must carefully select the cases suitable for home confinement and
must maintain continuous supervision throughout the ante-natal
period, together with the midwife. The midwife must have adequate
skill and experience m conducting labour and an experienced
general practitioner obstetrician must be available in case of
emergency.
In my opinion, the most important factor in successful home
midwifery is proper selection of cases for home confinement.
Care of Premature Infants.
The term "premature infants" refers to babies weighing
5½ lbs. or less at birth, irrespective of period of gestation. Stillbirths
are excluded.
(a) Number of premature infants notified (1) Born at home 25
during the year (including transferred
notifications) whose mothers norm- (2) Born in hospital
ally reside in the Authority's area. or nursing home 69
(b) Premature infants born in the area
(whether their mothers normally
reside in the area or not) but exclud- 25.
ing babies born in maternity homes
and hospitals in the National Health
Service.