SEPT. 25.] THE NEW ZEALAND GAZETTE. 2209

6. The last preceding regulation shall not apply to any midwife employed in the Government service so long as she continues in that service, or to any midwife attached to the staff of any public hospital and not engaged in midwifery work, or to the Matron or staff nurses of any maternity hospital training school, or to the licensee of any private hospital in which midwifery cases are not received.

GENERAL REGULATIONS RELATING TO THE PRACTICE OF MIDWIVES AND TO ASEPSIS.

7. (1.) A midwife shall provide herself with all necessary appliances for carrying out her work with due regard to cleanliness and asepsis. She shall wear, when at work, dresses and aprons of washable material, and have a sufficient number to allow of frequent change. She shall have a sufficient number of overalls, of an approved pattern, made of a washable material, one of which is to be worn by her during labour and when attending to the lying-in woman. She shall observe strict personal cleanliness.

(2.) A midwife shall not attend a case while she is suffering from any septic sores, boils, or any other septic disease.

(3.) A midwife who is attending a case in which there are foul-smelling discharges shall not go to another case without first changing her dress, and thoroughly cleansing and disinfecting her hands and forearms, and sterilizing such appliances as she may have had occasion to use and is obliged to take with her.

(4.) After any confinement every midwife shall carefully cleanse her hands, arms, and finger-nails from all remains of blood, lochia, or liquor amnii. She shall keep her nails cut short and preserve the skin of her hands as far as possible from chaps and other injuries.

(5.) She shall carry with her a midwifery bag or case made of canvas or leather with a detachable lining which can be boiled. The bag shall contain—

(a.) Clinical thermometer :
(b.) Metal catheter : ‡
(c.) An enema syringe :
(d.) A douche-can, or siphon douche, with glass vaginal nozzle carried separately :
(e.) A pair of scissors :
(f.) A clean nail-brush, antiseptic soap, and clean towel‡:
(g.) A pair of rubber gloves and two guarded finger-stalls for use in making vaginal examinations :
(h.) An efficient antiseptic for disinfecting the hands, &c. :
(i.) An antiseptic for douching in special cases :
(j.) Soft cotton thread (boiled) for tying cord :
(k.) A small supply of sterilized cotton-wool, tow, and clean boiled linen :
(l.) A small bottle of ergot (only to be used after third stage of labour) and of tincture of iodine.

(6.) On each occasion on which the genital organs, or their neighbourhood, have to be touched, every midwife shall previously cleanse and disinfect such parts by some approved method and shall disinfect her hands and forearms by scrubbing vigorously with hot water and antiseptic soap for five minutes at least, rinsing with fresh water, and soaking in an approved antiseptic solution for five minutes.

(7.) All instruments and other appliances brought into contact with the patient’s generative organs shall be sterilized by boiling in water for at least ten minutes.

(8.) (a.) Internal examinations shall be made only when necessary; and before making any such examination, or before passing a catheter, every midwife shall wash the patient’s external parts with soap and water, and shall then swab them with an antiseptic solution : she shall then disinfect her hands in the manner hereinbefore prescribed, and put on the examining hand a sterilized glove or guarded finger-stall. The perineum and vulva and such parts of the patient as may come into contact with the gloved hand in making such vaginal examination shall be protected by covering them with guards or with towels properly sterilized by boiling, or by other adequate means.

(b.) For all washing of the external parts during labour or the lying-in period sponges or flannels shall not be used; but materials

• These articles must be contained in separate sterilizable containers.