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10
Hospital Confinements.—During 1938, 1,045 women were confined in the Willesden Maternity
Hospital. In addition to these a number of Willesden mothers were confined in Institutions outside
Willesden, 519 births of Willesden residents being notified from such outside Institutions—123 from
Queen Charlotte's Hospital, 69 from St. Mary's Hospital, 42 from Middlesex Hospital, 34 from Queen
Mary's Maternity Home, Hampstead, 22 from University College Hospital, 16 from Royal Free Hospital
and smaller numbers from other Hospitals; 70 from a Nursing Home and smaller numbers from other
Nursing Homes. These together with some 448 in the Central Middlesex County Hospital are approximately
66 per cent. of the births belonging to Willesden and show the desire of the present-day mother
for institutional confinement.
The following table shows the increasing demand for institutional confinement:—

A report on the Willesden Maternity Hospital by Mr. Arnold Walker, F.R.C.S., the Council's
Consultant Obstetrician, appears later in this report.
Ante-Natal Work for Institutions not under the Council.—Requests are received
from the Middlesex County Council and from various London Hospitals for home visits to expectant
mothers, and for special reports by the Council's Health Visitors in connection with women who are
to be confined in these Hospitals.
127 such reports were supplied to London Hospitals and 331 to the Middlesex County Council
during the year.
298 Expectant Mothers booked for confinement in the Central Middlesex County Hospital
were referred to the Willesden Health Centres for Ante-natal care.
Puerperal Pyrexia.—47 cases were notified during the year. All recovered.
Maternal Mortality.—During 1938 there were 5 deaths classed to pregnancy and childbearing—3
to Puerperal Sepsis, and 2 to other puerperal causes.
The puerperal mortality rate from Sepsis was, therefore, 1.01 per 1,000 registered live births
and 0.98 per 1,000 registered total births. The corresponding figures for 1937 were 0.98 per 1,000
registered live births and 0.95 per 1,000 registered total births.
The total puerperal mortality rate was 1.68 per 1,000 registered live births and 1.63 per 1,000
registered total births. The corresponding figures for 1937 were 3.27 per 1,000 registered live births
and 3.17 per 1,000 registered total births.
During 1938 there were, in addition, 2 maternal deaths from non-puerperal causes and
2 maternal deaths from criminal abortion.
The total maternal mortality from all causes excluding criminal abortion, was thus 2.36 per
1,000 registered live births and 2.28 per 1,000 registered total births as against 3.92 and 3.80 in 1937.
The total maternal mortality from all causes including criminal abortion was 3.03 per 1,000
registered live births and 2.93 per 1,000 registered total births as against 4.58 and 4.43 in 1937.
Sterilised Accouchment Sets.—These sets are supplied in accordance with the arrangements
stated in my Annual Report for 1930, p. 10.
During 1938, 558 were supplied free, 6 at full cost and 103 at part cost.
Specialist Help.—The Council accept responsibility for the payment of the fee of one of
their specialists called in by a medical practitioner to assist him in connection with a difficult
case of labour occurring in a Willesden resident. 3 such consultations were paid for in 1938.
The services of the Council's Consultant Obstetrician are also available in cases of Puerperal
Fever and Puerperal Pyrexia when desired by the practitioner in attendance.
Provision of Anesthetist.—The Council further accept responsibility for the payment of a
fee to an anaesthetist called in by a medical practitioner in connection with confinement cases. No
such fee was paid in 1938.
Home Helps.—The Council provided the services of home helps in connection with 321 confinement
cases.
Maternal Mortality Investigations.—The Council has continued to take part in the
investigation of deaths of mothers in childbirth for the Maternal Mortality Committee of the Ministry
of Health. The investigations are carried out by the Council's Consultant Obstetrician. 8 cases
were inquired into during 1938.
Hospital Treatment of Children under 5 Years of Age (See page 39).