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76
Of the midwives attending to cases in their own homes, most
have limited practices. Of the 25 of local residents who were in
practice at the end of the year two attended either as midwives or
maternity nurses to 100 women in their own homes, 6 attended
between 50 and 90; 9 attended between 20 and 50; and 8 attended
less than 20 cases.
By the rules of the Central Midwives Board it is obligatory
on midwives to send a notification to the Local Supervising Authority
in certain circumstances. The following are the particulars of
notifications received during the years:—
Sending for medical assistance 209
Stillbirth 10
Death of Infant 5
Death of Mother -
Laying out the Dead 5
Artificial Feeding 11
Liability to be a Source of Infection 13
The details of the circumstances in which medical practitioners
were summoned to cases were:—
During Pregnancy 19
During Labour 141
During Lying-in 26
For infant 23
56 of these summonses were issued from October 1st to December
31st, during which time, of the conditions for which a practitioner
was summoned during pregnancy, the commonest was in
antepartum haemorrhage in four cases. Delayed second stage or
obstruction were the most frequent reasons for which assistance
was required during labour, accounting for all but six of these
cases, adherent placenta being the reason on three occasions.
Ruptured perineum was the reason for thirteen and a raised temperature
for three of the summonses to patients in the post-natal
stage.
While the local authority is responsible in the first instance
for the payment of the medical practitioners' fees for attendance
on cases to which they have been summoned by medical aid notices,
the Council is empowered to recover all or part of such fee from
the patient or those responsible for her. The scale in operation on
which milk is granted free or at half-cost to those falling within
the provisions of the Maternity and Child Welfare scheme was
adopted in determining what contribution should be requested,
though no claim is to be made in respect of cases of ophthalmia
neonatorum. The obligations of the Council to be responsible for
the payment of the practitioners' fees are now somewhat restricted
by the operation of the Medical Practitioners' (Fees) Regulations,
1936, in which the conditions on which fees are to be payable to
medical practitioners are:—