Report of the Departmental Committee appointed by the Lord President of the Council to consider the working of the Midwives Act, 1902.

  • Great Britain. Midwives Act Committee.
Date:
[1909]
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Licence: In copyright

Credit: Report of the Departmental Committee appointed by the Lord President of the Council to consider the working of the Midwives Act, 1902. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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    matter of distribution tlian su])ply. Miss TrendeU's experience as inspector of midwives and county superintendent in Herefordshire led lier to a similar conclusion, 5120-1. Mr. Kaye, speaking with a full knowledge of the widely differing conditions to be met with in the vast area of the West Riding, said much the same thing. In answer to a query what was wanted, he declared organisation and distribution, absohitely, pure 3496. and simple. So also Mr. Parker Young : that is the only question. 6737, 36. In our judgment the evidence of Miss Amy Hughes_ and Miss K. Stephenson together indicate the lines upon which voluntary organisation to that end should be conducted. 37. It is essential that such organisation should be based upon principles adaptable to every need within its sphere of influence. Taking the county area as being the most suitable, we recommend that the constitution of a county association should follow these lines : — (1) The encouragement of all district nursing, upon either of the two methods generally in force throughout the country, viz., the district visiting system and the cottage resident system. The choice of system to be left to the discretion of the particular locality requiring assistance. (2) The recognition and supply of three grades of nurses, all of whom should be certified midwives, viz. :— ■ (a) highly trained, fully certificated district nurses ; (h) nurses with not less than twelve months' general and midwifery training, willing to work upon either the visiting or resident system ; (c) trained and certified midwives. (3) The formation, where practicable, of county training homes, (4) The establishment of one or more emergency homes from which midwives can be sent for short periods of time to special districts requiring help. (5) Affiliation to a central organisation in London for mutual co-operation and assistance, especially for the supply and training of candidates, and increased facilities in borrowing and lending nurses. (6) Co-operation between the local supervising authority and the voluntary nursing association with regard to the inspection of midwives. (7) The funds of the association to be supplied as follows :— ■ . (a) by voluntary subscriptions ; (6) by grants to local associations from boards of guardians ; (c) by grants from the county council for training in midwifery ; (d) by fees paid for the services of the nurses. 38. The combination of rural midwifery with district nursing is now generally recognised as not only practicable but expedient. With some exceptions of an unconvincing character, the evidence was conclusive on this point. A considerable part of district nursing deals with non-infectious cases, and these, of course, present no difiiculty; but in others modern methods of disinfection, if intelligently pursued and effectually enforced in accordance with the requirements of the medical officer of health and the local supervising authority, are so complete as to render isolation and kindred measures of precaution superfluous. The thoroughly trained district nurse who will understand and practise asepsis is, therefore, the best-equipped agent to undertake the care of lying-in women, if she has qualified herself to become a certified midwife, and it is obvious that she can obtain this qualification much more easily than one without her advantages. It should, of course, be clearly understood that, whenever a district nurse attends a septic case, she should be carefid to observe the Rules of the Central Midwives Board (such as E. 5 in the last issue) with regard to disinfection. 39. The facilities which the law affords to boards of guardians to contribute to the support of district nursing associations in return for services rendered,—powers which we understand are found to be both advantageous and economical,—thus become indirectly ancillary to the subsidising of midwifery ; this may be of material help in the solution of the problem as to how midwives are to be maintained in areas which do not supply a large number of births; and the Committee think it would be desirable that the attention of boards of guardians should be called to their powers in this respect and to the advantages which both the poor under their