Historical Methods of Accountability for Midwives
By Health Department Officials
Mandatory Supervision of Midwives by Doctors

~ concerning management of complicated midwifery cases by German midwives -- "the midwife ... must notify a physician in writing ...or communicate personally over the telephone. And the physician must in such case respond at once, unless actually engaged on a case that requires his immediate attention, when he must so communicate to the midwife or messenger. Should the midwife or the physician fail to follow these laws, (they both) are subject to punishment." [1911-C, p. 203] ^47

~... (S)upervising the midwife,... and not only that but a medical profession forced by law to respond to the call of the midwife in trouble. p.208 ^50

~"In case an emergency arises where time is of utmost importance and her powers are limited by law from doing what she knows to be necessary, after notifying the physicians or even before if the emergency demands, it shall be her DUTY to do whatever seems necessary for her to perform ---save only version and instrumental obstetrics-- but in each ... instance she must communicate as soon as possible with the medical examiner, telling him the exact circumstance and abiding by his decision as to whether or not her action was justified." [1911-C, p. 203] ^48

"These are the rules for harmony laid down in the statute book, but the midwife is not well paid, and it is profitable for her to deliver the case if possible without calling the physician, so she is all too apt to let the case go as long as seems safe without her falling into the clutches of the law. Then too the physician when called to such a case is far from being as careful as if it had been his case from the beginning, for it is so easy to say that had he been called earlier "all would have been well".[1911-C, p. 205] ^49

d. Regulation by Registration and Supervision.

"The primary object of registration is to bring the class registered under the supervision of competent officials, so that the acts of a body of individuals admittedly untrained may be subjected to some measure of supervision. Thus in many States the law requires midwives to give notice to the local Health Officer of any cases of fever of a woman in childbed and to refrain from attending any other women until given written permission to do so. Similar laws also require notification to be given of any reddening or discharging from the eyes of the new-born infants. For the effective execution of laws of this character, registration is very essential. Registration also permits the circularization of midwives to give them such advice as may best assist the mothers and infants under their care." [1911-E;PriceMD] ^51