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]
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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![19 May 1909.] Mr. J. T. DoDD. [Continued. than the iincertified Gamp has been paid hitherto, and certainly she will necessarily do less work. For instance, in Oxford the certified woman does not do the washing at confinement. 6969. The washing of the whole family ?—Of the mother and baby—but the uncertified woman does. I can give you the Oxford figures. The usual charge for the imcertified woman is 5s. or 7s. 6d. This usually includes the washing of the bed clothes and baby's clothes. The charge of the certified woman is not under 10s. or 15s. and sometimes a guinea. She does not do the washing. That is speaking of Oxford. Now I made enquiries about the riu-al districts and there the fee ranges from 5s. Then in the retiim from Oxford- shire, made in reply to the Central Midwives Board's enquiries in 1908,* the answer to the question, do you anticipate a serious shortage of practising midwives in 1910? was yes, certainly. So that the mothers will have to pay more, and they will get less. 6970. No, they will get good attendance instead of bad. Do you consider good attendance is less valuable than bad ?—No, not at all. It is very good indeed, but there must be somebody at the sa,me time to attend to the woman. There must be some more nursing done in the rural districts especially. 6971. The certified woman will be better qualified to do good mn-sing ?—Quite so, but she cannot stay.. In one case I know of, a woman is paid 5s. a week, and she helps in the family. 6972. Is she working in connection with any asso- ciation ?—I do not suppose she is. 6973. She is an independent person, is she ?—I am speaking of an independent person. Then here is a case in Hertfordshire of a midwife, an uncertified person. Usually she went out at 7s. 6d., but she had to charge as low as 4s. 6d. Then here is a case of 5s. a week for 2 weeks, and she had to do the washing and the house work. The woman in the rm-al districts must have somebody to attend to her, and the midwife may be looking after a dozen parishes, whereas the neighbouring Gamp often does some of the ntirsing, and so on. Therefore the practical result is that, if the midwives are not forthcoming, there will be a difficulty in that respect. 6974. Are yoti not aware that there are very many organisations all over the country which are giving a great deal of assistance; if they are given time, and their operations are treated with some patience, will they not solve the difficulties which you appear to think insurmountable ?—I think they might do it in time perhaps, but also it is essential to the life of the children and to the welfare of the nation that we should take the matter in hand at once and give them, (i.e., the mothers and childi-en), what they have a right to, namely the necessary relief. 6975. That is being done all over the country ?— Each woman has a right by law to proper attendance in confinement. 43 Elizabeth, cap 2, section 1, gives the right to necessary relief. The decision of the Court of Appeal in Attorney General v. Guardians of Merthyr Tydfil (L.R. [1900], Ch. 516) shows that a woman has this right, although she is mamed and her husband might have provided for her; and the answer of the President of the Local Government Board in the House of Commons on the 29th November 1906, shows that she has the right to it on her own application. All this refers only to necessitous women, i.e., those unable to pay for themselves. The husband, if able, may be liable to repay. 6976. Proper attendance in confinement is there- fore available now if the woman cannot afford to pay for it and chooses to avail herself of the poor law ?—Somehow or other she does not get it; and in my opinion, if I may venture to put that forward, the best way of meeting the difficulty is the way mentioned in the precis which I have laid before the Committee. 6977. But what you consider to be the great evils of the present system are to a great extent due to neglect of the opportunities which the law as it stands provides?—That is quite true. This neglect of the opportunity of coming to the poor law exists, because * See Appendix V. (Vol. I.). the guardians have made it so veiy difficult and very disagreeable to have to do with the poor law. They have done their very best to deter people from coming. It ^ has been their wish to redxice pauperism; and in doing so, unfortimately, they have not given the relief that people are faiiiy entitled to by law. 6978. You anticipate that these evils are likely to be increased, do you ?—Yes. 6979. In April next year, that is ?—Yes. In sec- tion 31 of my precis I have stated that the unqualified woman acts sometimes not only as midwife but as nursB to the sick woman. 6980. Have you many of these imqualified women acting in Oxford now ?—Yes, we have a fan- num]>er of them. I cannot tell you how many. 6981. Do they act under a doctor at all, or entirely on their own account?—A gi-eat many act with a doctor; some with and some without. 6982. Do you think that doctors are likely, after the 1st of April 1910, to go on making use, under their nominal supervision, of the services of these women ?— I cannot say what wiU be done then. 6983. Do the mothers themselves prefer to employ these women instead of getting skilled assistance ?—I think they do prefer these old women sometimes ; they are used to them. 6984. On the ground merely of use and wont ?— They are used to them. A woman very much likes to have the same woman as in previous confinements; they are neighbours, and so on. 6985. These women are a source of danger you will admit, I suppose, rather than a help to the people who employ them ?—Yes, when compared with a certified midwife or a doctor; but they are far better than nobody, and if you do not supply certified midwives, the patients will be in a worse case, because the worst of these women will keep on. 6986. But do you anticipate that there will be any difficulty in obtaining the services of qualified midwives in Oxford after April 1910 ?—Yes, in Oxford I should say there will be a difficulty in the sense of the poor people not being able to obtain money to pay for them. I do not think there will be any difficialty, supposing the boards of guardians were to appoint midwives and pay them a reasonable fee for attendance upon all women who could not afford to pay for themselves, which could be done by law. Then I do not think there would be any serious difficulty. But then, of course, you would have to encom-age the women who were not able to pay to come for such relief. It would have to be explained to tliem that medical relief would be forthcoming. 6987. But that is sufficiently known already, surely ? —I do not think it is, and they do not like going to the relieving officer and standing the brunt of his questions ; and what is more, the guardians do what they can to deter them. 6988. In regard to this particular question ?—Yes, certainly. Guardians have for many years tried to cut down relief, especially outdoor relief, and they have been told that medical relief is specially dangerous because it leads to other relief, and that confinement cases should be dealt with all the more strictly as they can be foreseen. They say you knew it nine months beforehand, and you might have provided for it. It is the only illness we know of coming on nine months beforehand. 6989. But it is not an iUness.—Most women find it so. 6990. But it is not what we call an illness, in the sense of being due to morbid conditions.—I venture to think it is an illness in most cases, or, if I am not to call it an illness, it is in some ways much more serious than an illness. If neglected it is very serious, because there are two lives in question, and it is that want of appreciation of the seriousness of it by men that has done so much mischief. 6991. But a woman in that case is not in an abnormal state ?—She is abnormal as compared with her usual condition. She is not in her usual condition of health, and what is more, as you say it is not an illness, I bow to youj- ruling; but I say she requires all the care of a doctor or skilled person, just as much as](https://iiif.wellcomecollection.org/image/b21361113_0308.jp2/full/800%2C/0/default.jpg)
