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Borough to utilise the information thus obtained. The work, in the first instance, was entrusted
to the Lady Inspectors, who in the first quarter of the year, paid primary visits to 491 infants,
mostly in the northern parts of the borough.
The value of the information supplied by the registrars is by no means inconsiderable;
but, as stated in the report adverted to, " registration being, as a rule, long delayed,* particulars
as to births of infants who die within the first month of life, do not usually reach the Medical
Officer of Health much, if any, sooner than particulars as to their deaths." Evidence to this effect
was given in the report: it will suffice here to state that of the deaths of infants, in the year
1902, 35 per cent. occurred within the first four weeks after birth, a period within which scarcely more
than 20 per cent. of births are registered. Such being the state of the case, it is obvious that
the value of the particulars of births the registrars are authorised to supply, would, as I said,
be " greatly enhanced could registration be made compulsory within, say, seven days."
At the date of the report a sub-committee had been appointed by the Public Health Committee
to consider the recommendation I had made for the appointment of female "Health
Visitors," and it was stated that in the event of the Council deciding to make such appointments,
"efforts would be made to obtain information at the earliest practicable date after the
birth of children to the poorest classes—through the agency of medical men, registered midwives,
district visitors and others."
Soon after the appointment of the Health Visitor, a scheme was set on foot for obtaining
information of births through district visitors who, obviously, could be approached only through the
beneficed clergy, to each of whom I wrote as follows:—
" Infantile Mortality—I am desirous of obtaining early information of births occurring
in the poorer parts of the Borough, with a view to visitation of the mothers by the Council's
Lady Health Visitor, shortly after their confinement; and should be greatly obliged if,
through the agency of district visitors, or otherwise, you could assist me in the matter.
" The object in view is to reduce, if possible, the present excessive amount of infantile
mortality, i.e., the proportion of deaths under one year of age to registered births.
" To show the importance of the matter, I may mention that about one-third of the
births are registered after the age of six weeks, whilst one-third of the deaths of
infants under one year of age, occur within the first month of life. From this it follows
that few babies can be visited within the period when the danger to life is greatest, their
existence being unknown to the sanitary authority.
"I should be pleased to send forms for report on receiving names and addresses of
district visitors or others willing to supply the desired information."
The one clergyman who replied to the letter intimated that he had called a meeting of his
fourteen district visitors, who had promised their assistance. Forms for the report of births were
forwarded to the several ladies, from one of whom I received particulars of three births.
A letter was also addressed to the certified midwives residing and practising in Kensington,
whose names and addresses were supplied to me by the Medical Officer of Health to the
County Council, the local supervising authority under The Midwives Act, 1902. The letter ran
as follows: —
"The Council have appointed a Lady Health Visitor to visit poor mothers shortly
after their confinement, in the hope of bringing about a reduction of the present high rate
of infantile mortality.
"I may mention that I receive, every Monday, particulars of births registered in
the Borough in the preceding week; but, unfortunately, about a third of the births are
not registered until six weeks and upwards after their occurrence, whereas a third of the
deaths of babies under one year of age take place within a month after birth.
"The work of the Health Visitor would be of greatly increased value if she were
enabled, by receiving early information of a live birth, to visit the mother within a few
days after her confinement.
"You would be doing good service to poor women and their babies, and I should be
much obliged, if you would kindly report to me the births which occur in your practice in
Kensington.
" Should you be willing to do this, I shall be happy to send you forms for the purpose."
* Births should be registered within 42 days, and may be registered without fee within three months.