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Though prematurity may be caused by many factors, in a recent
investigation by Dr. J. W. B. Douglas after a national survey, it was
stated that (1) mothers of premature babies make less use of the
available antenatal services than mothers of babies born at term;
(2) the incidence of premature births is abnormally high among first
babies where the mother is doing paid work during the last month of
pregnancy. (Neither of these two conditions can be explained statistically
by the shorter duration of the pregnancy, nor the greater youth or
poverty of the mothers); (3) the harmful effects of work late in pregnancy
are not limited to those gainfully employed outside the home—it
appears that lack of domestic help is also associated with a high risk of
prematurity.
Perhaps one of the most important factors as far as public health
is concerned, is the nutrition of the mother. It is thought that the
improved national nutrition which has occurred since the enlightened
policy of the Ministry of Food (which commenced early in the war),
was started has caused the rate of prematurity to drop, just as the
stillbirth rate has dropped, but there are no certain statistics to cover
this point. Local authorities under circular 20/44 of the Ministry of
Health were encouraged to arrange for special help for such children.
Certain arrangements were made in this borough, but it is generally
thought that in a built-up area such as this, with easy transport to
hospital, it is better for a premature baby to be removed to hospital,
so that it can have the benefit of the expert nursing care and specially
designed apparatus which is available there and nowhere else.