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over by the Essex County Council.
The midwifery service has continued to function smoothly and harmoniously thanks to
the goodwill of all concerned, and doctors and midwives have co-operated well to ensure that
the patient should not suffer from any ambiguities or lack of definition inherent in the new
situation which arose on July 5thc
Of the 3737 West Ham births 1246 were delivered in their homes within the Borough,
the distribution being as follows:-

In 37 of these cases the midwife acted as Maternity Nurse. Medical Aid was summoned
in 480 cases. In 366 cases help was required for the mother and 114 on account of the baby.

Arrangements had been made for the four Municipal Midwives to receive instruction in
the administration of Analgesia early in 1949.
SUPERVISION OP MIDWIVES. The Senior Assistant Medical Officer for Maternity and
Child Welfare is the Supervisor of Midwives and there is no nonmedical Supervisoro Though
every effort is made to keep in touch with the midwives who supplement official notification
by 'phone calls and frequent calls at the office, it is difficult to maintain as much personal
contact as one could wish.
HOME NURSING. From 5th July under the National Health Service Act the Home Nursing
Service became the responsibility of the Local Health Authority. Prior to this date the North
of the Borough had been partly covered by the Beachcroft District Nursing Association, and
partly by the Plaistow Maternity Hospital District Nurses, It was decided to request the
Essex County Council, to whom the Beachcroft District Nursing Association was similarly
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