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I am pleased to state that this appeal met with success, and gladly express my obligations
to the ten midwives who, in a period of sixteen weeks, reported 356 births soon after their
occurrence. In almost every instance the mother was visited within a few days after her confinement
; and (as also in other cases, visited at later periods upon receipt of the registrars'
returns) oral advice was supplemented by the printed card, drawn up for the purpose,
entitled " Advice for the Guidance of Mothers on the Feeding and Care of their Babies
The births registered within the four months during which the system was in operation
numbered 1,068, and more than one-third of the mothers were visited within the month.
Valuable, however, as the midwives' returns were, the information supplied by them was
far from being as complete as could be desired; I did not see, moreover, how it could be increased.
Happily the County Council took action which may lead to important developments.
Believing that it would be of " assistance to them as the Local Supervising Authority under the
Midwives Act, 1902, if complete returns of births occurring in the practice of midwives in London
could be obtained," the Medical Officer of Health was directed to ask the several midwives to
furnish him with a weekly list of the births attended by them, on forms provided for the purpose.
The suggestion had been made to the County Council that it would be advantageous for the
Metropolitan Medical Officers of Health " to receive information with regard to births occurring
in the practice of midwives, in order that advice may be given, by the officers of the Sanitary
Authority, to mothers, on the feeding and care of infants, in those cases where such advice would
appear advisable." And such information has since been supplied, in the form of a weekly
list of births, to the Medical Officers of Health of the several Metropolitan Boroughs by the
County Medical Officer. During the first sixteen weeks I received 376 notices of births compared
with the 356 received from midwives direct during the preceding 16 weeks.
The advantage of the arrangement consists in the early date at which information
of births reaches the Medical Officer of Health in midwives' cases, compared with information
supplied by the registrars. This is well illustrated in the two tables below,
showing that in the first four weeks under the new arrangement, information of births
was received from midwives in 111 cases (out of 116) within 14 days after their
occurrence, whilst of registered births information was received in 12 cases only out
of 242 within a corresponding limit of time. Thus it follows that the Health Visitor is able
to visit the majority of mothers within a fortnight of their confinement in midwives' cases,
whereas in the case of registered births, the visit is not possible in a tenth of the cases within
that limit of time, when advice is of the greatest value, and is most acceptable. Too often, when
the visit is made in cases reported by the registrars, the mothers will have resumed their usual
occupations which take them from their babies during the daytime, and so be away from home
and not seen.
Notices of Births received from the Medical Officer of Health of the London County Council
in the four weeks, November 5th to December 3rd, 1905.

The shortest period between the occurrence, and the notification, of a birth was 5 days, the
longest 18 days, whilst of the 116 births reported, very few had been registered within the period
of 18 days.
Births registered in the four weeks, November nth to December gth, 1905.