I move: "That the Bill be read a Second Time." The Midwives (Ireland) Act of 1918 had for its purpose the arrangement for the better training and better regulation of the practice, general supervision and control of midwives. It arranged for the setting up of a Central Midwives Board consisting of three persons nominated by the Minister, one of them being a medical practitioner, four representatives elected by the doctors resident in the Saorstát, and four representatives of the midwives appointed by the Minister after consultation with the nurses' associations. The Act transferred to that Board the control of midwives generally and the making of regulations in regard to their training, practice and general control. It forbade the use by any person other than a person certified by the Board of the name "midwife" after the 1st of January, 1919, and after the 1st of January, 1924, it forbade the practice of midwifery by uncertified persons. The provisions of the Act of 1918 provided that a person who did not habitually and for gain practise midwifery could do so on odd occasions. There was a loophole in that and, as a result of the experience of the Central Midwives Board, this Bill is brought before the House on their advice and at their request for the purpose of tightening up the description of persons entitled to practise midwifery and, in the second place, to extend the powers to them under their regulations by which they can prescribe a type of badge which midwives, desiring to wear a badge for identification purposes, shall be able to wear.
The Act of 1918 made it possible that so long as a person did not practise midwifery habitually or for gain she could, though unqualified, attend cases. In practice it has been found that midwifery work is carried on habitually and for gain by persons who are not fully qualified. The amendment proposed in the Bill as well as reiterating the types of qualified persons who may practise midwifery, stipulates that any person attending a woman in childbirth, she being unqualified, shall be guilty of an offence unless she can satisfy the Court that such attention was given in a case of sudden or urgent necessity. It also has a provision by which persons, being persons undergoing training with a view to becoming duly qualified midwives, can give such attention as part of a course of practical instruction in midwifery recognised by the Medical Registration Council or the Board. Such persons may also practise midwifery in these circumstances though not qualified. Recent statistics in regard to mortality amongst women directly attributable to childbirth in 1929 are the lowest recorded in this country. The death rate per thousand in 1927 was 4.51, in 1928 4.93 and in 1929 4.14. The average rate for the decennial period up to 1928 was 4.88. The downward tendency is due to the better control of midwives under the Central Midwives Board and to the additional supervision provided by the county councils by the presence of the county medical officer of health.