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This scheme, although a great step forward in community care has the
disadvantages of splitting the family unit, it savours of illness and it
separates the expectant mother from her general practitioner and her
domiciliary midwife, who has become a well known and trusted friend, just
at the critical time when she needs a familiar face or voice.
As the great advantages of continuity of care were obvious, the
Harrow domiciliary midwifery service kept in close touch with surrounding
hospitals and on the 9th of September, 1968, statutory authority was given
for domiciliary midwives to deliver in hospital as well as in patients' homes.
In November, 1968, the Harrow midwives began to spend some time in
Edgware General Hospital and Bushey Maternity Hospital to become
familiar with the labour ward lay out, the hospital techniques in use and
the hospital staff.
By February, 1969, all the domiciliary midwifery staff including the
supervisor, had spent three days in each of the Hospitals and on the 28th
January 1969 the first "domiciliary" expectant mother from Harrow
was taken into Edgware General Hospital, had her baby delivered by
her domiciliary midwife, then and returned to her family.
The advantages of this type of service may be summarised thus
1. The patient receives highly skilled ante-natal care from her
general practitioner, her domiciliary midwife and the hospital
staff.
2. She has maximum continuity of care.
3. She is able to rely on someone she knows, throughout.
4. She is taken from her home only when it is considered necessary
in her particular case, and may be accompanied by her husband.
5. In the very unlikely, but possible event of some unexpected
emergency, highly skilled help and equipment is available with a
minimum of movement of the patient and loss of valuable time.
6. The need to convert a domestic bedroom into a delivery theatre
is not necessary.
7. The withdrawal of the mother from the family unit is kept to a
minimum.
8. Maximum use can be made of valuable hospital time, for pregnancy
is not, and ought not to be treated as an illness and the
mother takes up less "hotel type" accommodation, which is
expensive.
9. The domiciliary midwife no longer has to work in isolation.
This particular scheme has proved to be extremely popular and
efficient and in 1969, 129 mothers from Harrow were delivered in the
hospital by their domiciliary midwives.
For helping to make this scheme work, great credit is due to the
midwives, who have persevered and accepted change in order to ensure that
expectant mothers receive the best possible care.