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93
carried on a domiciliary practice, while 6 though resident in adjoining
areas attended cases in this district. At the end of the year there were in
practice 10 independent midwives carrying on a domiciliary service,
these between them attending 35 cases during the year, 25 as midwives
and 10 as maternity nurses.
Midwives' Notifications to Local Supervising Authority : The
Central Midwives Board is the body concerned with the education,
registration and general control of midwives. Section E of the Rules
provides for the regulating, supervising and restricting within due limits
of the practice of midwives. The Harrow Urban (Supervision of Midwives)
Order 1936, made by the Minister of Health under S.62 of the
Local Government Act, 1929, constitutes the Council, the local supervising
authority for the purpose of the Midwives Acts, 1902-1926.
Notifications on a prescribed form must be sent by a midwife to the
local supervising authority in the following circumstances : when the
death of a mother or child occurs ; in all cases of still birth, when no
doctor was in attendance at the time of the birth ; when she has laid out
a dead body ; when she has been in contact with a person suffering from
any condition which might raise suspicion of infection, or is herself liable
to be a source of infection ; and whenever it is proposed to substitute
artificial feeding for breast feeding.
Rule 12 requires that in all cases of illness of the patient, or child, or
of any abnormality occurring during pregnancy, labour or lying-in, a
midwife must forthwith call in a registered medical practitioner. A
medical practitioner responding to a call, will be paid his fee by the local
supervising authority for his attendance in accordance with the scale
prescribed by the Ministry of Health, if he submits his claim within a
period of two months from the date on which he was called in. This fee
may be recoverable from the patient according to her means. The Council
decided some years ago not to seek the recovery of any part of this
payment.

Of the 250 summonses to medical practitioners, 47 were on account
of some condition during pregnancy, 67 during labour, 102 in the lying-in
period, and 34, some abnormality of the infant.
Of the 47 summonses to a patient during pregnancy, 17 were because
of albuminuria, oedema, or toxaemia, and 19 because of haemorrhage.
Of the 67 summonses to a patient during labour, the reason in 44
instances was delayed labour, with cause unspecified. In a further 3
there was some abnormal presentation. Eleven summonses were to
patients suffering from abortion (actual or threatened).