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Instructions to midwives require that where haemoglobin
estimations were found to be 65% or less, patients should be
referred to their family doctors with a request that they might be
sent back for a re-estimation of haemoglobin after 4/6 weeks.
Family doctors undertaking maternity medical services have been
advised that blood specimens could be taken from their patients
either at an ante-natal clinic or a weekly clinic at the Town Hall.
Ante-Natal Care.
The arrangements in regard to the scope of ante-natal supervision
were detailed in the report for 1956.
Following the issue of Ministry of Health Circular 9/56,
consultations on a professional basis late in 1956 took place at the
request of the Chairman of the Group Hospital Management Committee.
Discussions were between consultant obstetricians in the
Group, representatives of family doctors and of the Health Services'
medical staff.
The recommendations made included clarification of the
arrangements for ante-natal supervision and of the confinement, the
routine and freqency of examinations and tests, including X-ray
examination of the chest, education in the preparation for childbirth,
and instruction in relaxation exercises.
In addition an "ante-natal co-operation card" was suggested
which was to be carried by the patient until the confinement and
presented on admission to the hospital. A sealed envelope was
designed to be carried by the patient and provision was made for
the date of each examination to be clearly marked by the medical
attendant or midwife. Failure to attend an examination was to be
followed up at once either by the doctor, the midwife, or health
visitor as appropriate.
The "co-operation card" was brought into use during 1957
and the scheme is reported to be working well.
Ante-Natal Care and Confinements.
There were 1,416 confinements of Walthamstow mothers in
1957 against 1,373 in 1956. The percentage of hospital confinements
remained practically unaltered at 75.4. This percentage in
fact has hardly varied over the last four years.
Home confinements were 348 against 331 in 1956 and of the
348 confinements, 104 were midwives' cases, the remaining 244
being doctors "booked" cases with, of course, a midwife in attendance
as a maternity nurse. Of the 104 midwives' cases 98 were
attended by "Carisbrooke" midwives.