MIDWIVES [ S.L.458.04 1
SUBSIDIARY LEGISLATION 458.04
MIDWIVES REGULATIONS
23rd October, 1951
GOVERNMENT NOTICE 505 of 1951.
Title.
Licence to practice 
midwifery.
2. Every woman who holds the licence to practise midwifery
shall, before offering her services as a practising midwife or
commencing to practise as a midwife, give notice in writing of her
intention so to do to the Chief Government Medical Officer. She
shall give a like notice every time she changes her address.
Possession of 
articles.
Cap. 464.
3. In compliance with Part IV of the Health Care Professions
Act, every midwife should be in possession of a bag or basket lined
with washable linen and containing the following articles:
( a ) an appliance for vaginal irrigations;
( b ) a different appliance for enemata;
( c ) a catheter, an obstetrical stethoscope, a clinical
thermometer, a pair of surgical scissors, a pair of
umbilical scissors, and two artery forceps;
( d ) sealed sterilized packets containing cotton wool,
aseptic gauze, and aseptic thread for tying the
umbilical cord;
( e ) a glass stoppered bottle containing liq. ammon. fort.
oz. ii;
( f ) a collapsible tube containing a disinfectant cream such
as Dettol or any other recognized equivalent;
( g ) suitable quantities of efficient preparations for
disinfecting purposes;
( h ) at least two white washable aprons made to cover the
whole trunk and the arms;
( i ) a nail brush, a nail cleaner, and a cake of soap;
( j ) two pairs of surgical rubber gloves and two masks of
approved type.
The appliances and instruments mentioned above shall be
of such construction as to be easily cleaned and sterilised and they
must be invariably kept in such a condition as to be always ready
for use.
When called to a confinement the midwife must carry with
her the bag or basket and all its contents.
Dress to be worn.
material and over it an apron, a cap or veil to cover the hair, rubber
gloves and a mask as specified above. When engaged to attend a
labour, the midwife shall visit the patient in her own house to
advise her as to personal and general arrangements for the
2 [ S.L.458.04 MIDWIVES
confinement. She must see that the room is, as far as practicable, in
a hygenic condition and clean, and that all the linen is clean.
Disinfection of 
hands.
5. Before touching the genital organs or their neighbourhood,
the midwife must on each occasion wash thoroughly and disinfect
her hands and forearms.
Commencement of 
labour.
6. At the commencement of labour, or as soon as she reaches
the woman, the midwife shall wash the patient’s external genitals
and the surrounding parts with soap and sterilised warm water and
shall disinfect the same with an antiseptic solution. This
disinfection shall be repeated -
(i) before an internal examination is made;
(ii) after the termination of labour;
(iii) before passing a catheter; and
(iv) when necessary, during the lying-in period.
For this purpose, the midwife must on no account use
ordinary sponges or flannels, but only aseptic cotton wool or clean
pads soaked in antiseptic solution.
No vaginal irrigations shall be given either before or after
labour, except when ordered by a doctor.
Prohibition of 
giving of 
injections.
7. No midwife shall be in possession of any oxytoxic drugs or
give injections or drugs, except a simple asperient, without a
written order by a doctor.
Disinfection of 
instruments.
8. All instruments and other appliances must be disinfected
by boiling before use.
Internal 
examinations.
9. No more internal examinations shall be made by the
midwife than are absolutely necessary, and from the rupture of the
membranes till the completion of labour the midwife shall
endeavour to keep the parturient woman in a recumbent position.
She is to follow carefully the progress of labour and its effects both
on the mother and on the foetus.
Prohibition of 
leaving of patient.
10. A midwife in charge of a case of labour must not leave the
patient without giving an address at which she can be found
without delay, and she must stay with the woman from the
commencement of the second stage (i.e. the commencement of the
bearing down pains) until at least an hour after the placenta has
been expelled. In cases where a doctor has been called, she must
await his arrival and faithfully carry out his instructions.
Examination of 
placenta.
11. The midwife in charge must in all cases of labour examine
the placenta and membranes before they are destroyed, and must
satisfy herself that they have been completely expelled. When she
is in doubt, the placenta and membranes shall be kept for the
doctor’s examination.
Washing of 
external genitals.
12. After the midwife has made certain that the womb is fully
contracted, she is to wash the external genitals as directed in
regulation 6, and then bandage the abdomen of the woman in
accordance with the rules of practice.
Removal of soiled 
material.
13. The midwife must cause to be removed all soiled material,
blood, faeces, urine, and the placenta from the neighbourhood of
MIDWIVES [ S.L.458.04 3
the patient and from the lying-in room, as soon as possible after
labour and in every case before she leaves the patient’s house.
Foetus born 
apparently dead.
14. In the case of a foetus born apparently dead, the midwife
should carry out the methods of resuscitation which have been
taught her, call immediately a doctor and persevere in the treatment
till his arrival or for not less than an hour after the child has ceased
to give any signs of life.
Eyelids and 
surrounding parts 
to be cleansed.
15. As soon as the child’s head is born, and if possible before
the eyes are opened, its eyelids and the surrounding parts must be
carefully cleansed with boracic acid lotion. Should any irritation or
redness of the eyes of the child develop at any time, the midwife
shall advise the parents and insist on calling in a doctor at once. In
cases of refusal on the part of the parents the medical officer of
health is to be informed by the midwife and meanwhile the washing
of the eyes should be frequently repeated.
Child in danger of 
death.
16. On the birth of a child which is in danger of death, the
midwife shall inform the father, or in his absence, one of his
nearest relatives, of the child’s condition, and have a doctor called
in forthwith.
Visit to patient.
during the eight days following labour, in order to take the
temperature of the woman and to enquire into the condition of the
lochia, the involution of the uterus and the condition of the bladder
and bowels, and in general to follow the progress of the
puerperium.
Cases of illness.
any abnormality occurring during pregnancy, labour or lying-in,
the attendance of a doctor is essential and must be insisted on by a
midwife if she is called or had already been called, to the case. The
midwife is not allowed to attend, or to continue her attendance, on
such cases except under the direction of a doctor.
This regulation applies in particular -
( a ) when during pregnancy, labour or lying-in, a woman
appears to be dying or dead;
( b ) when, during pregnancy, there is any abnormality or
complication, such as -
(i) excessive nausea and vomiting;
(ii) abortion, actual or threatened;
(iii) loss of blood;
(iv) albumin in the urine;
(v) dyspnoea;
(vi) puffiness of hands or face;
(vii) fits of convulsions;
(viii) purulent discharge;
(ix) sores of the genitals;
(x) dangerous varicose veins;
(xi) deformity or stunted growth or other condition
suggesting disproportion between head and
4 [ S.L.458.04 MIDWIVES
pelvis;
( c ) when, during labour, there is any abnormality or
complication, such as -
(i) fits or convulsions;
(ii) purulent discharge;
(iii) sores of the genitals;
(iv) excessive bleeding;
(v) malpresentation;
(vi) presentation other than the uncomplicated head;
(vii) when no presentation can be made out;
(viii) placenta not completely expelled two hours after
the birth of the child;
(ix) rupture of the perineum or other injuries of the
soft parts;
(x) multiple pregnancy;
(xi) if during the two hours following the rupture of
the membranes the foetus is not yet born;
( d ) when, during the lying-in, there is any abnormality or
complication, such as -
(i) fits or convulsions;
(ii) abdominal swelling and tenderness;
(iii) offensive lochia;
(iv) rigor, with raised temperature;
(v) rise of temperature, lasting for more than
twenty-four hours, or a rise of temperature
above 101° F. as measured by the mouth;
(vi) steadily rising pulse rate;
(vii) unusual swelling of the breasts with local
tenderness or pain;
(viii) excessive or prolonged bleeding;
(ix) phoebitis or white leg;
( e ) when the child shows any abnornality or complication,
such as -
(i) injuries suffered during birth;
(ii) any malformation or deformity;
(iii) feebleness whether in a premature or a full-time
child;
(iv) inflammation of, or discharge from the eyes,
however slight;
(v) inflammation about, or haemorrhage from the
navel;
(vi) skin eruptions.
Cap. 464.
This regulation does not exempt the midwife from the duty
of calling in a doctor in accordance with Part IV of the Health Care
Professions Act.
MIDWIVES [ S.L.458.04 5
Occupation or 
place liable to be a 
source of infection.
19. No midwife shall follow any occupation, or reside in a
place which, in the opinion of the medical officer of health, is of its
nature liable to be a source of infection.
Corpse for burial.
laying out a corpse for burial.
Notification to 
medical officer of 
health.
21. A midwife must without delay notify thereof the medical
officer of health in each of the following cases, namely:
(i) when she has been in contact with a person,
whether or not a patient, suffering from
puerperal fever or any other condition which
may raise suspicion of infection;
(ii) when she is herself liable to be a source of
infection.
In each such case the midwife (unless relieved by the
medical officer of health of that duty) must take the following
special measures against infection before visiting another patient:
(i) she must have herself, her instruments and
appliances, and, when necessary, her dwelling,
disinfected to the satisfaction of the medical
officer of health;
(ii) unless the medical officer of health otherwise
directs, she must have all washable clothing
boiled, and must send all other clothing to be
disinfected by the Sanitary Authority.
Register of cases.
partnership or in an institution, must keep a separate register of
cases in the form shown in the Schedule attached to these
Regulations.
Except in the case of a simple aperient, a midwife must
note in her register on each occasion all those cases in which she
administers or applies in any way any drug, stating the name and
dose of the drug, the time of its administration or application, and
the name of the doctor who ordered it.
6 [ S.L.458.04 MIDWIVES
S C H E D U L E
REGISTER OF CASES
RE{ISTRU TAL-KA|IJIET
Serial No. of case ....................................................................
Nru. tal-ka\ (kif imiss)
Date of expected confinement .................................................
Meta tistenna li jkun il-]las
Name of doctor, if any, certifying pregnancy and date of such
certificate, if any ...................................................................
Isem it-tabib, jekk ikun hemm, li ji``ertifika t-tqala u d-data ta`-
`ertifikat, jekk ikun hemm
Name and address of patient .................................................... 
Isem l-omm u fejn toqg]od
Age ................... 
G]omor
Number of previous labours and miscarriages .........................
Kemm kellha
Date and hour of midwife’s arrival at confinement ..................
Data u ]in meta l-qabla tasal fuq il-]las
Presentation ............................................................................
Presentazzjoni
Date and hour of child’s birth ..................................................
Data u ]in tat-twelid tat-tarbija
Sex of child ................. Whether born living or dead ...............
Tifel jew tifla Jekk twiledx/twildetx ]aj/]ajja
jew mejjet/mejta
Full time or premature ............................................................
Jekk hix tarbija ta’ \mienha, jew imwielda qabel i\-\mien
Number of weeks ........................
Numru ta’ [img]at
Name of doctor if called ..........................................................
Isem it-tabib, jekk jissejja]
Complications (if any) during or after labour ...........................
Komplikazzjonijiet (jekk jinqalg]u) matul jew wara l-]las
Date of midwife’s last visit .....................................................
Meta l-qabla tag]mel l-a]]ar \jara
Condition of mother then ........................................................
L-istat ta’ l-omm dak in-nhar
Condition of child then ...........................................................
L-istat tat-tarbija dak in-nhar
Remarks (*) ............................................................................
Rimarki (*)
MIDWIVES [ S.L.458.04 7
NOTE: If any drugs, except a simple aperient, have been 
NOTA: Jekk tkun tajt xi medi`ina, barra minn xi purgant ]afif, b’xi 
administered or applied in any way, state here the 
mod jew ie]or, g]id hawnhekk l-isem u d-do\a tal-medi`ina, 
name and dose of the drug, the time and cause of its
il-]in u l-g]aliex tajtha u min ordna li ting]ata.
administration or application, and by whom prescribed.
