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ante-natal supervision and who are to be confined in
their own homes. 12 sets were issued.
(d) Consultant Services.— Arrangements are in force by which
a consultant is available to assist general medical
practitioners in necessitous cases in the event of difficulty
occurring during labour.
Under the scheme the consultant was summoned
on six occasions, once ante-natally, three times owing to
difficulties occurring during labour and twice to recently
parturient women.
The ante-natal case was a woman too ill to attend
hospital, the illness being due to pyelitis. Of the cases
of difficulty in labour, the first was a case of delayed
labour; the patient was removed to hospital and by
forceps delivery a living child born. The second, a
primipara of 35, had been 48 hours in labour; after
incision of the cervix, episiotomy and the application of
high forceps, a living child was delivered. The third
patient, also a primipara, suffered from an impacted
breech in a contracted pelvis. The extended legs were
delivered and, following an episiotomy, the head was
extracted with forceps, a living child again being born.
Both the post-natal cases were due to post-partum
haemorrhage. The first patient was given two blood
transfusions (the operator incidentally acting as donor);
when her condition had improved sufficiently the placenta
was removed. In the other case the uterus explored and
then plugged.
In an Institution.
The same arrangements for the admission of expectant mothers
to hospitals for their confinements continued in operation, namely,
endeavouring to engage a bed at one of the hospitals with which
the Council has entered into an agreement, and in default of
obtaining a bed, arranging for the admission to one of the local
maternity homes. 36 women were assisted towards the payment
of their fees for their confinement in an institution under this
arrangement.
In July the Council agreed that in those cases where the
Council accepts liability for the payment of the whole or part of
the hospital fees, they would also pay the ambulance charges in
the first instance, any such fees to be recovered from the patient
in the same proportion as the hospital fees are recovered. The
ambulance rules have been amended so that when an ambulance is
required in connection with a maternity case the person calling
the ambulance must arrange for a midwife or woman friend or
relative to accompany the patient in the ambulance. Under this
arrangement the fees of 13 women were paid either in part or
entirely.