The Act set up the Central Midwives Board, giving it special disciplinary powers over midwives. It also imposed on county councils and the councils of county boroughs the duty of supervising the work of midwives. For further details the Act itself and the Rules of the Central Midwives Board made under the Act should be consulted. The Midwives Act, 1918, gave further powers to the Central Midwives Board and to local supervising authorities, and made it the duty of the latter to pay the fee of a doctor called in by a midwife in any of the emergencies for which Rules are made by the Central Midwives Board, the fee paid to be in accordance with a scale prescribed by the Ministry of Health. As at least three-fourths of the total births in England and Wales are attended by midwives with or without the assistance of doctors, their work has great importance in relation to the reduction of maternal disablement and mortality and to the prevention of early infant mortality, and it is of happy augury that they are being enlisted more and more in official work for safeguarding the health of the mother and her unborn or recently delivered infant. An important recent addition has been made to the rules of the Central Midwives Board, which makes it obligatory on the midwife to notify to the medical officer of health any instance, while the patient is under her charge, in which for any reason breast-feeding has been discontinued. _Administrative Work._—Largely through the machinery provided by the Midwives Act and the Notification of Births Act a system of supervision of maternity and child welfare has been organized in every county and county borough, and this has been responsible for a large share of the improvement experienced in recent years. The character and extent of development of the work varies greatly in different centres; and as a rule the work is more fully developed in county boroughs than in counties. In county districts it has sometimes been found necessary to unite the offices of assistant inspector of midwives, infant visitor and tuberculosis visitor in one adequately trained health visitor, thus saving time in travelling by enabling the visitor to have a smaller district allotted to her than if she undertook only one branch of work. In some counties the school nurse’s work is also undertaken by the health visitor. In some country areas arrangements have been made for infant visiting to be carried out by district nurses who are also midwives.