View report page

60
SECTION 23: DOMICILIARY MIDWIFERY
The West Ham Borough Council now provides directly the domiciliary midwifery
servioe to the whole of the borough with the exception of the northern fringe. In this
area some of the mothers book midwives from the Lady Rayloigh Training Home which is
about i mile outside the borough, and is administered by the Essex County Council.
At the 31st December there were 6 domiciliary midwives on the staff.
Supervision of Midwives. The Senior Assistant Medical Officer for Maternity and
Child Welfare has continued to act as medical supervisor of midwives. The Non-Medical
Supervisor of Midwives, who is also the supervisor of home nurses, left towards the end
of the year to take up similar duties in-her home town after 2 years service in West Ham,
and on the 31st December her successor had not yet been appointed.
Maternity Outfits, each with an 8 ounce bottle of dettol,.are supplied at the
appropriate time through the domiciliary midwives to all expectant mothers .who are to be
confined at home.
Administration ofAnalgesia by Midwives.
All the domiciliary midwives employed are qualified to administer gas and air, and
have been trained in the administration of Pethidine. The number of machines available for
the administration of gas and air analgesia is sufficient for.all home confinements, and for
demonstration .to the mothers at the ante-natal clinics, so that they are familiar with its
use before labour commences. By the end of the year 3 Trilene machines had been bought and
were already in use by some of the midwives. It is hoped to extend this number so that
eventually each midwife will have her own machine and will have been trained to use it.
Out of 313 domiciliary confinements, gas and air was given to 111 mothers
(approximately 35%) and Pethidine to 77 mothers (approximately 25%) and Trilene to 40
mothers (approximately 12%).
Refresher Courses for Midwives.
In conformity with the rules of the Central Midwives Board, 1 midwife attended a
refresher course during the year, and the supervisor attended a special course for
supervisors of midwives.
Relaxation Classes.
During the year we were able to restart, at a number of clinics, the "relaxation and
preparation for motherhood" classes on the lines previously organised at West Ham Lane
Clinic (which had had to be suspended during the reorganisation of the midwifery service).
Groups are formed as and when there are - sufficient numbers of mothers, at the appropriate
stage of pregnancy. Eaoh group usually follows a course of 8 weekly sessions, at which the
midwife undertakes the training in relaxation, breathing exercises, and posture. Health
Visitors from the clinic generally Join the mothers for tea and give a short talk and lead
the discussion which follows. Visual aids such as the birth atlas and film strips are
used from time to time.