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Of the 279 summonses to medical practitioners, 44 were on account
of some condition during pregnancy, 64 during labour, 125 in the lying-in
period, and 41 some abnormality of the infant.
Of the 44 summonses to a patient during pregnancy, 22 were because
of albuminuria, oedema, or toxaemia, and 13 because of haemorrhage.
Of the 64 summonses to a patient during labour, the reason in 49
instances was delayed labour, with cause unspecified. In a further 9
there was some abnormal presentation. Summonses to patients suffering
from abortion (actual or threatened) numbered 5.
Of the 125 summonses to patients in the puerperium, 91 were on
account of rupture of the perineum. Post-partum haemorrhage, with or
without adherence of the placenta, was the reason in 8, a raised temperature
in 10, phlebitis 3, and inflamed breast 6.
Of the 41 summonses to infants, 11 were on account of some discharge
from the eye, 18 because of feebleness or asphyxia, 4 because
of deformity, and 8 some other abnormal state or condition.
Out of 817 midwifery cases attended, 279 is a percentage rate of 34.
The corresponding figures in the years 1942 to 1945 were, 33.1, 32.3, 32.8,
and 38.0.
Local Authority's Midwifery Service : The sixteen midwives
work in four teams of four, this arrangement proving the most convenient
to enable each to obtain the off-duty time to which she is entitled.
Last year the number of patients attended by the Council's midwives
was 1,071, being a percentage of 26.1 of the total number of confinements
of local mothers. To 762 they attended as midwives, and to 309 as
maternity nurses.
Of the patients attended by midwives acting as such, 512 were
assessed to pay the full cost, in 56 cases no charge was made, while 194
were assisted. The corresponding figures in regard to patients attended
by midwives as maternity nurses were 266, 14, and 29.
When the domiciliary midwifery service started, the Ministry
anticipated that each midwife in such a district as this would be able
to attend about 100 cases, midwifery or maternity, per annum. Insufficient
allowance, though, had been made for the effect of the improved
off-duty periods of the midwives ; and that it is desirable the midwives
should attend the ante-natal clinics, particularly those sessions at which
any of their patients are present. The figure then has been reduced. In
practice over the years, the local average of 68 cases per midwife was
found to be one which could be adequately coped with. This, though,
allows little enough in reserve to meet the times of a smaller number of
midwives being available because of the long-continued absence of any
member of the staff, nor of course does it allow for any substantial
increase in the total number of patients to be attended by the existing
staff. Absence on account of sickness has during the year been higher
than average, while further difficulties arose through the endeavours to
secure that each midwife should attend a course of instruction of a fortnight
to qualify her to obtain her certificate as to her competency
to administer gas and air analgesia. There is a general shortage of midwives
; this district apparently being comparatively well off, no