Abstract

PIP: A survey of domiciliary midwifery was recently conducted in London. Of 1937 patients delivered in the October 1, 1970 through February 29, 1972 period, 172 had been booked for home delivery. The cooperation of all general practitioners and midwives in the area was sought, and arrangements were made for all infants born at home to be visited by a research pediatrician at about their 6th day of life. Almost 40% of the mother had 1 or more recognized "risk factors," and 10% of them according to the researchers should not have been accepted for home confinement. There were signs of fetal distress during labor in 8 cases; in all these delivery was spontaneous, but in 1 the infant took 2 minutes to breathe properly. 7 infants had a birth weight below the 10th percentile for gestational age. For most of the infants the neonatal period was uneventful. The infants with birth and neonatal problems were fairly evenly distributed between mothers who had recognized risk factors and those whose obstetric risk would be regarded as low. Survey findings seem to confirm the conclusion of previous studies that domicilary midwifery -- no matter how well organized -- will never be as safe and as well run as hospital service.