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in adjoining areas, attended cases in this district. At the end of the
year there were in practice 11 independent midwives carrying on a
domiciliary service, these between them attending 107 cases during
the year.
Midwives' Notifications to Local Supervising Authority :
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. During the year the following numbers of notifications
were received.
Sending for medical assistance 256
Still birth 9
Death of infant 4
Death of Mother —
Laying out the Dead 1
Artificial Feeding 18
Liability to be a Source of Infection 11
Of the 256 summonses to medical practitioners 37 were on account
of some condition during pregnancy, 58 during labour, 108 in the lying-in
period and 53 some abnormality of the infant.
Of the 37 summonses to a patient during pregnancy, 22 were because
of albuminuria, oedema or toxaemia and 9 because of haemorrhage.
Of the 58 summonses to a patient during labour, the reason given
in 45 instances was delayed labour with cause unspecified and in a
further 3 there was some abnormal presentation. 10 summonses were
to patients suffering from abortion, actual or threatened.
78 of the 108 summonses to patients in the puerperium were on
account of the rupture of the perineum. Post-partum haemorrhage
with or without adherence of the placenta was the reason in 7, raised
temperature in 6, phlebitis 10, and inflamed breast one.
Of the 53 summonses to infants, 9 were on account of some discharge
from the eye, 15 because of feebleness or asphyxia, 7 because of
deformity and 12 some other abnormal state or condition.
256 out of 781 midwifery cases attended gives a percentage of 32.8.
The corresponding figure in 1943 was 32.3 and in 1942, 33.1.
Local Authority's Midwifery Service: The number of patients
attended by the Council midwives was 697 in which they acted as midwives
and 282 in which they acted as maternity nurses, a total of 979,
being a percentage of 27.1 of the total number of confinements of local
mothers in this year.
Of the patients attended by midwives acting as such 362 were
assessed to pay the full cost, in 73 cases no charge was made, while 262
were assisted. The corresponding figures in regard to patients attended
by midwives acting as maternity nurses were 226, 18 and 38.
The average number of cases attended by each midwife was 61.
Where a Council midwife acting as maternity nurse rendered service
in cases of circumcision, an additional standard charge of 10s. 6d. was
made. It has now been decided that this same charge be made where