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Section 23—Midwifery
The domiciliary midwife working in liaison with the general practitioner
obstetrician provides ante-natal supervision of mothers expecting
to be confined at home. Regular booking sessions are held by the midwives
at most clinics and visits are made to homes to see that everything
is in order for the home confinement. The ante-natal care includes instruction
in the use of analgesia apparatus—gas and air and trilene.
Sterilised maternity packs are available to all, except those who have
booked a hospital bed for their confinement. Following negotiations with
the manufacturers, cetain improvements were made in the contents of
these packs, especially in the small emergency one issued in cases of
early discharge from hospital.
During the year the establishment of midwives was fourteen full-time
and three part-time and, in addition to the routine ante-natal and postnatal
supervision of patients, the midwives attended 820 home deliveries.
In addition, 340 mothers were discharged from hospital less than 10 days
after delivery and were nursed at home by the domiciliary midwives. 114
of these cases were originally booked for home delivery but had to be
admitted to hospital for medical reasons. 201 were booked under the 48
hour Planned Early Discharge Scheme and 25 were discharged early
either due to death of infant or other reasons.
Planned Early Discharge of Maternity Patients
This scheme is working well and is expanding mainly due to the fact
that it is much to the liking of the mothers concerned. During the year,
201 cases were nursed under the scheme and towards the end of the year
the department was dealing with approximately 25—30 cases per month.
No adverse effects to any mother or child have been observed.
Standard Ante-Natal Co-operation Card
The introduction of this card on a national basis was recommended
by the Maternity Services (Cranbrook) Committee, who expressed the
view that, if provided for every woman receiving maternity care, some of
the present lack or duplication of care would be eliminated.
The main purpose of the card is to ensure that each member of the
obstetric team is aware of the attention given by other members. It is
retained and produced by the patient at every ante-natal examination
until the final post-natal examination, when it should be passed to her
general practitioner for inclusion in her medical records.
Such a card has now been introduced in the Borough and has been
found to be most satisfactory in use.
Day and Night Duty Rota
This system for midwives has continued during the year and worked
well to the mutual benefit of patients and the midwifery staff. The arrangements
whereby the emergency night calls under the night duty rota system