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43
1909
Gorst, the City of Cologne is provided, as are most German cities,
with paid official visitors of the poor, men and women of education and
position, who are under a legal obligation to render service in this way to the
municipality, and every poor woman on giving birth to a child is visited by one
of these officials, almost invariably a woman. If the circumstances of the
mother are such that she is compelled to go out to work to earn her living, a
report is made to the municipality and a daily grant is made to her out of the
municipal funds, on condition that she stays at home and nurses her infant.
The Official Visitor sees that the condition is fulfilled. Here then is a recognition
by the State of the infant's right to its mother's milk and of the State's
own obligation to see that the right is fulfilled.
In this country the fate of an illegitimate child is generally a very sad one,
so that the mortality among them is double that of legitimate children, which
proves at once that there is a terrible wastage of life among these children.
There can be no doubt that they are born just as viable as many of the legitimate
infants, but owing to neglect after birth, they soon fade away. That their
lives can be preserved is proved by the experience of the city of Leipsig,
where every illegitimate* child becomes on birth a ward of the municipality;
its condition is inspected by public officials from time to time, and it may only
be put out to nurse to persons publicly authorised; it must be produced monthly
at the municipal offices for medical inspection, and the result is that the deathrate
of illegitimate infants in that town is half that of legitimate infants.
This fact is only mentioned to show that a very large number of infant
lives can be saved if proper measures are adopted to that end. When one
considers the enormous wastage of life in the first week of their existence—and
last year in Islington it amounted to more than 18½ per cent, of the total
deaths under 1 year—one cannot but be struck with the necessity that exists
for establishing some institution at which mothers bearing children might
seek advice. Among the 156 deaths at this age, no less than 27 were from
congenital defects, and 25 from immaturity, indicating as strongly as possible
that something must have been very seriously wrong in the ante-natal condition
of the mothers These deaths also were greatest in number during the succeeding
tiiree weeks, so that at the end of the fourth week premature birth was responsible
for 118 deaths, congenital defects for 29, and immaturity for 46. At the
end of the year it was found that in addition to these deaths, bronchitis and
pneumonia had also levied a heavy toll, while diarrhoea had added a very large
number. Then it may be taken, as Dr. Newman, in his splendid address on
Child mortality in relation to the health of the State well points out,