Final report of Departmental Committee on Maternal Mortality & Morbidity.

  • Great Britain. Committee on Maternal Mortality & Morbidity.
Date:
1932
Catalogue details

Licence: Public Domain Mark

Credit: Final report of Departmental Committee on Maternal Mortality & Morbidity. Source: Wellcome Collection.

    68/160 (page 66)
    sidered of more importance than that of gloves, and we were told that the morbidity in the beds attached to the training school had diminished since the introduction of masks. They are used during labour, but not in the lying-in wards. The necessity of thorough abdominal examination is insisted upon. Very few vaginal examinations are made, and the pupil is told that she must not examine vagitally unless she feels that the examination will be of definite value in helping the mother or child. Vaginal examination by the midwife is altogether forbidden in infected cases, and also where there is dystocia or contracted pelvis, on account of the possibility of Caesarean section being required later on. | The pupils are taught that the function of a midwife is to attend normal labour only, and they are not allowed to give opium, pitui- tary extract or other drugs, with the exception of ergot when the placenta has been delivered. If opium is required it is a case for the doctor, and it is thought that if this rule were relaxed there would be a demand for other drugs, and possibly anaesthetics, to be added to the list. The necessity of routine examination of urine is emphasised, but pupils are not taught to take the blood pressure. Ante-natal care and examination form now an important part of the training, and it is considered that midwives should be quite able to pick out obstetric abnormalities, and even general conditions, likely to in- crease the risk of parturition. Hxamination of all cases by a doctor is not thought to be necessary. During their two years’ residence in the Rigs-Hospital an average number of 3,000 deliveries takes place in the wards devoted to the training of midwives, and many of the pupils personally deliver over 100 cases, besides watching and attending clinical demonstra- tions on other normal or abnormal cases. The holding of a mid- wife’s qualification is not considered necessary or even advisable for general nurses—in fact, the midwives’ profession is looked upon as entirely distinct from that of nursing, an arrangement which effects an obvious economy in opportunities for practical instruction, The Practice of the Midwife. In 1929 the number of midwives in Denmark was 1,063. Apart from Copenhagen, where a considerable number of midwives practise privately, 71 per cent. cf the midwives hold appointments as ‘‘ dis- trict midwife,’ and these are distributed throughout the country in such a way that a midwife is available for every expectant mother. On a vacancy arising, candidates are selected by the County Medical Officer of Health, who gives preference to those whose home is in the neighbourhood. Now that telephones and motor-cars are in general use, it is found that midwives can cover more ground than formerly, and the districts are being enlarged accordingly. The midwife’s income is made up of a retaining fee from the county, varying from 700 to 1,000 kroner (£37-£55) per annum, and in addition she charges fees to her patients on a tariff of about 1 per cent. of the husband’s income, with a minimum of 17s. 6d. and a