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MIDWIVES REGISTRATION BILL.
544 have settled so south of the Thames are the Southwark and Vauxhall, the their boundaries to their mutual satisfaction. There are Lambeth, and the Kent. Roughly speaking, the Kent instances in which small areas are still supplied by more Ci Company supplies the south- east, the Southwark and Vauxhall tt south-west, and the parts between these districts-that than one company. Within the Parliamentary districts of the is, Kennington and Newington-are supplied by the Lambeth supply of some of the companies water is supplied by other is public authorities. There are also private water supplies in and Southwark Companies in common. The Southwark and Vauxhall Company supplies RoehampLondon, and not only in London, but throughout the district
companies themselves by private arrangements
tc ton, Putney, Wandsworth, Battersea, Clapham, Newington,
generally.
and Kennington, and part of Brixton is partly supplied by tl this company and partly by the Lambeth. The area supplied’ b: the Southwark and Vauxhall Company is 19,040 acres. Figure 2 defines the areas supplied by the eight different by 1Jw Lambeth Company, besides partly supplying the discompanies. The New River Company supplies Higbgate, Upper Holloway, tricts already mentioned, distributes water to I;errnond;ey, S Peckham, and Dulwich. Its area extends, Kentish Town, Righbary, Stoke Newington, part of Dalston, Rotherhithe, and the district between these places and the Thames, tl through Dulwich, Forest-hill, Sydenham to the Crystal Palace, Anerley, Brockley-hill, Bell-green, and as far to the Hoxton, a great part of the City of London, including the P Tower, and all the district along the Thames as far as s’south as Beckenham. The Kent Company supplies parts of£ Hatcham in common with this company. The area of’ Charing-cross. At Charing-cross the line of supply goes updistribution is 39,360 acres. Northumberland-avenue, takes in the northern part ofd Company, as far as its area of distribution Trafalgar-square, then goes in a northerly direction up the is The Kent Water the is concerned, and Poland-street. The line then extends in largest of them all; as far as population Haymarket ais concerned it is the least. It supplies parts of the south northerly direction up the Tottenham Court-road as far as bank of the Thames, from Limehouse on the Wet to9 the High-street in Kentish Town. At the top of Tottenham b Woolwich, but its area of distribution includes Plumstead, Court-road the boundary area extends to the north-west to S Blackheath, Eltbam, and Southend. The. the Small-pox Hospital, Hampstead, then goes in a north- Shooter’s-hill, westerly direction to include the Hampstead district. Thus,total number of acres covered is 113,280. roughly speaking, the districts supplied are the E.C., W.C., and the parts north of these districts. The company also supplies districts out of the metropolitan area, the total
THE AREAS SUPPLIED
area
BY THE
EIGHT WATER COMPANIES.
MIDWIVES REGISTRATION BILL.
being 59,520 acres.
The Chelsea Company supplies the districts which lie to the north of the Thames from Fulham to Charing.cross-Fulham,
Walham-green, Chelsea, Brompton, Knightsbridge, Pimlico, Westminster, and part of St. James’s.
boundary
area
of distribution
runs
The
northern from the Crab Tree at
THE following is the text of the Midwives IBill, now before the House of Commons :The chief
object
of this Bill is to enable the
public,
Registrationand
especially
Lillie Bridge.road, Richmond-road, such of the poor as are in the habit of employing midwives, to. between those midwives who have been trained and have the Old Brompton-road, and then goes in a northerly direc-distinguish o evidence of being competent for their duties and those who given tion to Prince’s Gate and along Knightsbridge and Piccadillyhave r not. This Bill provides that henceforth no woman shall call herself a midto the north-east corner of the Green Park. The boundary unless she has been placed on the midwives’ register, and that in then runs down the eastern side of the Green Park-that is, wife order to be placed on the register she must produce evidence either-(1) in the south-eastern direction-for about two-thirds its disof having undergone a proper training and subsequent examination, or tance, and then passes to the north-east to include ( of having (at the time of the passing of the Bill) .een in bonâ fide’ as a midwife for a specifed number of sears. It is not proI St. James’s Palace, Carlton-terrace, and the southern part practice posed to make it illegal for a frienaly neighbour to render assistance teof Trafalgar-square. Here it is in contact with the a lying-in woman in an emergency. River area. The area supplied by the Chelsea Company is A system of examination and certification by various voluntary
Fulham, up Crown-road,
(2) liew
3482 acres. The West Middlesex
bodies has been established for several years in the chief
centres
o[
It is proposed to place the duties hitherto undertaken by has a less compact area of population. t these voluntary bodies in the hands of a duly constituted Board, distribution than the Chelsea, with whose area, of distributionacting under State control. It is further propused to make provision it comes in contact from Princes’ Gate to the Crab Tree at for the efficient regulation and supervision of the practice of midwives. Fulham. The West Middlesex Company supplies Hammer-under rules approved by the General Medical Council and for the those who are enrolled upon theexercise of smith, that part of Fulham now called West Kensington, ’Register. discipline amongst South Kensington, and Kensington, the northern boundary See Reports of Select Committee on Midwives Iiegistration, together, of this part being the Uxbridge-road. The companywith the proceedings of the Committee. Minutes of Endence, and Index, ordered by the House of Commons to be printed supplies also the Regent’s Park and Portman-square districts,Appendix, June 17th, 1892, and Aug. 8th, 1893. extending as far south as Oxford street, as far north as Brondesbury, and including the district of St. John’s Be it enacted by the Queen’s most Excellent Majesty, by and with Wood. The area of the West Middlesex Company’s water- the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority supply is 17,280 acres. of the same, as follows :The Grand Junction Company supplies the western 1. This Act may for all purposes be cited as the Midwives 1,egissuburbs, Shepherd’s Bush, Wormwood Scrubs, and the tration Act,1897. 2. In this Actdistrict which is called North Kensington and Bayswater The term "midwife" means a woman who undertakes to attend and part of Paddington. The total area supplied by the cases of labour in accordance with the regulations to be laid is acres. 29,760 down under this Act. company " Midwives register" means a register of midwives kept in purThe IJcxst London Water Company supplies part of Stamsuance of this Act. ford Hill, Upper and Lower Clapton, Homerton, Hackney, ’’ Midwives Board " means the Board constituted under this Act for Bow, Bromley, Poplar, Limehouse, Stepney, the London the purpose of carrying out the provisions of this Act. Docks, Shadwell, and the Isle of Dogs—that is to say, the 3.-(1) From and after the first day of January one tnonsand eight hundred and ninety no woman shall be entitled to take or use the parts north of the Thames from St. Katherine’s in the east name or title of midwife (either alone or in combination with any other to the outlet of the River Lea, and in the county! of Essex word or words), or any name, title, addition, or description implying West Ham, Walthamstow, Leyton, Woodford, and Loughton. that she is registered under this Act, or is specially qualified to act as a midwife unless she be registered under this Act. The total area of supply is 50,880 acres. .2) Any person who, after the first day of Jannuary, one thousad tight h1mdred and ninety-, not being registered under this Act. shall The area of distribution of the companies to the south take or use the name of midwife or any other such name, title, addition, of the Thames is not so easy to follow as that of the or description as aforesaid, shall bet liable on summary conviction to a. fine not exceeding five pounds. companies on the north because there is much more over(3) No woman shall be placed on the midwives register until she the north of the to As we have Thames, seen, shall have complied with the rules and regulations to be laid dawn in lapping. of tne terms of this Act. roughly speaking, the East London Company supplies the part pursuance The certificate of registration under this Act shall not confer (4) River the the New called the East-end, popularly Company any woman any right or title to be registered under the Medical central districts and the parts to the north of them. The upon Acts in respect of such certificate, or to assume any name, title, or Chelsea Company supplies Chelsea and Fulham. In the case of designation implying that she is by law recognised as a licentiate or the other two companies the distribution is rather less difficult practitioner in medicine or surgery, or that she IS qualified to grant any certificate or any certificate of the cause ot death. to define. The Grand Junction ha=, as it were, a wedge of medical 4. Any woman who, before the expiration of two years from the distribution in the centre of the area of the West Middlesex passing of this Act, claims to be registered under this Act shall be so Company. The companies which supply the districts to the registered provided she produces evidence satisfactory to the Midwives
Company
-
545 Board that at the passing of this Act she has either been in bona-fide practice asa midwife for a period of two years, or holds a certificate in from the Royal College of Physicians of Ireland or from the Obstetrical Society of London, or such other certificate as may be approved by the Board. 5. On the passing of this Act a Midwives Board shall be constituted by the General Medical Council and shall consist(1) of twelve registered medical practitioners, three to be appointed by the Royal College of Physicians of London, three by the Royal College of Surgeons of England, three by the Society of Apothecaries, and three by the Incorporated Midwives
midwifery
Mii Board respecting the carrying out of the provisions of the Midwives Act or of any of them. Act, ( Where any woman deems herself aggrieved by any order, con(2) vie viction, judgment, or determination of or by any matter or thing done under this Act by any court of summary jurisdiction, such un< ma may appeal therefrom to the court of quarter sessions. 1 15 Nothing in this Act respecting midwives shall apply to medical practitioners. qm qualified 1 This Act shall not extend to Scotland or Ireland. 16.
woman
legally
Institute ; and
of si t persons to be appointed for terms of three years by the Lord President of the Council. One-third of the elected members of the Board shall annually retire, THE but shall be eligible for re election after the lapse of one year. The THE duties of the Midwives Board shall be as follow : (a) To make rules for regulating the conditions of admission to the THE YEAR 1895 AND register and the mode of conducting the qualifying examinations. (o) To appoint examiners. MID(c) To decide upon the places where, and the times when, examinations shall be held. (d) To frame for approval by the General Medical Council rules regulating the admission to the register of women already in bona fide practice as midwives at the passing of this Act. J BY WILLIAM ALEXANDER, M.D. R.U.I., F.R.C.S. ENG., (e) To prepare and publish annually a register of midwives. VISITING SURGEON, LIVERPOOL WORKHOUSE HOSPITAL. To frame for approval by the General Medical Council rules for regulating, supervising, and restricting within due limits the practice of mid wi yes. (D) To decide upon the conditions under which a midwife may be Two years ago, in consequence of what I still consider a suspended from practice. mis-statement made before a Commission, I To decide from the of the name of gr grave (A) upon the removal register a’,y midwife for disobeying the rules and regulations from the results the wards of the obtained in to time laid down under this Act by the Midwives Board or for for twenty-one As other mbconduct and to decide upon the restoration to the Li register of the name of any midwife so removed. the is still before the and ti the (i) And, generally, to do, subject to the approval of the General Medical Council, any other duty which may be necessary for pI at this workhouse illustrates and as the the due and proper carrying out of the provisions of this of the m in report for another many Act. 6. There shall be payable by every woman presenting herself for two on remarks the from a t years, with examination or registration such fees as the Midwives Board may, of d’ disinterested to readers observer, may be with the approval of the General Medical Council, from time to ,ime determine. All fees paid by midwives or by candidates for THE T LANCET. - examination shall be patd to the Midwives Board. The said boari The total number of confinements were 635. Of these shall devote such fees to the payment of expenses connected with - examination and registration and to the general expenses of the Board. women 7 whilst 309 221 were married and 414 were Should these fees not equal the expenditure of the Midwives Board, were n. A number of these 289, were the deficiency shall be supplied from the respective local county funds, inmates of the workhouse for some time before conin proportion to the number of registered midwives resident in the
(2)
R: REPORT OF
LYING-IN WARDS OF LIVERPOOL WORKHOUSE HOSPITAL FOR 1896; OR, WORKHOUSE WIVES, THEIR TRAINING AND PRACTICE.
Royal lying-in
time published
Liverpool Workhouse Hospital midwifery practice public, question
dispute,
points
primiparas.
years.1 profession
period midwifery question interesting single, patients,
being
6. and cleanliness, regular, simple diet, and regular fined, 7. The Midwives Board shall appoint a registrar who shall be charged hours were brought to bear upon them; 339 came direct with the custody of the register, and shall also act as secretary to the fj from town in labour, and 7 came from the Lock wards, Board.
county.
V where ’8. A copy of the m:dwives register for the time being shall be they were under treatment for venereal disease. The evidence iu all courts that the wumen therein specified are registered 12 maternal deaths within the thirty-one days after confinement Mcording to the provisions of this Act; and the absence of the .,were three, and not one of these three had any puerperal name ot any woman from such copy phall be evidence, until the " One died from broncho-pneumonia, from which contrary be made to appear, that such woman is not registered trouble. s bad been suffering for four days prior to confinement, according to the provisions of this Act. Provided always that in she the case of any woman whose name does not appear in such copy a and she died four days after. A post-mortem examination certificate under the hand of the registrar of the entry of the name of such woman on the register shall be evidence that such woman is showed normal pelvic organs and verified the chest disease. The second case was confined in the midst of a spree. She registered under the provisions of this Act. 9. Every local sanitary authority throughout England and Wales had t a rigor the day before, her temperature was 102° F. shall, on the passing of this Act, appoint its medical officer of healtn during her confinement, and she was found to be suffering or other registered medical practitioner or practitioners as the local I acute pulmonary congestion. The labour was accomsupervising authority over midwives in the sanitary district. It shall from bu the duty of the local supervising authorityI under imminent danger of suffocation, and in spite plished 1. To exercise general supervision over all midwives practisingof medicine, inhalations, stimulants, &c., she died in twentywithin the sanitary district in accordance with the rules to be hours from the lung disease. The third case had been four laid down under the provisions of this Act. i the surgical wards for some time, with head symptoms 2. To investigate charges of malpractice, negligence, or mis- in conduct on the part of any midwife practising within his district, that t pointed to a cerebral tumour without localising it. She and if he consider that a p1’í1nâ-fac ie case is established to report was stupid and inert, took her food only when it was given the 6ame to the Midwives Board. 1 her, but otherwise took no interest in anything around 3. To report at once to the Midwives Board the name of any mid- to wife practising in his district convicted of a misdemeanour or her. ] The baby was born, and the recovery proceeded n
°
’
,
.
.
felony. without any febrile symptoms. The condition 4. To keep a current copy of the midwives register, accessible at alll naturally of stupor gradually deepened, double incontinence and coma reasonable times for public inspection. and she died nineteen days after delivery. We i ’5. To satisfy himself, in the case of any midwife practising orsupervened, desiring tu practise within his district, as to the validity of her could not obtain a post-mortem examination. We have claim to be placed on the register. ’!. The local supervising authority shall at once report to the followed all the other cases until they left the workhouse or )IlLiv,ives Board the death of any midwife, or any change in the name; the thirty-one days of the Registrar-General were fulfilled, ur address of any midwife in his district, so tb at the necessary alteraand certainly no other of the 635 cases died within that c:on may be made in the register. 11. An woman who procures or attempts to procure herself to be time. These 635 women gave birth to 646 babies-335 p’eed ou the register of midwives by making or producing, or causing males and 311 females, twins eleven times. The presenta>
-
to bt: made or
tions
01’
cord, 1.
produced, any false or fraudulent declaration, certificate,, represewratiun. either in writing or otherwise, ana any p-rson assist2ng her therein, shall be deemed guilty of a misdemeanour, and shall
Cu!BB’Ütion thereof be liable to a Jine not exceeding Jive p01tncls, or to o or without hard labour for any term not exceeding g -7 ) ,) rr.r,o_’%,... 12 Any person appointed to keep the register of midwives wilfully ma);!’.g or causing to be made any falsification in any matter relating to Mie :-rh’<-r of midwins shall be deemed guilty of a misdemeanour and d eba!1 I !i.tb!e to a fine not exceeding ten poMNO. or to be imprisoned d v. ’ft or la itnout hard labour for any term not exceeding three months. offeoces this under Act on 13. Any punishable summary conviction may 1)e and anv fine under this Act recoverable on summary y ’/11": ictl,.n may te recovered, ill manner provided by the Summary y oJ U! 1B1:Lt10n Acts. ’y 1;;’; expenses of any prosecution shall be defraved out of the county iuc’l -,4 the cistrict where the prosecution takes place. LV U.— An appeal shall be tllowed to the Privy Council should any disagreement arise between the General Medical Council and the
on
Le
-i(3ned with
were:
head, 623; breech, 11; hand, 2; foot, 8; face, 1;
The operations consisted in 21 applications of forceps and 4 cases of version, and the complications consisted of 6 cases of hæmorrhage, 1 case of tumour of the brain, 1 of adherent placenta, 3 of retained placenta, and 57 where some increase of temperature took place after
delivery. The class of cases treated in this hospital belong to the lowest stratum of society, and the fact that 43 gave birth to hopelessly dead, and often decomposed, babies shows that neither their health nor their habits tended to uneventful and safe recoveries, The results are as satisfactory as they could possibly be from an obstetrical point of view, and while ——————————————————————————————————————————————————————————————————————————"
1
Liverpool Medico-Chirurgical Journal, July, 1894.
companies themselves by private arrangements
tc ton, Putney, Wandsworth, Battersea, Clapham, Newington,
generally.
and Kennington, and part of Brixton is partly supplied by tl this company and partly by the Lambeth. The area supplied’ b: the Southwark and Vauxhall Company is 19,040 acres. Figure 2 defines the areas supplied by the eight different by 1Jw Lambeth Company, besides partly supplying the discompanies. The New River Company supplies Higbgate, Upper Holloway, tricts already mentioned, distributes water to I;errnond;ey, S Peckham, and Dulwich. Its area extends, Kentish Town, Righbary, Stoke Newington, part of Dalston, Rotherhithe, and the district between these places and the Thames, tl through Dulwich, Forest-hill, Sydenham to the Crystal Palace, Anerley, Brockley-hill, Bell-green, and as far to the Hoxton, a great part of the City of London, including the P Tower, and all the district along the Thames as far as s’south as Beckenham. The Kent Company supplies parts of£ Hatcham in common with this company. The area of’ Charing-cross. At Charing-cross the line of supply goes updistribution is 39,360 acres. Northumberland-avenue, takes in the northern part ofd Company, as far as its area of distribution Trafalgar-square, then goes in a northerly direction up the is The Kent Water the is concerned, and Poland-street. The line then extends in largest of them all; as far as population Haymarket ais concerned it is the least. It supplies parts of the south northerly direction up the Tottenham Court-road as far as bank of the Thames, from Limehouse on the Wet to9 the High-street in Kentish Town. At the top of Tottenham b Woolwich, but its area of distribution includes Plumstead, Court-road the boundary area extends to the north-west to S Blackheath, Eltbam, and Southend. The. the Small-pox Hospital, Hampstead, then goes in a north- Shooter’s-hill, westerly direction to include the Hampstead district. Thus,total number of acres covered is 113,280. roughly speaking, the districts supplied are the E.C., W.C., and the parts north of these districts. The company also supplies districts out of the metropolitan area, the total
THE AREAS SUPPLIED
area
BY THE
EIGHT WATER COMPANIES.
MIDWIVES REGISTRATION BILL.
being 59,520 acres.
The Chelsea Company supplies the districts which lie to the north of the Thames from Fulham to Charing.cross-Fulham,
Walham-green, Chelsea, Brompton, Knightsbridge, Pimlico, Westminster, and part of St. James’s.
boundary
area
of distribution
runs
The
northern from the Crab Tree at
THE following is the text of the Midwives IBill, now before the House of Commons :The chief
object
of this Bill is to enable the
public,
Registrationand
especially
Lillie Bridge.road, Richmond-road, such of the poor as are in the habit of employing midwives, to. between those midwives who have been trained and have the Old Brompton-road, and then goes in a northerly direc-distinguish o evidence of being competent for their duties and those who given tion to Prince’s Gate and along Knightsbridge and Piccadillyhave r not. This Bill provides that henceforth no woman shall call herself a midto the north-east corner of the Green Park. The boundary unless she has been placed on the midwives’ register, and that in then runs down the eastern side of the Green Park-that is, wife order to be placed on the register she must produce evidence either-(1) in the south-eastern direction-for about two-thirds its disof having undergone a proper training and subsequent examination, or tance, and then passes to the north-east to include ( of having (at the time of the passing of the Bill) .een in bonâ fide’ as a midwife for a specifed number of sears. It is not proI St. James’s Palace, Carlton-terrace, and the southern part practice posed to make it illegal for a frienaly neighbour to render assistance teof Trafalgar-square. Here it is in contact with the a lying-in woman in an emergency. River area. The area supplied by the Chelsea Company is A system of examination and certification by various voluntary
Fulham, up Crown-road,
(2) liew
3482 acres. The West Middlesex
bodies has been established for several years in the chief
centres
o[
It is proposed to place the duties hitherto undertaken by has a less compact area of population. t these voluntary bodies in the hands of a duly constituted Board, distribution than the Chelsea, with whose area, of distributionacting under State control. It is further propused to make provision it comes in contact from Princes’ Gate to the Crab Tree at for the efficient regulation and supervision of the practice of midwives. Fulham. The West Middlesex Company supplies Hammer-under rules approved by the General Medical Council and for the those who are enrolled upon theexercise of smith, that part of Fulham now called West Kensington, ’Register. discipline amongst South Kensington, and Kensington, the northern boundary See Reports of Select Committee on Midwives Iiegistration, together, of this part being the Uxbridge-road. The companywith the proceedings of the Committee. Minutes of Endence, and Index, ordered by the House of Commons to be printed supplies also the Regent’s Park and Portman-square districts,Appendix, June 17th, 1892, and Aug. 8th, 1893. extending as far south as Oxford street, as far north as Brondesbury, and including the district of St. John’s Be it enacted by the Queen’s most Excellent Majesty, by and with Wood. The area of the West Middlesex Company’s water- the advice and consent of the Lords Spiritual and Temporal, and Commons, in this present Parliament assembled, and by the authority supply is 17,280 acres. of the same, as follows :The Grand Junction Company supplies the western 1. This Act may for all purposes be cited as the Midwives 1,egissuburbs, Shepherd’s Bush, Wormwood Scrubs, and the tration Act,1897. 2. In this Actdistrict which is called North Kensington and Bayswater The term "midwife" means a woman who undertakes to attend and part of Paddington. The total area supplied by the cases of labour in accordance with the regulations to be laid is acres. 29,760 down under this Act. company " Midwives register" means a register of midwives kept in purThe IJcxst London Water Company supplies part of Stamsuance of this Act. ford Hill, Upper and Lower Clapton, Homerton, Hackney, ’’ Midwives Board " means the Board constituted under this Act for Bow, Bromley, Poplar, Limehouse, Stepney, the London the purpose of carrying out the provisions of this Act. Docks, Shadwell, and the Isle of Dogs—that is to say, the 3.-(1) From and after the first day of January one tnonsand eight hundred and ninety no woman shall be entitled to take or use the parts north of the Thames from St. Katherine’s in the east name or title of midwife (either alone or in combination with any other to the outlet of the River Lea, and in the county! of Essex word or words), or any name, title, addition, or description implying West Ham, Walthamstow, Leyton, Woodford, and Loughton. that she is registered under this Act, or is specially qualified to act as a midwife unless she be registered under this Act. The total area of supply is 50,880 acres. .2) Any person who, after the first day of Jannuary, one thousad tight h1mdred and ninety-, not being registered under this Act. shall The area of distribution of the companies to the south take or use the name of midwife or any other such name, title, addition, of the Thames is not so easy to follow as that of the or description as aforesaid, shall bet liable on summary conviction to a. fine not exceeding five pounds. companies on the north because there is much more over(3) No woman shall be placed on the midwives register until she the north of the to As we have Thames, seen, shall have complied with the rules and regulations to be laid dawn in lapping. of tne terms of this Act. roughly speaking, the East London Company supplies the part pursuance The certificate of registration under this Act shall not confer (4) River the the New called the East-end, popularly Company any woman any right or title to be registered under the Medical central districts and the parts to the north of them. The upon Acts in respect of such certificate, or to assume any name, title, or Chelsea Company supplies Chelsea and Fulham. In the case of designation implying that she is by law recognised as a licentiate or the other two companies the distribution is rather less difficult practitioner in medicine or surgery, or that she IS qualified to grant any certificate or any certificate of the cause ot death. to define. The Grand Junction ha=, as it were, a wedge of medical 4. Any woman who, before the expiration of two years from the distribution in the centre of the area of the West Middlesex passing of this Act, claims to be registered under this Act shall be so Company. The companies which supply the districts to the registered provided she produces evidence satisfactory to the Midwives
Company
-
545 Board that at the passing of this Act she has either been in bona-fide practice asa midwife for a period of two years, or holds a certificate in from the Royal College of Physicians of Ireland or from the Obstetrical Society of London, or such other certificate as may be approved by the Board. 5. On the passing of this Act a Midwives Board shall be constituted by the General Medical Council and shall consist(1) of twelve registered medical practitioners, three to be appointed by the Royal College of Physicians of London, three by the Royal College of Surgeons of England, three by the Society of Apothecaries, and three by the Incorporated Midwives
midwifery
Mii Board respecting the carrying out of the provisions of the Midwives Act or of any of them. Act, ( Where any woman deems herself aggrieved by any order, con(2) vie viction, judgment, or determination of or by any matter or thing done under this Act by any court of summary jurisdiction, such un< ma may appeal therefrom to the court of quarter sessions. 1 15 Nothing in this Act respecting midwives shall apply to medical practitioners. qm qualified 1 This Act shall not extend to Scotland or Ireland. 16.
woman
legally
Institute ; and
of si t persons to be appointed for terms of three years by the Lord President of the Council. One-third of the elected members of the Board shall annually retire, THE but shall be eligible for re election after the lapse of one year. The THE duties of the Midwives Board shall be as follow : (a) To make rules for regulating the conditions of admission to the THE YEAR 1895 AND register and the mode of conducting the qualifying examinations. (o) To appoint examiners. MID(c) To decide upon the places where, and the times when, examinations shall be held. (d) To frame for approval by the General Medical Council rules regulating the admission to the register of women already in bona fide practice as midwives at the passing of this Act. J BY WILLIAM ALEXANDER, M.D. R.U.I., F.R.C.S. ENG., (e) To prepare and publish annually a register of midwives. VISITING SURGEON, LIVERPOOL WORKHOUSE HOSPITAL. To frame for approval by the General Medical Council rules for regulating, supervising, and restricting within due limits the practice of mid wi yes. (D) To decide upon the conditions under which a midwife may be Two years ago, in consequence of what I still consider a suspended from practice. mis-statement made before a Commission, I To decide from the of the name of gr grave (A) upon the removal register a’,y midwife for disobeying the rules and regulations from the results the wards of the obtained in to time laid down under this Act by the Midwives Board or for for twenty-one As other mbconduct and to decide upon the restoration to the Li register of the name of any midwife so removed. the is still before the and ti the (i) And, generally, to do, subject to the approval of the General Medical Council, any other duty which may be necessary for pI at this workhouse illustrates and as the the due and proper carrying out of the provisions of this of the m in report for another many Act. 6. There shall be payable by every woman presenting herself for two on remarks the from a t years, with examination or registration such fees as the Midwives Board may, of d’ disinterested to readers observer, may be with the approval of the General Medical Council, from time to ,ime determine. All fees paid by midwives or by candidates for THE T LANCET. - examination shall be patd to the Midwives Board. The said boari The total number of confinements were 635. Of these shall devote such fees to the payment of expenses connected with - examination and registration and to the general expenses of the Board. women 7 whilst 309 221 were married and 414 were Should these fees not equal the expenditure of the Midwives Board, were n. A number of these 289, were the deficiency shall be supplied from the respective local county funds, inmates of the workhouse for some time before conin proportion to the number of registered midwives resident in the
(2)
R: REPORT OF
LYING-IN WARDS OF LIVERPOOL WORKHOUSE HOSPITAL FOR 1896; OR, WORKHOUSE WIVES, THEIR TRAINING AND PRACTICE.
Royal lying-in
time published
Liverpool Workhouse Hospital midwifery practice public, question
dispute,
points
primiparas.
years.1 profession
period midwifery question interesting single, patients,
being
6. and cleanliness, regular, simple diet, and regular fined, 7. The Midwives Board shall appoint a registrar who shall be charged hours were brought to bear upon them; 339 came direct with the custody of the register, and shall also act as secretary to the fj from town in labour, and 7 came from the Lock wards, Board.
county.
V where ’8. A copy of the m:dwives register for the time being shall be they were under treatment for venereal disease. The evidence iu all courts that the wumen therein specified are registered 12 maternal deaths within the thirty-one days after confinement Mcording to the provisions of this Act; and the absence of the .,were three, and not one of these three had any puerperal name ot any woman from such copy phall be evidence, until the " One died from broncho-pneumonia, from which contrary be made to appear, that such woman is not registered trouble. s bad been suffering for four days prior to confinement, according to the provisions of this Act. Provided always that in she the case of any woman whose name does not appear in such copy a and she died four days after. A post-mortem examination certificate under the hand of the registrar of the entry of the name of such woman on the register shall be evidence that such woman is showed normal pelvic organs and verified the chest disease. The second case was confined in the midst of a spree. She registered under the provisions of this Act. 9. Every local sanitary authority throughout England and Wales had t a rigor the day before, her temperature was 102° F. shall, on the passing of this Act, appoint its medical officer of healtn during her confinement, and she was found to be suffering or other registered medical practitioner or practitioners as the local I acute pulmonary congestion. The labour was accomsupervising authority over midwives in the sanitary district. It shall from bu the duty of the local supervising authorityI under imminent danger of suffocation, and in spite plished 1. To exercise general supervision over all midwives practisingof medicine, inhalations, stimulants, &c., she died in twentywithin the sanitary district in accordance with the rules to be hours from the lung disease. The third case had been four laid down under the provisions of this Act. i the surgical wards for some time, with head symptoms 2. To investigate charges of malpractice, negligence, or mis- in conduct on the part of any midwife practising within his district, that t pointed to a cerebral tumour without localising it. She and if he consider that a p1’í1nâ-fac ie case is established to report was stupid and inert, took her food only when it was given the 6ame to the Midwives Board. 1 her, but otherwise took no interest in anything around 3. To report at once to the Midwives Board the name of any mid- to wife practising in his district convicted of a misdemeanour or her. ] The baby was born, and the recovery proceeded n
°
’
,
.
.
felony. without any febrile symptoms. The condition 4. To keep a current copy of the midwives register, accessible at alll naturally of stupor gradually deepened, double incontinence and coma reasonable times for public inspection. and she died nineteen days after delivery. We i ’5. To satisfy himself, in the case of any midwife practising orsupervened, desiring tu practise within his district, as to the validity of her could not obtain a post-mortem examination. We have claim to be placed on the register. ’!. The local supervising authority shall at once report to the followed all the other cases until they left the workhouse or )IlLiv,ives Board the death of any midwife, or any change in the name; the thirty-one days of the Registrar-General were fulfilled, ur address of any midwife in his district, so tb at the necessary alteraand certainly no other of the 635 cases died within that c:on may be made in the register. 11. An woman who procures or attempts to procure herself to be time. These 635 women gave birth to 646 babies-335 p’eed ou the register of midwives by making or producing, or causing males and 311 females, twins eleven times. The presenta>
-
to bt: made or
tions
01’
cord, 1.
produced, any false or fraudulent declaration, certificate,, represewratiun. either in writing or otherwise, ana any p-rson assist2ng her therein, shall be deemed guilty of a misdemeanour, and shall
Cu!BB’Ütion thereof be liable to a Jine not exceeding Jive p01tncls, or to o or without hard labour for any term not exceeding g -7 ) ,) rr.r,o_’%,... 12 Any person appointed to keep the register of midwives wilfully ma);!’.g or causing to be made any falsification in any matter relating to Mie :-rh’<-r of midwins shall be deemed guilty of a misdemeanour and d eba!1 I !i.tb!e to a fine not exceeding ten poMNO. or to be imprisoned d v. ’ft or la itnout hard labour for any term not exceeding three months. offeoces this under Act on 13. Any punishable summary conviction may 1)e and anv fine under this Act recoverable on summary y ’/11": ictl,.n may te recovered, ill manner provided by the Summary y oJ U! 1B1:Lt10n Acts. ’y 1;;’; expenses of any prosecution shall be defraved out of the county iuc’l -,4 the cistrict where the prosecution takes place. LV U.— An appeal shall be tllowed to the Privy Council should any disagreement arise between the General Medical Council and the
on
Le
-i(3ned with
were:
head, 623; breech, 11; hand, 2; foot, 8; face, 1;
The operations consisted in 21 applications of forceps and 4 cases of version, and the complications consisted of 6 cases of hæmorrhage, 1 case of tumour of the brain, 1 of adherent placenta, 3 of retained placenta, and 57 where some increase of temperature took place after
delivery. The class of cases treated in this hospital belong to the lowest stratum of society, and the fact that 43 gave birth to hopelessly dead, and often decomposed, babies shows that neither their health nor their habits tended to uneventful and safe recoveries, The results are as satisfactory as they could possibly be from an obstetrical point of view, and while ——————————————————————————————————————————————————————————————————————————"
1
Liverpool Medico-Chirurgical Journal, July, 1894.