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Arrangements for Ante-natal Supervision by Midwives.
The four municipal midwives attend the local authority ante-natal clinics where
their patients are seen by the medical officer and close liaison is maintained. In
addition, they are also booking and seeing patients in their own homes as well as visiting
the patients' homes.
The patients booked by the Plaistow domiciliary midwiyes are examined by the midwives
on Regional Hospital Board premises and their medical care is undertaken by the
hospital medical officers. The patients booked by the Essex County Nursing Association
attend the Lady Rayleigh Training Home but are examined by the medical officer at a West
Ham municipal ante-natal clinic on at least two occasions.
The patients booked by the Silvertown and North Woolwich District Nursing Association
attend the West Ham municipal ante-natal clinic In Silvertown where they are examined by
the midwife and the Council's medical officer.
It is recognised that these arrangements are incompletely co-ordinated but they
represent a stage towards the objective of focusing all domiciliary midwifery work upon
the municipal clinics.
Co-operation with General Practitioners undertaking Maternity Medical Services.
As previously mentioned, the number of patients who book maternity medical services
is not large (see page 31 ). General practitioners' patients are welcome at the municipal
ante-natal clinics, either for medical examination should he so wish, for blood tests, or
for the teaching of relaxation, parentcraft, etc.
On the suggestion of the Medical Liaison Committee, the Executive Council has
provided general practitioners with cards on which to notify the domiciliary midwife that
a patient has engaged them for maternity medical services. The card is completed by the
doctor and given to the patient to take to her midwife. The card clearly Indicates whether
the doctor wishes the midwife to act as a midwife or as a maternity nurse, whether he wishes
to be present at the confinement or to be informed that his patient has been delivered.
Arrangements for selecting women whose confinement In hospital is recommended on social grounds.
Patients who come in the first place to the municipal ante-natal clinics and who wish
to be recommended for confinement in hospital on social grounds are referred to the midwife
who would deal with the home confinement. The midwife's report is forwarded to the Health
Department where it is scrutinised by the Senior Assistant Medical Officer and, if necessary
a supplementary report obtained from the Health Visitor. If, from the report, it appears
that hospital confinement is desirable a bed is booked for the patient.
Patients attending maternity units In the first place are usually booked without such
investigation as the number of beds in this area is ample. Recently, however, such patients
who apply at one of the hospitals have on occasion been referred to the local authority antenatal
clinic for Investigation of their home circumstances.
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