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NATIONAL HEALTH SERVICE ACT, 1946.
SECTION 22: CARE OF MOTHERS AND YOUNG CHILDREN.
EXPECTANT AND NURSING MOTHERS
Facilities provided for Ante-Natal and Post-Natal care were continued with ten weekly
combined ante-natal and post-natal sessions at the Municipal Centres, and one at the South
West Ham Health Society's Clinic. The clinic held in the Silvertown area is now combined
with the Child Welfare session. Mothers attend by appointment and in each case the medical
examinations are undertaken by one of the Council's medical officers.
The municipal midwives conduct most of the examinations of their patients at the
Maternity and Child Welfare Centres, at the same sessions as the ante-natal clinics
conducted by the medical officer, but in an adjacent room. This has fostered close cooperation
between the midwives (and their pupils) the doctors, and the health visitors
who also have duties at the ante-natal clinics.
Early in the year agreement was reached with the Medical Liaison, Local Obstetric
and Local Medical Committees on an arrangement whereby any doctor who had agreed to give
maternity medical services to a mother, would have the opportunity of examining her in the
presence of the midwife, on at least two occasions. The midwife was given the responsibility
of contacting the doctor as early as possible in each individual case, in order to arrange
for these joint examinations, and to decide whether they should be held at the municipal
clinic or at the doctor's surgery.
In addition, in order to make it clear to the general practitioner that the services
of the local authority were available for his maternity patients, it was agreed that the
card which is sent by the general practitioner to the midwife (when he has booked a patient
for maternity medical services) should be amended to include a section in which the doctor
might indicate whether he wished his patient to be offered facilities for blood test, chest
x-ray, training in relaxation, or teaching in mothercraft at the local clinic. A number of
doctors have availed themselves of these arrangements which have fostered personal contact
between midwife and doctor. In particular, there is considerable advantage to the patient
in this joint examination in which patient, midwife and doctor may exchange views and
information, without the formality of written communication.
Arrangements for women who book domiciliary midwives from the Essex County Council
Service, based on the Lady Rayleigh Training Home in Leyton, include attendance at the
municipal clinics for some of their medical examinations.
Patients requiring specialist advice are usually referred to the consultant at one
of the maternity units in the borough, while those wishing or requiring a hospital bed are
referred to the hospital of their choice.
One thousand three hundred and forty-one expectant mothers have made a total of
6,9l8 attendances at the ante-natal clinics during the year. Two hundred and twenty seven
attended for examination during the post-natal period and made a total of 266 attendances.
This is 72% of the total of 340 domiciliary confinements, but does not include post-natal
examinations undertaken by general practitioners.
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